INVITATION  AIDS_ASIA e FORUM.

Hi,

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

[AIDS_ASIA 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/

Towards Sustainable ARV Service in ASEAN: "Countries Are Not Powerless"
Jakarta, June 28, 2005

Over fifty participants of a closed meeting titled "Towards Sustainable
ARV Service in ASEAN" agreed on Tuesday that ASEAN countries need to
collaborate and maintain the sustainable generic ARV and OI treatment in
response to the increasing needs of such services. They also recognized
the need for all stakeholders (MOH, National Drug Regulatory Body,
Global Fund, NGOs, PLWHA, Pharmaceutical Industries, etc) to coordinate
and join hands in realizing those goals.

The meeting was held on June 28, 2005 in Dharmais National Cancer
Hospital, Jakarta, Indonesia. Speakers from Thailand, Vietnam and
Indonesia share their experiences in implementing 3 by 5 program and
identify the obstacles. The meeting is attended by government officers,
national legislators, pharmaceutical representatives, health care
providers, People Living With HIV/AIDS, WHO representative,
international and local NGO activists as well as journalists who
actively participated in the discussion.

During the meeting, all participants discussed issues such as each
country's estimation of ARV use, the capacity of generic ARV production
in each country, procurement system, funding and possibility of
collaboration in ASEAN. The participants also discussed the impacts of
WTO regulations and Indian Patent Act to the sustainable ARV and OI
services in the region.

"Countries are not powerless," said Dr. Olaf Valverde Mordt of MSF
Belgium for Indonesia, referring to the patent-related situation.
Efforts made by countries like Thailand, Indonesia, Brazil and South
Africa have proven that they still can serve their people in need of ARV
with their local productions. He added that there was possibility for
Indonesia, Thailand and Vietnam as ARV generic producers to fulfill the
needs of ASEAN countries by exporting their products. At the same time,
the countries should also pay attention to the drug's quality, price and
intellectual property protection.

Dr. Rosmini Day, Director DTDC, CDC of Indonesian Ministry of Health
said that 3 by 5 program in Indonesia has targeted 10,000 PLWHA to have
access to ARV by end of 2005. She, however, said that government only
estimates 5,500 people will need ARV in 2005 and estimate 6,500 people
next year. She admitted that poor recording and reporting system has
caused government cannot calculate the real needs.

Prof. Zubairi Djoerban, Chairman of the Working Group on HIV/AIDS
Faculty of Medicine, University of Indonesia (Pokdisus FKUI-RSCM), said
that currently around 3,500 people receiving ARV in Indonesia.
"Actually, there are still many people in small cities who need the
drugs."

Dharmais President Director Prof. Samsuridjal Djauzi suggested
government to provide ARV exceeding the need estimation to avoid
miscalculation due to poor reporting system. "It is better for us to
provide sufficient ARV than to face shortages. Because it is to no avail
if we ask the patients to keep adherence while the drugs are not
available."

Samsuridjal, who is also the head of Access to Therapy in Pokdisus, said
that the country would face immediate increase of ARV needs, especially
from international organizations that provide ARV schemes and people who
prefer to pay their treatment by their own money.

Starting from 2004, state-own pharmaceutical company PT Kimia Farma has
produced generic ARV only for government use. Its quality of ARV
products has been approved by comparative study of dissolution rate and
bioequivalent. "We still have 90% of idle capacity since we just used 10
% of production capacity as of 2004," said Gunawan Pranoto, Director of

Kimia Farma. The company's production capacity could serve ARV for
31,250 patients.

Ong Van Dung of Vietnam pharmaceutical company Stada VN, said in his
written paper that the company has supplied ARV to more than 50 medical
facilities in local as well as central levels. It also supplies ARV to
more than 2,500 patients every month. The treatment protocol with the
fixed-dose combination would decrease the treatment cost with 3 ARVs
approximately US$ 220 per year from 2005. Vietnam has 80,000 cases of
HIV/AIDS and 30,000 of them are in need of treatment.

In Thailand, the target of 3 by 5 in March 2005 is around 100,000 people
in need of ARV. A report from the Ministry of Public Health in April
this year revealed that cumulative clients who use ARV in Thailand was
around 98,000. Government Pharmaceutical Organization (GPO) said that
the number of people who need ARV in Thailand based on WHO estimation
was 98,000 while Thai expert said the figure could be 200,000.

Lawan Sarovat of MSF-Belgium for Thailand said that the goal of 3 by 5
program is not only access for all but sustainable access for all. "If
we don't have drugs in our country, we cannot access that." She also
emphasized the need for all stakeholders to take actions to meet the
needs of people for treatment. Besides getting ARV from national program
by the Ministry of Public Health, there are some people who get ARV from
other schemes, such as social security scheme, civil servant medical
scheme and those who pay by their own pocket.

Since 1995, GPO has produced ARV for the local needs and 90 percent of
GPO's ARV market is for government, 8 percent for private sector and 2
percent for export. Mr. Itsaraet Gosriwatana, the International Sales
Manager of GPO said that ARV export is for humanitarian purpose and it
is mostly distributed to NGOs and private sector in Cambodia, Myanmar,
etc. For quality, safety and efficacy of ARV products, the GPO has
conducted bioequivalent study, WHO GMP - standard of production and
clinical study.

He, however, showed his concerned over Free Trade Agreement (FTA)
between Thailand and the US, especially about the Intellectual Property
Right. "FTA may restrict or limit the use of public health safeguards in
the TRIPS Agreement." He also said that there are some risks of local
productions such as the effects of the use of compulsory licensing and
Indian Patent Law.

One participant proposed that limited resources in ASEAN countries
should be use efficiently and national policy must fulfilled people's
needs (ARV).

                    .

-Debbie & Samsu-

The Indonesian Perspective's

"Second edition of Asia Pacific HIV/AIDS Web site Guide to bridge
digital gap"

CWS Indonesia is committed to reduce the impact of digital inequity in public
health through information, capacity building and education. The inequity in
Internet resources has far reaching implications. Many commentators and
communication researchers have noted that the consequences of digital divide-
the division between those who have access to Internet resources and those who
don't have access - will be much worse than many other health inequities already
existing. The production of this web site guide on HIV/AIDS for Asia-Pacific
Region is in line with our commitment.

The first version of the web site guide was released in 2003, both in
print and web version. The 2003 guide has been compiled with the help
of a large number of HIV/AIDS activists, researchers and people living with
HIV/AIDS. Our request for information on web pages – posted on various HIV/AIDS
related discussion forums in this region was well received and we would like to
thank all of them.

In the end of 2004, CWS Indonesia conducted a review on all HIV/AIDS
related web sites in Asia-Pacific and added a sectoral division based
on the wishes of our local NGO partner organizations in Indonesia. In
line with the dynamism of the Internet itself, this guide is a growing result of
our work, thus changes and comments are welcome.

CWS Indonesia will launch the second edition of the Asia Pacific
HIV/AIDS Web site guide (online version only) during the upcoming 7th
ICAAP (7th International Congress on AIDS in Asia Pacific) which will
be held in Kobe from 1-5 July.

The second edition of the Asia Pacific HIV/AIDS Web site guide will be launched
during an Internet Mediated Communication workshop
facilitated by CWS Indonesia together with ICHE, APPACHA and AFXB on
Saturday, July 2nd, 2005 at 14:30 - 18:00 local time, Room 503,
International Conference Center, Kobe. (Code SaSBW08)

Please follow this link to arrive at our second edition of the Asia
Pacific HIV/AIDS Web site guide:

http://www.cwsindonesia.or.id/en/program/hivaids/wac04/aspachivwebguide04.htm

Please follow this link to arrive at our sign up page of the Internet
Mediated Communication workshop:
http://www.cwsindonesia.or.id/icaap7

Early registration for Internet Mediated Communication Workshop at 7th ICAAP

Workshop title:
Scope of Internet Mediated Communication in HIV/AIDS response

Date:
Saturday, July 2

Time:
14:30 - 18:00 local time

Location:
Room 503, International Conference Center, Kobe

Code:
SaSBW08

Facilitators:
Joe Thomas
Maurice Bloem

Early registration opens at (*Only a maximum of 30 people can attend
the workshop): For registration

http://www.cwsindonesia.or.id/icaap7/regst.php?nws
_procs=A&cws_langu=1&_inUNm=


Objective:
To explore the full potential of IMC as part of the global efforts to
combat the causes and consequences of HIV infection. This workshop
would introduce the participants to the theory and practice of IMC,
with special emphasis on the use of e-forums.

Promoting equity in accessing Internet Mediated Health Communication
(IMC) is a greater challenge in capacity building and promoting social capital.
The implication of digital divide is greater than many of other aspects of
health inequity. There is an urgent need to explore the full potential of IMC as
part of the global efforts to combat the causes and consequences of HIV
infection.

Output
Increased knowledge of Internet Mediated Communication to help close
the digital divide in combating the causes and consequences of HIV
infection

For RSVP please contact:
imckobe@...

Stop TB is a network of partners working together to eliminate
tuberculosis as a public health problem.

We encourage you to forward this announcement to friends or col-
leagues who you feel might be interested in the content below.
--
Call for proposals -- the International Union Against Tuberculo-
sis & Lung Disease funding opportunity

8 June 2005 - Paris

The International Union Against Tuberculosis & Lung Disease now
calls for proposals for fidelis, a grant programme to support
innovative tuberculosis control activities.

fidelis funds projects that will improve the detection and suc-
cessful treatment of new sputum smear positive (NSP) tuberculo-
sis patients, especially among people with limited access to
health services.

fidelis are particularly interested in receiving high quality
proposals with:
a) a lower cost per weighted treatment success;
b) a larger number of additional cases cured;
c) clear evidence of complementarity to existing health services
and TB control efforts and for which the probability of sustain-
ability within the existing system is judged to be highest;
d) the highest numbers of additional treatment success among
people with limited access to health services;
e) convincing evidence that the innovations developed will be
taken up into routine practice within the community.

The grant size ranges from US$ 150,000 to US$ 250,000. The dead-
line for receipt of applications is 1 August 2005.

For more information, please visit the web site:
http://www.fidelistb.org/

For further assistance contact:
Prof. Donald Enarson, Coordinator of fidelis
International Union Against Tuberculosis and Lung Disease (The Union)
68, boulevard Saint-Michel, 75006 Paris, France
Fax No. +33-1-5680-2820
Email: enquiries@...

Dear All,

This is indeed extremely sad... UNAIDS should have done its homework
BEFORE they recruited the translator for the Cambodian group, from FHI.

I am in  full agreement with WNU and their concerns re conflict of interest: FHI
is one of the parties of the now-infamous Tenofovir trials - and their
explanations in defense of the trial have never held water.

I still feel this UNAIDS effort to develop globally-acceptable ethical norms for
research on sex workers and other marginalised key populations is important -
therefore I hope that UNAIDS takes necessary safeguards during the consultation
to hear and respect sex worker group representatives' concerns during the
meeting to ensure that what emerges as final guidelines/products do not go
against the interests of sex worker communities and other key population groups
at risk of HIV.

In solidarity,


Dr. Amitrajit Saha
Kolkata (India)
E-mail: amitrajitsaha@...

Statement from WNU on UNAIDS Ethics of Clinical trial workshop

Dear all,

From June 5th to 7th, we the members of Womyn's Network for Unity
(WNU)participated in a meeting about ethical guidelines in Pattya,
Thailand.  During that meeting, representatives from Cambodia,
Thailand, and India gathered to discuss ethical drug trial
guidelines and to prepare for a presentation in Geneva.

  At that time, we asked if we could send a translator to the meeting
in Geneva.  They informed us that we could not because they would
prefer to find a translator in Europe.  Our concern was to find a
translator who not only spoke Khmer and English but who also
understood the issues related to ethical drug trials.  They informed
us that they would send the results of the meeting in Pattya to
their translator.

Today, June 17th, one day before the meeting, we have just received
information that they chose a translator from Family Health
International (FHI).

This poses a major conflict of interest seeing that FHI is funded by
USAID, which supported the unethical drug trials.  Please imagine
the problems that will arise: can the translator possibly present
our representative's views?  Is it fair that they can choose a
translator who is so obviously in conflict with our needs?  We do
not believe they could not find anyone else.

  We deserve a fair translator.  They insured us that they would find
one and instead they have betrayed that guarantee.

In solidarity,
Secretariat of Womyn's Network for Unity (WNU)


Womyn's Agenda for Change
Office Telephone +855 (012) 222 171
Office Fax / Telephone +855 (023) 722 435
Check us out at http://www.womynsagenda.org

CWS-P/A’s Response to HIV/AIDS in Pakistan

Church World Service-Pakistan/Afghanistan (CWS P/A)is an ecumenical
organization, working in Pakistan and Afghanistan for the evelopment and relief
of marginalized communities since 1954.

Globally the organization is a member of CWS, Inc. and locally it is rooted
through its advisory board and regional networks. It operates through its seven
offices in Pakistan and Afghanistan.

CWS-P/A is operational among a network of over 350 partners. This network is
composed of NGOs, CBOs and religious bodies coming from different ethnic and
religious backgrounds from Pakistan and Afghanistan.  It assists communities to
access better health and education, strengthen agricultural initiatives, achieve
community based economic development and recover from emergencies and disasters.
It also supports organizations through financial assistance, information
sharing, networking, research, advocacy, skill and issue based trainings.

Church World Service-Pakistan/Afghanistan has been taking the issue of HIV/AIDS
very seriously and has been involved in two active projects in Pakistan during
2004-2005.

The first project was on Mass Awareness on HIV/AIDS for health practitioners in
the province of Sindh. There are a number of health
professionals whose knowledge on HIV/AIDS is limited to only the term.

They are not aware about the modes of transmission or how it affects the body.
In the otherwise majority of illiterate people, the values and opinions of
health professionals are considered the ultimate source of authentic
information. Therefore, CWS-P/A realized that it was of vital importance in the
awareness of HIV/AIDS that the conceptions of health professionals be made clear
so that they may influence the lives of people in the right direction. An
initial baseline survey was conducted with selected health professionals and a
Knowledge, Attitude and Practices survey was undertaken. Based on the results of
the survey three, (3 day,) workshops were arranged.

The second project was on Community Awareness Program on HIV/AIDS.

It was felt that in order to create greater impact the community should be
directly involved in the awareness of HIV/AIDS. For this purpose during
2004-2005, fifteen workshops were conducted with various communities, semi-urban
& rural, in the provinces of Sindh and Punjab. It is a known fact that in order
to achieve progress of significant impact in awareness raising on HIV/AIDS, both
males and females need to be educated at the same time.

Keeping in mind the cultural sensitivity of Pakistan, CWS-P/A ensured that
separate sessions were held on consecutive days for males and females of the
same community. These community awareness sessions were each for a day and the
community was mainly made aware about the modes of transmission and prevention.

A total of 750 people were educated during these sessions. These sessions were
developed and facilitated by trainers from within CWS-P/A. Ms. Beenish Asif, Ms.
Ayesha Hassan, Mr. Eid Muhammad Shams, and Mr. Syed Moazzam Ali were among the
trainers.

In both the projects being run by CWS-P/A great care has been taken to include
the concepts of gender and how gender and HIV/AIDS are linked.

Although, in numbers, Pakistan has significantly very few cases of HIV/AIDS but
the traditional customs, traditions, values and ways of life all point in the
direction of multiplication of new HIV infections.

Beenish Asif
E-mail: cwsea@...

Title:  A Review of National Treatment Programs: Scaling up ARVs in
the Region

Date:  Saturday, 2 July 2005

Time:  12:45 – 14:15 (90 minutes)

Location:  Kobe Convention Center, Room: C-502

Panel:
Praphan Phanuphak, M.D. (Bangkok, Thailand)
Fujie Zhang, M.D. (Beijing, China)
Nagalingeswaran Kumarasamy, M.D. (Chennai, India)
Samuel Nugraha (Jakarta, Indonesia)

Moderators:
Aikichi Iwamoto, M.D. (University of Tokyo)
Kevin Robert Frost (TREAT Asia)

Target Audiences:
Front-line HIV/AIDS care and services providers, including social
workers, healthcare workers, case managers, counselors, educators,
administrators, activists, and persons living with HIV/AIDS.

Description:
The TREAT Asia satellite symposium will spotlight current national
treatment programs from four countries that could influence the
nature of HIV treatment in the region. Experts from these countries
will provide an overview of the programs, as well as their insights
and opinions.

The presentations will be followed by a moderated discussion with
the panel in an attempt to answer some of the larger questions of
antiretroviral therapy in the region, such as sustainability and
durability, and the possible ramifications to the region of the
success or failure of the four spotlighted national programs.

Seating is limited to 200.  Boxed lunch service provided.

To RSVP, please contact Stan Wong at stan.wong@...

Asia Pacific People's Alliance for Combating HIV/AIDS (APPACHA)

APPACHA Newsletter `Solidarity+' will be released by His Excellency,
Shri K.R. Narayanan, Former President of India.

We cordially  invite you to a Panel Discussion on "Patents and
Access to Medicines" organised by Asia Pacific People's Alliance for
Combating HIV/AIDS (APPACHA) and ActionAid International - Asia.

This will be followed by the Launch of `Solidarity+', the bi-monthly
Newsletter of APPACHA.

11 June 2005: 5:00 PM to 7:00 PM, Conference Room 1, India
International Centre, 40, Max Mueller Marg, New Delhi - 110 003

Agenda

5:00 – 5:30: Registration

5:30 – 5:35: Welcome Note by Babu Mathew, Country Director,
ActionAid India

5:35 – 5:45: Introduction by Mukul Sharma, APPACHA

5:45 – 6:00: Musical Performance by Ricky Tombing, Delhi Network of
Positive People

6:00 – 6:10: Release of the Newsletter `Solidarity+' by His
Excellency, Shri K.R. Narayanan, Former President of India

6:10 – 7:00: Panel Discussion, chaired by Shri K.R. Narayanan

Panel List:

Dr. Amit Sengupta, Delhi Science Forum.
Dr. B.K. Keayla, National Working group on Patent Laws
Dr. Manorama Bawa, All India Women's Conference
Mr. K.K. Abraham, Indian Network of Positive People
Dr. Biswajit Dhar, Centre for WTO Studies, Indian Institute of
Foreign Trade
7:00 – 7:30: Open Discussion

7:30 – 7:35: Vote of Thanks by G. Mahesh, ActionAid International-
Asia

Followed by High Tea

For further details please contact:

Ganesan Mahesh by

E-mail: <gmahesht@...>

or
appacha@...

Dear E Forum Members,

We are happy to inform you that Asia Pacific People’s Alliance for Combating
HIV/AIDS (APPACHA) is organising a panel discussion on the theme “Patents and
Access to Medicines” on 11 June 2005 (Saturday) at 4 PM. in Conference Room 1,
India International Centre (IIC), New Delhi.

You are invited to participate in the panel discussion and launch of
‘Solidarity+’, a bimonthly newsletter of APPACHA. Kindly confirm your presence
and active participation for the same.

Asia Pacific People’s Alliance for Combating HIV/AIDS (APPACHA)

Background

Asia Pacific People’s Alliance for Combating HIV/AIDS (APPACHA) is a
multisectoral alliance which includes people affected and infected by HIV/AIDS,
health activists, community groups, faith-based agencies, human rights agencies,
student movements, policy makers, researchers, programme managers and trade
unions that share a commitment to combat the causes and the consequences of
HIV/AIDS. APPACHA members would be engaged in and informed by dialogue on
emerging areas related to HIV/AIDS issues in Asia. This would open up
opportunities to contribute to and influence HIV/AIDS prevention and care
policies and programmes.

The need of the hour is to look at the HIV/AIDS epidemic and respond to the
requirements of the most vulnerable sections across geographical boundaries. As
against regional efforts concentrating on smaller pockets, Alliances are
effective mechanisms to expand the response towards the prevention and
mitigation of the impact of HIV/AIDS by developing effective advocacy, empirical
knowledge and gathering and sharing technical expertise. It was with this vision
and commitment that the APPACHA was launched in Bangkok on 9 July 2004, during
the XV International AIDS Conference.

APPACHA Newsletter

Carrying forward this vision — Solidarity+ — the bi-monthly newsletter of
APPACHA was visualised. It is expected to serve as an effective tool to address
contemporary socio-political and economic trends in Asia and Pacific regions on
HIV/AIDS.

We are pleased to inform you that the first issue of Solidarity+ has rolled out.
On the occasion of launching the first issue of Solidarity+, APPACHA proposes to
organise a panel discussion on the theme “Patents and Access to Medicines” at
India International Centre (IIC), Conference Room 1, New Delhi on 11 June 2005
at 4:00 PM.

G. Mahesh

Co-ordinator HIV/AIDS Cell,
ActionAid International – Asia
91, II Floor, Navjeevan Vihar, New Delhi – 110 017
Tele Fax: +91-11-26691993/ 94 Extn. 41
Email: gmahesht@...

5th International AIDS INDIA Conference-OCTOBER 20-24rd, 2005

To be held in Chennai. INDIA

Organized by the Department of Experimental Medicine and AIDS
Research Center Tamil Nadu DR MGR Medical University.

www.aidsindia2005.org

Transfer of knowledge-2005

Since 1997 the Department of Experimental Medicine of the TN DR MGR
Medical University has been conducting the International conferences
on AIDS INDIA.  3500-5000 individuals from all walks of life and
fields have participated and benefited from these conferences. You
have been regularly attending the conference and some of you have
taken interest to support the conf by your financial contribution.

This is to announce that The 5th International Conference on AIDS
INDIA will be held from October 20-24rd, 2005.

The conference is more relevant today than ever before; in the
context of the increasing numbers of the HIV/AIDS cases in India and
the neighboring countries and the paucity of relevant preventive and
Care programmes. In addition ART access to all is still on the
drawing boards of Governments and organizations working with
HIV/AIDS  However there are signs of good care programmes that are
in the horizon and this need to be amplified. We need to focus on
relevant research and learn from others as to how they have been
successful in preventing this epidemic and not to take hold in their
soil!

Several issues regarding the prevention and care need to be
discussed and new strategies to be pioneered to make India put a
halt to the incident HIV infections.

We invite you to participate and share your expertise and also
contribute to the scholarships and expenses involved in running the
conference of this magnitude.

This is a unique International Conference that has evolved a good
balance between science at one end and the social issues at the
other.

For more information on the Conference, kindly visit
www.aidsindia2005.org

We know you will favorably consider our invitation and provide your
support.

Dr. C.V. Bhirmanandham
Conference President

Dr. N.M. Samuel

Conference Chair
____________________

Dr. Mini Jacob
E-mail:<saramini@...>

INVITATION  AIDS_ASIA e FORUM.

Hi,

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

[AIDS_ASIA 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/

Workshop on  the scope of Internet Mediated Communication (IMC) in HIV/AIDS Work
in Jakarta

On May 30, 2005, CWS Indonesia conducted a workshop on Internet Mediated
Communication (IMC) in HIV/AIDS work in CWS Indonesia office in Jakarta.

Ten participants attended the workshop, including CWS Indonesia's partner
organisations from NOMAD – Manado, PKBI – Central Sulawesi, YTB – SoE, dan
Yayasan Gaya Celebes – Makassar, as well as CWS staff from Central Sulawesi,
West Timor and Manado.

The workshop, facilitated by Joe Thomas, began with seeking the expectations of
the participants of the workshop. Some wanted to acquire the skills of basic use
of  internet, as well the most finding out the most cost-effective way to access
the internet. some others wanted to find out the scope of internet as an
HIV/AIDS advocacy tool.

Out of the seven-session workshop, the session on assessing the reliability of
an internet site as information source was most fascinating for many of the
participants. A tool was presented to the participants to assess the quality and
reliability of the information presented on the web. This was very vital as in
HIV/AIDS work, people are provided with many information but most of the time
they have limited time and skill to check the reliability of the information.

The following issues/themes were discussed in the workshop.

Workshop on the Scope of Internet Mediated Communication in HIV/AIDS work in
Jakarta, Indonesia. 30 May 2005

AGENDA

Introduciton to the concept and practice of Internet Mediated communication
(IMC) in HIV/AIDS work

How IMC can assist you in enhancing your capacity in HIV/AIDS work?

Intrduction to popluar e FORUMS as a soruce of HIV/AIDS knowledge.

Introduction to the direcvtorty of HIV/AIDS websites in Asia Pacific region.

How to assess the reliability and credibility  of information on the internet?

How to use e-groups as a source of HIV/AIDS information and communication?

How to integrate IMC into you day-to-day work?

Follow-up plan & Introduction of Reading Materials

At the end of the workshop, Maurice Bloem, Regional Director CWS Indonesia /
Timor Leste, offered an exercise as a follow up for all of the participants,
where they will have to send an email to once a week to report on the 
reliability of the sites they have visited.

"Betti Siagian"
E-mail:  <bettiiss@...>

India launches 'smart card' to fight AIDS

Indo-Asian News Service
New Delhi, May 26, 2005

India is testing a new smart card system that will electronically
keep track of its HIV/AIDS patients and is expected to facilitate
medication through antiretroviral cocktails as well as track their
potency.

The cards, launched on Thursday, would be given to more than 300
patients receiving anti-retroviral drugs. They would need to bring
the cards each time they come to the hospital for anti-AIDS drugs or
for any other medical problem.

The cards would help health workers keep track of India's more than
five million HIV/AIDS affected patients and act as a portable
medical record. They fast-track treatment and medical response in
emergencies, provide greater security to medical records and ensure
immediate access and easy storage of data.

"These cards would revolutionise AIDS treatment," said Shubhashis
Gangopadhyay of India Development Foundation, which along with the
Confederation of Indian Industry (CII) and Indian Business Trust for
HIV/AIDS, is conducting the trials.

There are many uses of the health smart card in dealing with
HIV/AIDS when most of the affected population is mobile. For
instance, constant monitoring is necessary to prevent drug
resistance and the need to keep information confidential due to
social stigma.

The scheme has been praised by former US president Bill Clinton, who
is on a three-day visit to the country to oversee tsunami
rehabilitation and push for more efforts on the AIDS battle.

"The smart card idea is fantastic and I think that it would be
adopted by every country in the world," said Clinton.

With 5.1 million patients, India is the world's second largest
HIV/AIDS affected country after South Africa, which has 5.3 million
infections.

http://www.hindustantimes.com/news/181_1377563,0050.htm

The Cambodian Tenofovir Trial Controversy: Lessons to be learnt

Joe Thomas

Solidarity + Volume 1 Issue No. 1. May 2005. Bi-Monthly Newsletter
of the Asia Pacific People's Alliance for Combating HIV/AIDS
(APPACHA)http://health.groups.yahoo.com/group/AIDS_ASIA/files/Solidarity%20%2B/


This article will examine some of the political and ethical issues of clinical
drug trials using the NRTI (nucleotide reverse transcriptase inhibitor) drug,
Tenofovir DF, which was licensed to treat HIV-1 infection by the Department of
Food and Drug Administration (FDA), United States in October 2001 (Clinical
Trials Gov 2005).

Since some scientists believed that Tenofovir also could serve as a pre exposure
prophylaxis for HIV infection, a research project was initiated by the
researchers from the University of California, San
Francisco (UCSF) and the University of New South Wales, Sydney in order to prove
this hypothesis. They selected Cambodia as a potential site for this clinical
experimentation and sex workers in Cambodia as the potential clinical trial
participants.

The Ethics Review Committees (ERC) of the University of California, San
Francisco in the United States of America and the University of New South Wales
in Sydney, Australia, endorsed the trial as it complied with the global
standards of ethics of clinical trails.

However, under intense pressure from the representatives of the sex workers in
Cambodia and the advocates for ethical trials on vulnerable populations, the
Cambodian government withdrew support to these clinical trials, clarifying that
the trial protocol did not adequately address ethical concerns.

Likewise, similar studies planned by other researchers in Thailand and Cameroon
came under intense pressure from the potential trial participants for better
compliance with ethical standards. Community
groups from Thailand staged agitations to protect the interests of
clinical trial participants in Thailand and pressed for modifications to the
protocol of the clinical trial proposed to be conducted there. (Jack, A and
Kazmin, A. 2005)

This clinical trial raises several issues related to the ethics and politics of
international research involving researchers from the resource-rich countries,
initiating and implementing research in resource-scarce settings and in
selecting vulnerable populations as
their potential clinical trial participants. In this context, this
brief commentary examines the following issues of the proposed clinical trial in
Cambodia.

• The nature of informed consent

• The interpretation of the 'risk and benefit' of participating in
the trial
• The options for treatment after the trial, in the event of any long-term
after-effects arising from the trial itself

• The extent to which the researchers were willing to disclose the
risk associated with the study

• The methods adopted by the researchers to assess the risks and
benefits of trial participants expected to participate in clinical trials.

The role of multi-centric ethics review committees and the scope of
community-based ethics review committees also came under the spotlight as part
of this controversy.

This article is based on extensive reviews of literature, interviews
with the activists, sex workers and their representatives in Cambodia, and
summarises some of the lessons to be learnt from the
controversy.

Obligations and responsibilities of the researchers

This controversy provided an opportunity to revisit the issue of
the 'obligations and responsibilities' of the international clinical
researchers. Researchers must not use an approval of an International research
protocol (a research protocol approved by a home country ERC, to conduct a
clinical trial in another country) by an ERC from the researcher's home
institutions as an excuse to minimise their responsibilities towards the
participants of the research.

In some instances, the 'obligations and responsibilities' of the international
clinical researchers are legal obligations. For instance, the legal obligations
and responsibilities of US based
researchers are listed under the Code of Federal Regulations (CFR)
(Title 45. Public Welfare) of the Department of Health and Human Services,
Office for Protection from Research Risks. They are meant to ensure compliance
with regard to research conducted, supported, or otherwise subject to regulation
by the Federal Government outside the United States.

The researchers also have obligations to apply rigorous scientific analysis and
methods in all aspect of the clinical trial. It appears that in the context of
the proposed 'Tenofovir trial' in Cambodia, the researchers' commitment to
scientific rigour was restricted only to the research aspect of the trials.
There was no indication that they were even aware of the need for careful
analysis of the risk and benefit of the trial from a participant's perspective,
or that they owed a greater commitment to the welfare, rights, beliefs and
customs of the communities under study. A far more rigorous and scientific
analysis was essential to understand the risk associated with the participation
of vulnerable populations in clinical trials in Cambodia. A greater measure of
pragmatic efforts was also essential to demonstrate the 'principal of
beneficence' when such research is carried out.

In this case, even as the researcher claimed that Tenofovir had 'minimal
toxicity' (Shafer, 2004), the product information provided by the US Department
of Health and Human Services revealed
quite the contrary: 'Adverse events reported in patients receiving
Tenofovir DF included abdominal pain, anorexia, asthenia, diarrhoea, dizziness,
dyspnea, flatulence, headache, hypophosphatemia, lactic acidosis, nausea,
pancreatitis, renal impairment, rash, and vomiting'.

In yet another instance of research aberration, the principal investigators of
the Cambodian trial turned out to be non-clinical epidemiologists, in violation
of regulations that stipulate that only experienced and qualified clinicians are
competent to undertake research in complex anti-retroviral (ARV) regimes.


The researchers claimed that the rationale behind their selection of
Cambodia as a clinical trial site had to do with 'altruistic intentions', in
response to the high prevalence of HIV disease in the country. However, the real
motivations for the selection of Cambodia may well be less altruistic than
opportunistic, since there
is clearly a higher statistical probability of proving the research
hypothesis in a higher rather than lower HIV prevalence setting.


Informed consent is an ongoing dialogue

Informed consent has increasingly been interpreted as 'an ongoing
process of dialogue' between the researcher and the research participants (CFR
45). Compliance with 'informed consent' is also a
legal requirement (45 CFR 46.116) for US based researchers. The
documentation of informed consent must comply with 45 CFR 46.117.

According to the 'Code of Federal Regulations' of the United States
of America, informed consent is a process, not just a form. Information must be
presented to enable persons to voluntarily
decide whether to participate as a research subject. It is a
fundamental mechanism to ensure 'respect for persons' through
the provision of thoughtful consent for a voluntary act. The
procedures to be used in obtaining informed consent should be
designed to educate the subject population, in terms that they can
understand. Therefore, informed consent language and its
documentation (especially explanation of the study's purpose,
duration, experimental procedures, alternatives, risks, and
benefits) must be written in 'lay language', (i.e. understandable
to the people being asked to participate). The written presentation
of information is used to document the basis for consent and for the
subjects' future reference. The consent document should be revised
when deficiencies are noted or when additional information will
improve the consent process' (CFR 45).


It was evident from the field observations, that the principal
researchers of the proposed trial in Cambodia had demonstrated a
blasé attitude towards facilitating the process of 'informed
consent' among the potential trial participants. For instance, none
of the 'informants' interviewed for this article had ever even seen
a copy of the informed consent form.

The limitations of the mechanisms for the review of ethics of
clinical trials

This controversy brought to attention the need to strengthen local
ERC systems and the question of the effectiveness of transnational
ethics review mechanisms.


One of the key issues overlooked by the researchers of the proposed
Cambodian clinical trial was the need to consolidate local ethics
review systems, including the creation of the community-based ethics
review committees, as part of their extended responsibility. While
researchers may argue that such responsibilities go beyond the
immediate scope of their proposed research, the fact remains that
resources have to be allocated for the strengthening of local ethics
review systems as part of any complex clinical research project.

The research protocol for the Tenofovir trial had previously been
approved by ethics review committees of two prominent Universities,
comprising experts on ethics issues. Nevertheless and ironically
enough — serious lapses in ethical compliance were detected by a
group of impoverished sex workers in Cambodia. Despite their obvious
lack of training in analysing the ethical complexities of clinical
trials, they raised core questions of ethics of clinical trials and
the responsibilities of the researchers.

Thus, this controversy also exposed certain inherent limitations of
the international ethics review procedures, seen as characteristically high on
rhetoric but notoriously low in commitment to enforcing the ethical principles
that they preached.

The Tenofovir trial controversy is a warning note for the community
groups that the approval of a trial by an ERC associated with high-
profile institutions is not essentially a guarantee for an ethically
sound research. In addition, this is a reminder to the ERCs
approving such trials of the need to be more vigilant in their
responsibilities.

Methods of assessing risk and benefits of clinical trials

When the principal investigator of a research study claims that the
trial involves 'little risk' for the participants, he/she is not
only expected to be candid and precise about the nature and extent
of the risk, but also owes the participants an explanation as to how
this risk (including possible long-term repercussions) was
calculated.

Apropos the Tenofovir trial, Cambodian sex workers and their
representatives had themselves identified several categories of
risks (AIDS_ASIA E-Forum 2005). Furthermore, the methods and tools
used for assessing the risk and benefit also need to be disclosed as
part of the description or validation of the research methods.
However, based on the available documentation, the researchers did
not demonstrate the use of rigorous scientific methods of assessing
risk and benefits of clinical trials as applied to their proposed
trial.

Negotiating for minimum standards of 'Duty of Care'

Researchers are bound by the principle of 'duty of care', which
ensures that their decisions and actions do not harm the short and
long-term well-being of people and resources. According to UNAIDS
Guidance for HIV Vaccine Trials (2000), care and treatment for
HIV/AIDS and its associated complications are mandatory for
participants in HIV preventive vaccine trials, as is the 'minimum'
requirement of adhering to the highest standards of health care
achievable in the host country.

The process of negotiating for a comprehensive care package should
be agreed upon through a host/community/sponsor dialogue, which
reaches a consensus prior to the initiation of a trial (UNAIDS
2000). Researchers need to acknowledge the right of the trial
participants to negotiate for 'minimum standards' of care (which, in
turn, will be fixed after a systematic assessment of the risk and
benefits) both during and after the trial. However, it appears that
the potential Cambodian trial participants, efforts for
negotiating for a higher standard of 'duty of care' was ridiculed by
the researchers.

Health Equity: The criteria for prioritising clinical trial research
questions

Adequacy of research must also be justified on principles of justice
and equity. In a country like Cambodia, where vast health inequities
exist, researchers who carry out projects that may not produce
immediate benefits for the 'researched' community, have an
additional obligation to maximise the benefits and
reduce the risk associated with these trials, while assisting in the
development or facilitation of a strategic clinical research agenda.
Considering the high HIV disease burden prevalent in Cambodia, it is
imperative that an HIV clinical research must contribute towards
health equity benefits that are immediate.

Conclusion

In 1997, UNAIDS convened an 'expert group' to identify ethical
issues in AIDS vaccine trials (UNAIDS 1997). This group recognised
that 'thoughtful people of goodwill' can disagree on
ethical interpretations of the guidelines and that most of the
current guidelines will be applicable in their present form to the
ethical questions of AIDS vaccine research (Bloom 1998). Further
guidelines were proposed by UNAIDS in 2000 with specific emphasis
on the 'duty of care' (UNAIDS 2000).

By way of a response to the present controversy, a process of
further consultation, albeit less transparent and less participatory
in nature, has been initiated with the aim of developing a further
consensus on these issues. It is appropriate and timely that the
UNAIDS responded to the call to mediate to break the impasse.

However, at the same time, mediators should take care not to convey
the impression that they are trying to 'clean up the mess' created
by inconsiderate researchers. Considering the gravity of the ethical
dilemmas posed by the Tenofovir trial controversy, the mediatory
efforts undertaken by UNAIDS must be guided by the
deliberations of its own ethics review committees. It follows that
more concerted efforts are crucial both to create awareness of and
adherence to national standards as also to revise them at regular
intervals, based on prevailing local and international standards.

The case of the Tenofovir trials has also forced us to ask the
critical question of whether ethical guidelines should remain mere
guidelines or be made mandatory as legal obligations as well.

In conclusion, this controversy has sounded a clarion call for
heightened community vigilance with regard to the ethical aspects of
clinical trials, since it has become apparent that the mere approval
of a trial by an ERC is not in itself a sufficient promise of a
sensitive and ethically reliable study.

References

AIDS_ASIA E-Forum. (2005) Unethical Tenofovir trial: Cambodian sex
workers' Concern. Message 278.
http://health.groups.yahoo.com/group/AIDS_ASIA/message/278
(Accessed on 17 March 2005)

Jack, Andrew and Amy Kazmin (2005) Thai Aids campaigners question
new clinical trials. Financial Times. 12 March 2005 (Accessed on 12
March 2005) http://news.ft.com/cms/s/0bcd9024-929b-11d9- bca5-
00000e2511c8.html

Shafer, Kimberly Page (2004) Use of ARV in prevention of HIV
infection in high-risk populations. Women & HIV Research Directions,
International AIDS Conference, Bangkok, Thailand 2004.

UNAIDS (1997). Ethical Considerations in Clinical Trials of
Preventive HIV Vaccines. Proceedings of meeting held from 23 24
September 1997 (UNAIDS, Geneva, Switzerland, 1997).

UNAIDS (2000) Vaccine Research, UNAIDS Guidance Document. UNAIDS,
Geneva, Switzerland, 2000.

Code of Federal Regulations. Title 45. Public Welfare. Department Of
Health And Human Services, National Institutes of Health, Office For
Protection From Research Risks. Part 46. Protection Of Human
Subjects. Revised, November 13, 2001, Effective December 13, 2001.

www.ClinicalTrials.gov. Daily Tenofovir DF to Prevent HIV Infection
among Sex Workers in Cambodia.
http://www.clinicaltrials.gov/ct/show/NCT00078182 (Accessed on 12
March 2005)

http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm#46.114 th
(Accessed on 9 March 2005)

Bloom, Barry R. (1998) The Highest Attainable Standard: Ethical
Issues in AIDS Vaccines. Science Magazine January 9, 1998, Volume
279, Number 5348.American Association for the Advancement of Science.
______________________________

Dr. Joe Thomas is associated with APPACHA
(joe_thomas123@...)

Solidarity + Volume 1 Issue No. 1. May 2005
Bi-Monthly Newsletter of the Asia Pacific People's Alliance for
Combating HIV/AIDS

http://health.groups.yahoo.com/group/AIDS_ASIA/files/Solidarity%20%

Announcement of the Third Asia Pacific PLWHA Congress
                     "Bangkok + 1"
              30 June 2005, Kobe, Japan

We are delighted to announce that the 3rd Asia Pacific PLWHA Congress willbe
held on the 30 June 2005 in Kobe, Japan at 9 am, just prior to the  ICAAP. The
Congress is open to any person living with HIV/AIDS who is a residenceof any
country in the Asia Pacific Region.

Objectives:

To assess the progress of the 2004 Bangkok Declaration by PLWHA and discuss way
forward
To discuss and finalize the draft regional advocacy strategic action plans and
agenda prepared by APPRC with APN+ and INP+ based on the results of the Second
PLWHA Congress.
To discuss messages to be delivered at a dissemination  session as well as a
press conference

As this is a closed session only for positive people from the Asia
and Pacific region, prior registration is required.  Please send an
email to Mr.Manoj Pardesi (manojpardesi@...), the new coordinator of the
AsiaPacific PLWHA Resource Centre for further information and registration by
JUNE 3 (FRIDAY) latest.

Information about the venue (if not available, indicate that details
will be sent in due course).

About the PLHWA Congress

As part of the Asia Pacific PLWHA Coalition for Advocacy and Capacity
Transfer, an initiative started by the UNDP Regional HIV and
Development programme together with its partner APN+ (Asia Pacific Network of 
People Living with HIV/AIDS) and INP+ (Indian Network for People Living with
HIV/AIDS) to develop and strengthen the capacity of PLWHA for their meaningful
involvement in the HIV/AIDS responses in the region.

The Asia Pacific PLWHA Resource Centre (APPRC) based in New Delhi, India, 
together with the implementing partners, will be  organizing three annual Asia
Pacific PLWHA Congresses. The Congresses are to assist in  formulating  the Asia
Pacific PLWHA Advocacy agendas and regional strategic action  plans  tobe
implemented by the APPRC in the following areas:

1. GIPA and Empowerment
2. Access to treatment
3. Human rights

First PLWHA Congress

The first Congress was held on the 11 January 2004 in Bangkok in
conjunction with the Asia Pacific Community Forum (12th -14th January 2004) with
about 50 PLWHA participants from across the Asia Pacific Region.

Participants discussed various issues affecting their lives and came up with 
priority areas that require urgent attention and action.

Second PLWHA Congress Held in conjunction with the World Aids Conference in
Bangkok, July 2004 and attended by more than 100 PLWHA from Asia Pacific Region.
The  Congress  was
focused on developing an advocacy action plan which will be carried
out  by PLWHA groups across the region. A Declaration was also issued which  has
the voices of PLWHA from the region.

Contact Person:

Mr. Manoj Pardesi
APPRC, J-50 BK Dutt Colony
Jor Bagh Lane
New Delhi-3
India
Tel- +91-11-24652297/98
Email- manojpardesi@...
Website- www.plwha.org

shiba
E-mail: <shiba.p@...>

3 Questions to Richard Feachem by PLWHAs in Nepal

THREE QUESTIONS TO THE EXECUTIVE DIRECTOR OF THE GLOBAL FUND TO
FIGHT AIDS, TB AND MALARIA FROM PEOPLE LIVING WITH HIV/AIDS IN NEPAL

To,
The Executive Director
Global Fund

CC: Chair & Executive Board of the Global Fund

Respected Sir,

We the people living with and directly affected by HIV/AIDS from
different parts of Nepal would like to bring into your notice a few
issues that has been overtly neglected by our government and all the
donors working in Nepal – including the Global Fund to fight AIDS,
TB and Malaria.

Nepal has a concentrated epidemic with around 100,000 estimated to
be living with HIV/AIDS. However, among injecting drug users the
prevalence is staggering 50% - 70%, among sex workers 20% and so on
and so forth. A raging conflict and political unrest for the past
several years has fuelled the HIV epidemic.

Due to the concentrated epidemic scenario in Nepal donors get an
excuse not to fund treatment and care programs as they believe that
prevention should remain the mainstay in a low prevalence context.
This has also influenced the National AIDS strategy which fails to
even mention the word treatment let alone set strategies to treat
and care people living with HIV/AIDS. As a minority, we the
community of people living with HIV are discriminated by the
government and donors. Our needs and our priorities are often
disregarded because we are small in numbers. We are often told that
we will only receive treatment and care services when more people
come out. When we heard about the global fund and its mission 3
years back we had hoped that the fund will address our needs.

However our hopes were shattered when country coordinated proposal
failed to address our needs and priorities as they were based on the
national plan which focuses on prevention because of the reasons
mentioned already. Those who contributed to the proposal were the
NGOs who had experience only on prevention programs. Though Nepal
received funding from the global fund in 2003 the programs are yet
to be implemented. Another major barrier to this delay was instable
political scenario, weak national AIDS coordinating body and limited
international pressure. Again on the other hand we were told that
there are other pressing issues than HIV and AIDS.

Whenever we raise this issue with our own government or the donors
we are told that they are doing their best. Whenever we raise this
issue to the Global Fund, UNAIDS or WHO we are told that it is our
government who is `not working and is not their fault.'

Is it then our fault that we have a raging conflict?
Is it our fault that there is a political unrest?
Is it our fault that our government is in denial?
Is it our fault that we have a weak national plan?
Is it our fault that we have a passive international community?
Is it only our problem that we are living with and affected by HIV&
AIDS?

If yes, then we have nothing to say. However we would like to put
forth a few questions to the Global Fund that had promised not to do
business as usual.

1. What is the fund's strategy to deal with countries in conflict
and political unrest?
2. How does the fund facilitate the process in countries to ensure
that people living with HIV have access to treatment and care
through the GF resources?
3. When a country excludes people living with HIV and vulnerable
communities to apply through the country coordinated proposal how
will the fund help the communities to develop and submit a proposal?

(The government of Nepal has adopted a policy to only accept
applications from organizations that are registered for five years
which excludes several organizations run by people living with
HIV/AIDS, drug users and sexual minorities to apply for funding.)
With these questions laid down for you we hope that the fund will
encourage and assist the communities to develop and submit a
proposal for the 5th round.
_______________
Rajiv Kafle, Former Board Member GNP+, Advisor APN+, Communities
Delegation GFATM, Board Member International Treatment Preparedness
Coalition & National Association of People living with HIV/AIDS
(NAPN)
____________

"Rajiv Kafle"
E-mail: <rajhiv2002@...>

WHO's in charge of world health?

The World Health Organisation is the chief body of the United
Nations responsible for global health problems. It is charged with
monitoring the state of the health of the six billion citizens of
Earth, and with stepping in with cures, remedies and preventatives
when warranted. The health of the world is far from excellent, and
the same may be said of the WHO. Today is the start of the UN body's
annual meeting. It is discouraging to see that instead of coming to
grips with the agency's problems and shortcomings, its bureaucrats
are set to discuss a series of relatively unimportant matters which,
at best, will make a relatively few healthy people more healthy.

In the year of tsunami recovery, with its anti-malaria programme
faltering and the most important Aids initiative on the brink of
failure, the WHO will focus this week on quite different matters.
There is a Global Initiative to kick off, for example _ on diet,
physical activity and health. This is a project for middle-class
people with wide choices, and will provide recommendations on meals
and exercise. Then there are the projects on road safety, destroying
smallpox samples, finance and relations with non-governmental
organisations. There will be an entire conference session on the
health conditions in Israel-occupied territories, but there will not
even be one for all of Africa, the centre of the two most important
and failing WHO policies.

The WHO has spent untold funds _ perhaps to be accounted this week _
on a much-needed Aids programme called 3 by 5. The aim, when this
project began several years ago, was to have three million diagnosed
HIV/Aids victims in developing countries taking effective, anti-
retroviral drugs by the end of 2005. It sounded like a realistic
goal, given that five million new patients are diagnosed each year
with the virus or syndrome. But it hasn't worked out that way. A
devastating article in the current edition of the British medical
journal Lancet lists a few of the shortcomings. Just 30 of the
targeted 50 nations have been covered at all. The needed 400 WHO
staff currently stands at 112. Dr Jim Yong Kim, WHO director of the
Department of HIV/Aids, predicts recalcitrant governments in India,
Nigeria and _ of course _ South Africa make it almost impossible
even to achieve the modest goal of three million patients.

But here is the worse news. Of four million HIV/Aids victims in
Africa, just 325,000 or 8% will be under effective medical treatment
in the unlikely case that the 3 by 5 programme suddenly accelerates
to success by New Year's Eve. Without South Africa on board, tens of
thousands of Africans will be doomed to death by Aids because of the
failure of the WHO project. And now officials have determined the
knock-off anti-retroviral drugs from Indian firms are not at all
``bio-equivalent'' to the expensive, patented drugs they copied.
This will not be a subject for discussion at the WHO gathering this
week.

Nor is the deeply troubled anti-malarial programme called RMB, for
``roll back malaria''. Experts including, again, the Lancet have
harshly criticised RMB, centred in Africa as are most of the million
deaths to malaria each year. They say RMB has been such a failure it
may even have increased the number of victims. WHO teams were found
pushing outdated, ineffective drugs such as chloroquine and
sulphadoxine-pyrimethamine. Malaria does not appear on the WHO
meeting's agenda.

After the Dec 26 tsunami, the WHO began its work only on Jan 18, and
then in conjunction with a US government field team. There are
profound health problems throughout the African continent, where two
of the most prominent and important basic health-care plans are
floundering and facing failure. Yet the annual WHO assembly
beginning today is to focus on issues such as ``social health
insurance'', breastfeeding and an examination of the plight of the
Palestinians. These and dozens of other issues are important in
certain ways, and deserve national or regional attention. But the
WHO is, literally, the world's health organisation. Its Geneva
meeting gives the impression the WHO is either, willy-nilly,
flitting from issue to issue, or ignoring its most important
mandates.

http://www.bangkokpost.com/News/16May2005_news26.php

Shanghai plans responses to AIDS

The Lancet 2005; 365:1524-1525 [DOI:10.1016/S0140-6736(05)66435-5]

Scott Burris   a,   Joanne Csete b,   Xia Goumei c,   Zhou Dan d
and   Bebe Loff e

On Dec 15, 2004, a meeting was convened in Shanghai, China, to
discuss options for laws dealing with HIV/AIDS at the provincial and
municipal levels. The primary agencies responsible were the Shanghai
Academy of Social Sciences, the Shanghai Law Society, and the
Institute of Legislation and Temple University in the USA. With a
population of some 13 million, Shanghai is China's largest city and
enjoys a legal status equivalent to a province, enabling it to
create its own law. Participants in the meeting were mainly leaders
of the municipal government (including members of the Municipal
People's Congress and the health department), and researchers from
the Shanghai Academy of Social Sciences and other research
institutions. The meeting showed Shanghai's commitment to effective
HIV/AIDS legislation and the challenge of steering HIV/AIDS policy
through the shoals of fear and moral disapproval of drug use and
prostitution.

Both the content and process of law reform were addressed. A law-
reform exercise in Australia in the early 1980s was offered as an
example of a consultative process in which affected populations were
encouraged to share their experiences. Over 2 years, non-
governmental organisations were encouraged to come forward to help
shape the law, law that in turn supported an environment of
partnership between government and community.

At the Shanghai meeting, three important areas of concern were
identified, each tied to a different legal strategy for HIV/AIDS
control. First, there remains a great deal of anxiety in some of
those in the legislative process about low-risk exposures and
attempts to intentionally transmit HIV. Speakers and participants
offered anecdotes about vengeful people with HIV deliberately trying
to infect others, and robbers using infected needles to intimidate
victims. Similarly, some speakers alluded to the necessity of
testing hospital patients to protect medical staff, and disclosing
HIV test-results to employers to allow safety-related job
reassignment.

Fears about deliberate exposure to HIV have elsewhere come to be
regarded as exaggerated. Mandatory testing and disclosure as a means
of protecting individuals from exposure to HIV is elsewhere seen as
unnecessary and even counterproductive.1 The universal precautions
approach, in which workers are trained and equipped to manage
occupational exposure to blood or infectious body fluids, is now
well established. The Chinese Centres for Disease Control plans to
promote this approach, but it does not yet appear in Chinese
HIV/AIDS legislation. Including a universal precautions approach in
Shanghai's legislation, and providing the support for the necessary
training and equipment, could set a valuable example.

A second important theme was the need to enhance the involvement of
non-governmental organisations in HIV/AIDS prevention and care in
China. People in vulnerable populations, such as drug users and sex
workers, have begun to organise in China to advocate for policy and
law that respects their rights. The Shanghai meeting was notable for
the participation of an openly gay lawyer, Zhou Dan. Although
Chinese law formally contemplates a vital role for non-governmental
organisations in HIV/AIDS prevention and response, there are many
legal and social barriers to the development of a vigorous sector
for non-governmental organisations in China.2 The requirements for
establishing non-governmental organisations are set for the most
part at the national level, and include provisions requiring such
organisations to have a government or official sponsor, and that
allow only one non-governmental organisation on a topic for each
jurisdiction.3 Partnerships between Chinese non-governmental
organisations and non-Chinese funders and providers of technical
assistance are also limited. Whilst eliminating these barriers would
require national legislation, local governments can encourage the
participation of non-governmental organisations by providing greater
funding to these organisations and actively involving them in
planning and evaluation of HIV policies and programmes, including
the development of good law. Creative legal work might identify ways
in which provinces and municipalities can reduce bureaucratic
barriers to non-governmental organisations in the absence of reform
at the national level. Representatives of the Shanghai
administration reported that the problem of non-governmental
organisations will be addressed in the municipal legislation.

Finally, the meeting also highlighted the importance of policy
implementation. The approval of needle-exchange and drug-treatment
programmes on paper, or the passage of privacy and discrimination
protections, is not sufficient to assure that services are actually
delivered in a way that meets policy goals. Legislative planning
must include funding for training and monitoring of performance. The
implementation problem is particularly great in the area of privacy
and antidiscrimination law. Vitally, there was no disagreement that
people with HIV should be protected from discrimination and from the
inappropriate release of their medical information. At the same
time, however, it was also widely accepted that China lacks an
effective system for the enforcement of these basic human rights. An
enforcement mechanism, such as a Human Rights Commission charged
with investigating discrimination cases and promoting compliance, as
well as legal services, will be necessary to provide real protection
that people with HIV can rely on.

We declare that we have no conflict of interest.

References

1. World Health Organization. UNAIDS/WHO policy statement on HIV
testing.
http://www.who.int/hiv/pub/vct/statement/en
June, 2004 (accessed March 14, 2005)(accessed March 14, 2005)

2. State Council of China. Chinese national medium-and long-term
strategic plan for HIV/AIDS prevention and control (1998–2010).
State Council Document GF (1998) 38.
http://www.usembassy-china.org.cn/sandt/hivpolicypr98-2010.h...
Nov, 12, 1998 (unofficial translation, accessed March 8, 2005)
(unofficial translation, accessed March 8, 2005)

3. State Council of China. Regulations for registration and
management of social organizations. Order number 250.
http://www.humanrights-china.org/zt/NGOs/..%5CNGOs/200412004...
Sept, 25, 1998 (unofficial translation, accessed March 8, 2005)
(unofficial translation, accessed March 8, 2005)


Affiliations

a Temple University Beasley School of Law, Philadelphia,
Pennsylvania, PA19122, USA; Johns Hopkins School of Hygiene and
Public Health, Baltimore, Maryland, USA; and Center for Law and the
Public's Health, Johns Hopkins School of Hygiene and Public Health,
Baltimore, Maryland, USA

b Canadian HIV/AIDS Legal Network, Montreal, Quebec, Canada

c Centre for Public Policy Study of HIV/AIDS, Shanghai Academy of
Social Science, Shanghai, China

d Richard Wang & Co, Shanghai, China

e Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, Victoria, Australia

http://www.thelancet.com/journals/lancet/article/PIIS0140673605664355
/fulltext

US AIDS Policy: More Harm Than Good, Says Brazil

In an unprecedented move, the Government of Brazil yesterday refused
a $40 million grant from the United States to fight AIDS, saying its
ideological conditions were too severe.

Nearly 700,000 individuals are inflicted with HIV/AIDS in Brazil,
many of whom are living in poverty. The Bush Administration's grant
would have imposed scientifically unverifiable, ideological clauses,
such as one that asks the country to officially condemn
prostitution. Signing such a clause would have impeded AIDS
interventions within Brazil, which orchestrates open relationships
with prostitutes, homosexual men, intravenous-drug users and other
high-risk groups in order to fight the pandemic.

"It is a simple fact that in order fight AIDS, it's crucial to work
with the populations that face the greatest risk. It would be a
gross human rights violation to deny them life-saving assistance
based on moral grounds." said Atila Roque, Executive Director of
ActionAid USA, and himself a Brazilian. "That's why we should praise
the Brazilian government's decision, which will help to raise the
stakes of international debate concerning the Bush Administration's
ideological influence over foreign aid policies."

Added ActionAid International USA policy analyst, Rick
Rowden, "HIV/AIDS needs to be battled through a public health
approach which requires close working relationships with the most
vulnerable communities. You can't have a cooperative working
relationship with, say, prostitutes' associations that starts off
with a blanket moral condemnation of them. You might think you've
taken the moral high ground, but that is not the same thing as an
effective anti-HIV/AIDS strategy. From this point on, the US is
going to need to decide if it is going to be moralistic or
effective."

According to Dr. Paul Zeitz,Director of the Global AIDS
Alliance, "In turning down the US grant, the Government of Brazil is
actually protecting people at risk by ensuring science-based
prevention programs are implemented rather than ideologically-based
prevention programs that have no basis in scientific reality. This
is a phenomenal development by Brazil, a sovereign government which
is finally standing up against policies that are doing more harm
than good."

Interestingly, there are no Federal laws within the United States
banning prostitution. As a result, prostitution is legally condoned
within some Nevada counties. According to a 10-year UCLA study, the
occurrence of AIDS within condoned rather than condemned brothels is
significantly lower than that of the general population.

States Almir Pereira Jr, program coordinator for HIV/AIDS at
ActionAid International Brazil, "more than the refusal of accepting
the US grant, the Brazilian government's attitude represents its
commitment towards maintaining a democratic and progressive AIDS
program, as opposed to the conservative vision of the United States.

Unfortunately, it seems that the US policy is taking advantage of
the great poverty and high vulnerability of developing nations to
impose its conservative agenda as a condition for the countries to
receive the financial aid they desperately require."

NOTES TO EDITORS
ActionAid International works in Africa, Asia, Europe and the
Americas to fight global poverty and tackle the injustice that
causes it.

For Immediate Release, April 16, 2005
Sandy Krawitz of ActionAid USA
202-835-1240 or 202-492-7207 (cell),
sandy.krawitz@...
or Tony Durham of ActionAid UK,
44 20 7561 7636 or 44 7957 870314 (mobile) or
tony.durham@...

INVITATION  AIDS_ASIA e FORUM.

Hi,

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

[AIDS_ASIA 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/

Vacancy Announcement

The Office of the Resident Coordinator of the United Nations System's
Operational Activities for Development in Thailand

Term of Reference

Post Title:  Manager of the Secretariat of the United Nations
Task Force on Mobility and HIV Vulnerability Reduction
Type of Appointment  Local ALD – A4

Salary: Up to USD 101,164 per annum depends on level of experience
Duty Station:  Bangkok, Thailand
------------------------------------------------------
Job Summary:
To manage the Secretariat of the United Nations Task Force on
Mobility and HIV Vulnerability Reduction, reporting to the Resident
Coordinator and working in close co-ordination with the Steering
Committee of the Task Force.

Duties and Responsibilities:

1. Manage the secretariat and coordinate the Task Force.
	 Manage and account for project funds.
	 Develop and finalize, under the direction of the SC and Task
Force, the annual Work Plan, facilitating and monitoring the
implementation.
	 Ensure continued communication and information flow between
and among the SC and Task Force members in order to develop close
working relationships, shared ownership, and achieve Task Force
objectives and goals.
	 Prepare and disseminate progress reports to the RC, SC, and
Task Force members and donors.
	 Prepare and disseminate semi-annual, annual and final
project reports of the Task Force, which should include financial
reports, results achieved, and lessons learned.
	 Provide administrative and technical backstopping support as
required by the SC and Task Force.
	 Facilitate and organize meetings of the SC and TF, including
preparation of agenda, substantive focus, progress reports, and
financial reports.

2. Identify and mobilize financial and technical resources as
well as resources persons to facilitate and support the
implementation of the Work Plan.

3. Carry out advocacy activities with governments and regional
bodies in concert with the SC and TF in pursuit of the Work Plan.

4. Ensure that all relevant information generated by the Task
Force is gathered systematically and communicated to the public,
including maintaining and updating a website.

5. Liaise with other relevant organizations of the UN system,
regional/international inter-governmental organizations, NGOs,
agencies and governments to ensure that programmed activities are
carried out in a timely manner.

6. Facilitate evaluation of the Task Force

7. Other related duties as required.

Psychological and/or Attitudinal Skills:
• Holding high regard for integrity
• Well-developed professionalism, personal discipline and
impartiality;
• Flexible and open to learn and develop personally and
professionally;
• Adaptability to constantly changing Country Office
leadership;
• Commitment to customer service: meet internal and external
customer needs promptly;
• Responsive to changing circumstances and adaptive to
requirements at short notice;
• Excellent stress management skills;
• Competent in meeting inflexible deadlines and in resolving
difficulties while maintaining composure;
• Ability to take initiative, priorities and work
independently to cater for a wide range of stakeholders;
• Commitment to gender equality;
• Ability to work as part of a team, sharing information and
coordinating efforts within the team and the office community.

Qualifications:
• Post graduate academic degree in public health, social
science, or equivalent
• 5-10 years experience in mobility and/or HIV/AIDS with at
least 5 years of managerial experience
• In-depth knowledge on mobility and/or HIV/AIDS in Southeast
Asia
• Strong leadership, coordination and interpersonal
communication skills
• Fluency in oral and written English; knowledge of regional
languages an asset
• Familiarity with the UN system would be an advantage

Interested candidates should submit a detailed resume, a recent
photo, and UN Personal History Form (P11) along with a cover letter
clearly stating the position and respective reference number by 3
May 2005, to:

Human Resources Associate
G.P.O. Box 618, Bangkok 10501
or e-mail to : hr.thailand@...
Competitive salaries and benefits (such as pension, medical
insurance, and 30 days annual leave) will be offered according to
the UN General Service scales applicable in Thailand. Only short
listed candidates will be notified.

(Internal candidates will be given first priority)
____________________
Petcharamporn Siriut
Administrative Secretary
UNDP Regional Centre in Bangkok
3rd Floor, UN Service Building
Rajdamnern Nok Avenue, Bangkok, Thailand
Tel.: +66 (2) 288 2153
Fax: +66 (2) 280 2700
URL: http://regionalcentrebangkok.undp.or.th
E-mail: petcharamporn.siriut@...

Dear FORUM,

I had requested for a country wise break from the WHO regarding achievement of
the target in '3X5' project of the WHO but subsequently I found the information
from the WHO site (http://www.who.int/3by5/progressreport05/en).

Initially, the data was so unbelievable that I went through a little carefully.
First, the whole data is essentially based on the government supplied
information possibly reflecting the information coming from the US Department of
State which claimed that by the end of September 2004, the USA was supporting
treatment of 15 the HIV sufferers in fifteen focus nations.

The total number of people receiving treatment between the months of June till
December 2004 is 567900. By the end of December 2004, the number of people
having access to HIV treatment has come to 78000 (high estimate of the WHO)
which has been moderated down to 700000. The number given by different countries
are so precise that it has been given even in 1s and 2s.

Normally you would expect these numbers to be on exceptionally high
side as each and every government wants to claim that it is providing
extraordinary service to its citizens suffering from HIV. However, a little
closer scrutiny of these numbers suggests a different story. Botswana has been
regarded a success story. The number given for Botswana who are receiving HIV
treatment is 32839 in September 2004, a very precise number which grew to 39000
by the end of December 2004, approximately by 6000 i.e. 50% of approximately 75-
80000 people requiring HIV treatment are receiving it.

A look at the graph on page 18 of the WHO Report suggests a different story. As
per the graph, the number of people receiving ARV therapy in September 2004 is
approximately 18000 and if you add one quarter receiving treatment through
private facilities possibly through the so called public private partnership
(the African Comprehensive HIV/AIDS Partnerships, with the Bill and Melinda
Gates foundation, The Merck Company foundation and the pharmaceutical company
Merck & Co.), the number of people receiving ARV treatment
would be 22-23000, and not 32839 a very precise figure which jumped to 39000 in
December 2004. We are talking about miracles not access to medicines or to be
precise access to ARV therapy.

A look at Indian figure is more staggering. India is providing ARV therapy only
to 2841 HIV sufferers in November 2004. In December 2004, Indian access to ARV
therapy has been shown to be 36000. In one month, the access has jumped from
2841, a very precise figure to something like 12 fold.

Where did they get this information from? Number of countries providing ARV
treatment to more than 40% of the HIV sufferers needing treatment is an
interesting reading.

These countries are Argentina (90%), Botswana (50%), Brazil (86%), Mexico (74%),
Thailand (44%), Uganda (40%), Uruguay (100%) and Venezuela (51%). Countries that
appear to be total failures are Zimbabwe (8000 (9000) out of 295,000), Zambia
(13636 (22000) out of 149000), Tanzania (2880 (3500) out of 263000), South
Africa (14922 in Sept. 2004 to 62000 in December, 2004) out of 837000) Nigeria
(13579 (15000) out of 558000) Kenya (16952 (33000) out of 220000) Ethiopia (3836
(4500) out of 167000).

From the data it appears that Latin America has absolutely no HIV problem at all
whereas two African countries, Uganda and Botswana, closely aligned with the USA
have nearly covered half of the HIV sufferers.

Uganda is an exceptional case where the anti-AIDS medicines are most expensive.
So you are going to get a research literature from PhRMA spokespersons such as
Amir Attaran, Peter deMarios, Henry Grabowski that cost of the drugs is not
responsible for access to medicines although it may be entirely opposite of Amir
Attaran's mouth opening research that it is the poverty which is responsible for
non-access
to medicines. It does not matter which shoe you are using till you are able to
beat HIV sufferers.

For the year 2004, the budget for health in Uganda was US$ 180 million with an
approval from Global Fund of $137 million with a signed grant agreement for $36
million. (Charles Wendo, Ugandan Officials Negotiate Global Fund Grants:
Government Limits on Health-sector Spending may jeopardise funding agreement,
Lancet 363 Jan. 17, 2004, p 222). As per Charles, it costs $30 per patient per
month in Uganda to provide a triple antiretroviral combination.

Uganda has spent only 18 million dollars to treat 50000 people per year and if
we take 114, 000, then it has to spend only 41 million dollars per year.

The most interesting reading of all is the cost of ARV treatment worked out in
casse of Malawi at $300 per year.

Even if we accept the higher number of people provided ARV treatment, the total
cost works out to be only $210 million.

It is comparatively a very small amount and it appears that money is not a
problem as far as the WHO target is concerned.   Even accepting 3 million
target, all that is required, is only 900 million per year and accepting 5.8
million currently needing treatment, total yearly cost works out to be 1.74
billion dollars. One does not have to go to any other source and the much touted
Global Fund should be able to take care of all these minor requirements. You can
discount any other source of fund including those from the governments.

To top its report, the WHO has approvingly mentioned about The AIDS Medicines
and diagnostics Service) AMDS, essentially a constituent of the WHO (UN
Agencies-WHO (EDM, EHT, CPS, Essential drugs and HIV RA in Regional offices),
UNICEF, World Bank, UNAIDS,  UNFPA, UNDP; Technical organizations and donor
agencies-CCAR, CHAI, CPA, Crown
Agents, EPN, Esther, FIP, GFATM, IDA, JSI, MEDS,MSH;Observers-MSF, US State
Department ( PEPFAR),  USAID) whose one focus is on the tiered pricing system. I
had mentioned in my previous note regarding tierce pricing and the involvement
of the WHO in this scandal.

The whole report while talking of its achievement on the basis of sheer cooked
up data and the promotion of tiered pricing, a demand
from the US-EC pharmaceutical industry and promoted by the American Enterprise
Institute through Patricia Danzon, an alumnus of American Enterprise Institute,
(Patricia M. Danzon, 1997, Price discrimination of Pharmaceuticals: Welfare
Effects in the US and the EU, International Journal of the Economics of Business
301-321 (1997) Patricia M. Danzon, Testimony of the U.S. Senate Committee on
Health, Education, Labor and Pensions, 13th June 2000, available at
<http:www.senate.gov/~labor/hearings>; Patricia Danzon,

Differential Pricing for Pharmaceuticals: Reconciling Access, R&D, and Patents,
CMH Working Paper Series, Paper No. WG2: 10, Commission on Macroeconomics and
Health (A WHO Commission examining the Interrelations among investments in
health, economics growth and poverty reduction, 2001, Danzon argued that
“Implementation required the adoption of policies to prevent low prices in
low-income countries from “leaking” from the low-income countries to higher
income countries, thereby undermining the potentially higher
prices in these high income countries.

Such leakages occur due to parallel trade or “external referencing.””),
John Barton from Stanford University, (John Barton, Differentiated Pricing of
Patented Products, Working Paper
NO. 63, Indian Council for Research on International Economic Relations, March
2001), Juan Rovira from the World Bank (Juan Rovira, A Trade Framework for
Intellectual Property Rights, Equity Pricing and Market Segmentation, The World
Bank, Health, Nutrition and Population, World Bank Workshop, June 2, 2003;  Juan
Rovira, Meeting on the Role of Generics and Local Industry in Attaining the
Millennium Development Goals (MDGs) in Pharmaceuticals and Vaccines,
Washington Ds, June 24-25, 2003 June ), Jayashree Watal of the WTO and a new
convert F. M. Sherer (The Economics of Parallel Trade in Pharmaceutical Products
(WTO-WHO Hosbjor Conference) (2001)from the Harvard University is to consolidate
the control of the US-EC pharmaceutical industry on access to medicines to the
world’s poorest countries.

The WHO has become nothing but a captive agency of the USTR and through the
USTR, a captive agency of PhRMA, the research based pharmaceutical industry.
(“AMDS has pursued dialogue and negotiations with the research-based
pharmaceutical industry with a view to ensuing adequate supplies of affordable,
high-quality HIV/AIDS treatments.

One focus is one the tiered pricing and expanding the lists of countries
eligible for low and intermediate prices.” P. 34fo the WHO Report, 2004) Where
did this list of countries eligible for low and intermediate price has come
from? In all probability it is the list prepared by the EC to help poor so that
Glaxo can supply them at differential price.

(EC, Trade and Development: Access to Medicines available at
http://europa.eu.int/comm/trade/csc/med08qa_en.htm (q.4. Is
there any link between this regulation and the Trade related Aspects of
Intellectual Property Rights (TRIPs) discussions on enabling developing
countries to use of compulsory licenses to manufacture the drugs they need?

In principle, no. The discussion on compulsory licensing at the WTO TRIPs
Council is a separate exercise. However, in practice it’s clear that if poorer
countries get the medicines they need under tiered pricing arrangement, they
won’t need to use compulsory licenses.”) The fraud we have seen in the case
of Dowelhurst v. Glaxo where the sale by Glaxo to local persons were claimed to
be for export and was used to install ban on reexport of the medicines as well
as the Doha solution of 30th August, 2003.

The tierced pricing is meant for removal of Article 6 of the TRIPS Agreement and
the compulsory licensing option for developing countries which becomes clear
when we examine John Barton’s article financed by the WHO. John Barton,
observed that “Such a price differentiation appears unambiguously good, since
it makes the product available to those who would not otherwise be able to
afford it, and allocate the cost of research in an equitable way, without
harming patients in the developed world.” (p.1).

Barton also suggested amendment of Article 6 of the TRIPS agreement to prohibit
import of products subject to the ability of the patent holder to choose not to
exercise its rights, so that it could serve regions of several nations and
several prices. (It is clearly wise to slow reverese flow, which is probably,
but not necessarily. readily achieved by use fo intellectual property rights. In
the most
dramtic form, this would be an aagreemnt to amend Article 6 fo TRIPS to require
that patent rights on pharmacetuycal products be defined in such a way as to
probihit import of prodoucts lawfully marketed in another nation.”). Barton
went to the extent of suggesting that tiered pricing be made mandatory through
the International Drug Equity and Orphan Drug Development Treaty. (John Bartoon
,p. 21). No wonder, Bruce Lehman of IIPI put John Barton’s article on its web
site instantly.

Barton discussed the issue of export to fulfill the obligations of compulsory
licensing under Article 31 and found the legal issue “quite unclear” while
quoting the European Commission Study, “Arguments by smaller developing
countries that their right to issue compulsory licenses would be meaningless if
they could not grant a license to a foreign manufacturer should be taken
seriously, but TRIPS does not seem to give any legal certainty on this issue.”
(European Commission, Issue Group on Access to Medicines,
Legal Issues related to compulsory licensing under the TRIPS agreement, (2001)
available at
http://europa.eu.int/comm/trade/pdf/med_lic.pdf )

Sometimes you wonder whether these academics should be allowed to use their
academic appellations to prostitute themselves.

The World Health Organization's data cooking and its action as an USTR captive
agency give one the impression that the figure of 40 million HIV sufferers is
false and it may be much higher and it would not be a surprise that it is not
less than 100 million. Only sad part is that all of the HIV sufferers are on
their own teaching their youngsters how to dig graves.

Does one think that even one word of this report is not fraudulent?

Daya Shanker
E-mail: ds20@...
_______________________________________________
Cross posted from Ip-health mailing list
Ip-health@...
http://lists.essential.org/mailman/listinfo/ip-health

Subject: Malaysia: Do we want to be banished to an island??

Friends,

By now I am sure that most of us have heard about the statement made
by our learned mufti of Perak about wanting to banish those who have
infectious diseases and HIV/AIDS is definitely in it. Frankly speaking
this is not an unheard statment before.

If I have my way I could just laugh over it but this is not a laughing
mattter...

Lot's of things could be derieved from this irresponsible statement
which clearly points to the speaker is one ignoramus guru that needs
to be told so. We cannot allow this kind of thing go on any longer.
Why should we need to suffer in silence while others throw this kind
of blantant statement to us.

Is there a way out of this???

Come monday a briefing will be held in Malaysian AIDS Council (MAC) at 1.00pm
and followed by a press conference at 3.00pm.  It is not an MAC project but ours
PLWHAs.

MAC are kind enough to facilitate it for us. The point person from
the community will be Roslan Salina. Few of us will be on the panel to
speak our hearts out against the statement.

The only reason I agree to do this is simply I know it's something
that I have to do.  I am willing to speak up because I don't want to
be send to an island and be treated as an outcast.

For the last 3 years I have work so very hard by God's grace just to stay clean
and alive.

I am not going to allow anyone to make me feel I do not deserve
a second chance.

This press conference is our way to say that we are hurt and we want
to be treated as a human being. Roslan gave a very good statement in
the star. Please look at it.  This effort that a handful of us is
taking this monday won't means nothing if we don't have all of our
communty come to stand alongside with us. And do take comfort MAC and
other allies will be behind us and GOD will be there to protect us.

Please come in drove to make our stand...WE WANT TO LIVE

in solidarity,
Marh Mansor
E-mail:<pakaiotak2003@...>

Transvestites get ''married''

Apr. 21, 2005
Full moon acting as witness, the sounds of music, laughter and
tinkling anklet bells in Tamil Nadu heralded the marriage of thousands
of transvestites from across India to normal men - only to be widowed
the next day.

The annual four-day festival to Aravan, a deity locally known as
Koothandavar, started Tuesday on the full moon night or Chitra
Pournami in the Indian month Chitra. At a small Krishna temple in the
Koovagam village in Villipuram district, the transvestites underwent
the age-old ritual, replete with gaiety, pomp and splendour, inspired
out of an excerpt from the Hindu epic Mahabharata.

The temple priest, K. Shanmugam, says he has lost count of the
weddings he performed; at least 10,000, he estimates. According to
mythology, Aravan was one of Arjuna's many sons, sacrificed so that
the Pandavas could win the battle of Mahabharata. As a last wish, he
desired to get married, causing Lord Krishna to take the form of a
beautiful woman so that Aravan could marry him. Aravan was then
beheaded, and Krishna became a widow.

Known as Aravanis, the worshippers that include transvestite community
and many normal men, whose families have undertaken vows at the temple
for some boon, undergo the complete ritual - from marrying to getting
widowed. Weddings are performed by tying the mangalsutra, or symbolic
wedlock, under the full moon.

The day after the weddings, the married men go through a consummation
ritual, following which their "spouses" go through a ritual rubbing
off their vermilion from their forehead, donning white garb like widows.

Since 2003, the rituals have been held in an organized manner with
many NGOs partaking in the activities.

A rights conference takes place every year to assure participation of
Aravanis from different states. "We take our annual holiday this time
and come home," said Meena, a transvestite, who is part of a
filmmaking effort on their lives by the Don Bosco Institute of
Communication Arts.

According to state estimates, Tamil Nadu alone has 140,000
transvestites. The South India Aravanigal Rights and Rehabilitation
Centre, Tiruchirapally, is appealing to the government to legalise the
"third gender" in all India's forms and official documents so that
they are not forced into the "male" or "female" categories.

"If we don't get jobs, we are forced into prostitution. Give us a
livelihood opportunity," says Chandra, a transvestite activist working
with the South India AIDS Action Programme.

The organisation is also imparting vocational training to the Aravanis
to wean them away from begging and prostitution. Special cultural
events are organised by NGOs. Actors, who enact the Aravan story from
the Mahabharata, also act out AIDS-care and awareness skits. Films
related to gender issues are shown and a beauty pageant for "Miss
Koovagam" is being held for the transvestite community since 2003.

http://www.indiadaily.com/breaking_news/32414.asp

International Training Programme:
Policy Concerns, Planning and Management in HIV / AIDS
June 20-24, 2005

Organised by
Indian Institute of Health Management Research
A WHO Collaborating Centre for District Health System
1, Prabhu Dayal Marg, Sanganer Airport
Jaipur-302 011 (Rajasthan), India

Sponsored by

Management and Training Service Division (MTSD)
Commonwealth Secretariat. Through the
Commonwealth Fund for Technical Co-operation (CFTC)

BACKGROUND

HIV/AIDS has emerged as a major threat to mankind in the last few decades. The
disease, after reaching epidemic proportions in the western world and ravaging
several African countries, has taken root in the Asian region. UNAIDS has
estimated that more than 90 percent of all adult HIV infections are in
developing countires : about 800,000 children are living with HIV; and at least
43 percent of all infected adults are women.

In many developing countires the HIV/AIDS epidemic is spreading rapidly.
According to available UNAIDS reports, South and South-East Asia is the
epicenter of the HIV epidemic with the majority of new infections expected to be
occurring here. Within this region, India is estimated to have the largest
burden of the epidemic with about 3-5 million infections.

Evidently, AIDS has taken an immense and growing human toll. The Heads of the
Commonwealth countires have emphasized the need for creating an appropriate
policy environment and management of HIV/AIDS in the member countries. The
governments of the member countries and other stakeholders have taken steps to
actively confront the epidemic. However, it is important for the people working
in the field of HIV/AIDS Prevention and Control, Care and Support, to have a
better understanding of the policy environment and enhanced understanding of
related issues/dimensions. Resources are limited and the expansion of the
disease is menacing. Thus it becomes essential that the policy makers and
programme managers develop skills to manage and think strategically to make the
best use of the resources and to effectively implement the programme.

The programme has been designed and developed in collaboration with the
Commonwealth Management and Training Division, London, for the policy makers at
the national level, and programme managers at the national, provincial/state
level. In addition, scientists working on HIV/AIDS at the national institutes in
various Commonwealth countries may also be nominated. The nominations will be
done through the Commonwealth Secretariat, Management and Training Service
Division (MTSD), Marlborough House, Pall Mall, London SWIY 5 HX (Telephone: 44
(0) 20 7747 6343, Fax : 44 (0) 20 7747 6540/6335).

  PROGRAMME OBJECTIVES

The main focus of the training programme is on developing an understanding of
the policy review and analysis, and planning and management in HIV/AIDS
prevention and control in the context of Asia Pacific Region. The objectives of
the programme are as follows :

To familiarize the participants with overall policy analysis, planning and
formulation process

To critically examine various dimensions and issues related to HIV/AIDS policies
and programme implementation

To develop basic skills of operational management in the management of the
HIV/AIDS prevention and control programme in the regional perspective

To help develop a matrix of policy issues and strategic management interventions
in their own country’s perspective.

DURATION

The programme will be offered for a period of one week (5 days) during June
20-24, 2005.

PARTICIPANTS

The number of participants is limited to 20. The programme addresses the
competency needs of policy and decision makers and programme managers in policy
review and analysis, and programme management knowledge and skills.

CONTENTS

The course will cover the following broad areas :

Review of the global efforts being mode in HIV/AIDS related policies and
programmes

Approaches to policy analysis and planning

Policy initiatives and programme management issues

Planning, implementation, monitoring and evaluation in HIV/AIDS

Role of non-governmental organizations and the private sector

Financing of HIV/AIDS programme initiatives

Quality of care

Leadership and management in HIV/AIDS prevention and control

TRAINING APPROACH

The training will be participatory and issue-based. There will be an optimal mix
of lecture sessions, group work and discussions.

The participants will be given exposure to field and programme management at the
provincial and district levels. They will be administered selected HRD
instruments to analyze their own leadership and managerial styles. They will be
asked to prepare a policy matrix and plan of implementation for their respective
areas/countries and present it in the group. A pre- and post-training evaluation
will be conducted and expectations of the participants will be elicited.

FACULTY AND RESOURCE PERSONS

The programme will be conducted by highly experienced international experts and
the faculty of the Indian Institute of Health Management Research and programme
managers in India.

The Programme Co-ordinators are : Dr. S.D. Gupta, Director;
Dr. N. Ravichandran, Co-ordinator; Dr. Ch. Satish Kumar, Co-ordinator

COURSE FEE AND TRAVEL

The course fee, board and lodging and travel expenses will be paid by the MTSD,
Commonwealth Secretariat. Accommodation will be provided on twin sharing basis.

VENUE

Indian Institute of Health Management Research (IIHMR)
1, Prabhu Dayal Marg, Sanganer Airport, Jaipur-302 011, India
Tel. : (91) 141-2791431-34, Fax ; (91) 141-2792138
E-mail : iihmr@..., URL : www.iihmr.org, Gram : Healthinst

APPLICATION PROCEDURE AND DEADLINE

The applicants are requested to fill the attached application form. (The
application form may be photocopied or downloaded from the website :
www.thecommonwealth.org OR www.iihmr.org)

Interested persons are encouraged to apply as soon as possible to allow enough
time for visa and travel arrangements.

Please send in the application form by May 15, 2005 to the Commonwealth
Secretariat with a copy to the Director, IIHMR on the following address :

Commonwealth Secretariat IIHMR
Management and Training Service Division (MTSD) 1, Prabhu Dayal Marg
Marlborough House, Pall Mall, London SWIY 5 HX    Sanganer Airport, Jaipur-11,
India

Tel. : 44 (0) 20 7747 6343 Tel. : 91-141-2791431, 32, 33, 34
Fax : 44 (0) 20 7747 6540/6335 Fax : 91-141-2792138
E-mail : sdgupta@...; iihmr@...


International Training Programme on
Policy Concerns, Planning and Management in HIV/AIDS Jaipur, India
June 20-24, 2005

APPLICATION FORM

APPLICANT : Mr.     ,  Mrs.     ,  Ms.     ,  Dr.

Family Name ..............................
First Name ................................

  Home Address ..............................

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

Tel. : ..................................... Fax :
......................................

  Workplace Address .....................

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

Tel. : ............................... Fax : ................................

E-mail : .................................

City (+city code) ............................ Country
.................................

Citizenship ...................................
Passport No. .........................

Date and Place of Birth ......................

Location (city, country) ....................

  Present Work in HIV/AIDS

Job Title ..................................

Job Description ...........................

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

  Sponsoring Agency/Government

Name ................................
Address .............................

Tel. : ................................ Fax : ................................

E-mail : ...........................

City (+city code) ................... Country .............................

  Date ..........................                        Signature
......................

  Please attach the following to this application form

(Failure to complete this form may result in rejection)

1. Typewritten sketch biography, not exceeding 300 words

2. Please provide a brief description of three challenges in your program that
you plan to address with the skills learned in this course.

The deadline for aplication is May 15, 2005.

`A New Beginning' : A book written by Dr.R.H.Uzgare for HIV infected
persons was released in Mumbai on 10th March 2005 by Mr. Sanjay Suri
(Film: My Brother Nikhil). Other speakers at the function were Mrs.
Sathya Saran (Editor: Femina), Ms. Dipannita Sharma (Model and
Actress), Mr. Arun Kumar Khanna (Director: Emcure Pharma).

The book has foreword by Prof. Suzanne Crowe, Australia.

FOREWORD

The fight against AIDS in India requires an array of approaches, from the
sharing of local experiences between health care workers and their patients and
families, the breakdown of stigmatizing attitudes which prevent individuals
coming forward for testing and counseling, the local development of
cost-effective therapies, right through to in depth and critical analysis by
physicians and government of the knowledge and experiences gained by other
countries during their fight against this global pandemic.

There is a direct relationship between level of knowledge and prevention of
transmission and it is recognized that for education to be successful the facts
must be relevant to the local audience.

Thus this book, written by a compassionate and well-informed physician who
specializes in the care of individuals infected with the human immunodeficiency
virus, will provide an overview of HIV/AIDS which is relevant for people living
with this virus in India. It is written in a very readable style, with Dr
RajshekharUzgare's descriptions of numerous encounters with
his patients  in order to illustrate the points he wishes to make,
the issues which frequently arise in his clinic, the questions
commonly raised by his patients.

Dr Rajshekhar Uzgare covers all the issues so often shirked by other authors
because of their difficulty:
paediatric HIV infection, the HIV-infected pregnant woman, which
vaccines are safe for an HIV-infected person, and when should
antiretroviral treatment commence?   HIV/AIDS is incredibly complex.

Before his untimely death, Jonathan Mann,  the champion for human
rights in the fight against AIDS who established the World Health
Organization's Global Programme on AIDS, often used to quote Sir
William Osler "The physician who knew syphilis, in all of its
manifestations, knew medicine".  The spectrum of clinical
manifestations which may present as HIV infection indeed is so broad
that it  often results in the diagnosis of HIV infection being
missed.

It is an astute physician, with plenty of experience, who
understands HIV-related disease and considers the possibility with
virtually each and every patient who presents to the clinic.  His
thirteen years of experience in India in the practice of HIV
medicine, as well as his training and attendance at conferences
abroad,  has provided Dr Rajshekhar Uzgare with a level of knowledge
which, in the context of an expanding epidemic in rural and urban
India, will go a long way towards the education of both individuals
with HIV infection, and those health care workers treating them.

Suzanne Crowe
Professor of Medicine and Infectious Diseases, Monash University,
Melbourne.
Senior Consultant physician, Alfred Hospital Melbourne.
Head, HIV Pathogenesis and Clinical Research program, Burnet
Institute, Melbourne.

The book has following chapters –Laboratory diagnosis of HIV, Signs
and Symptoms, Counseling, Transmission, Prevention, Immunisation,
When to start treatment, Treatment(HAART and ART)- for HIV patients,
PMTCT, PEP, Paediatric HAART, Salient features of HIV, Diet,
Principles of counseling. Keywords are indexed at the end.

Book is priced Rs. 50/-
Available in Mumbai at Strand Book House (Flora Fountain, Fort),
Ideal book Depot, Dadar(W), Sharayu(R mall), Mulund(W) and other book depots. It
can be obtained by e-mail (druzgare@...) or phone(022-25681628, cell
9821137077)

This book was also presented to Mr. Kenneth Kaunda (Ex-President of
Zambia) on March 11 at a meeting in Mumbai. The book will be useful to
Seropositive persons, NGOs, patients, doctors, heath-care workers and patients'
families. It has the latest recommendations on HIV management.

Sharmila S. Kurian
E-mail: <shamiru@...>

Aussies prey on tsunami children
Kathryn Shine.April 16, 2005

ABOUT 20 convicted pedophiles tried to travel to Indonesia and
Thailand immediately after the Boxing Day tsunami to prey on
vulnerable, displaced children.

The pedophiles were forced to tell police they planned to travel
overseas, under the rules of the new national child sex offender
register.

Their details were forwarded to Thai and Indonesian authorities, who
are understood to have refused them entry to their countries.
NSW, Queensland, Victoria, Western Australia and the Northern
Territory have established registers that link to the national
database. The other states are due to join the scheme by the end of
the year.

Detective Senior Sergeant Martin Voyez, who heads the West
Australian register, said about 20 registered pedophiles from around
Australian attempted to travel to Thailand and Indonesia earlier
this year.

"After the tsunami, a large number of Indonesian and Thai children
were displaced and became very vulnerable," he said.

"This attracted a higher number of pedophiles to those areas than
usual.

"The details of the pedophiles on the system were communicated to
the Indonesian and Thai authorities.

"We know that countries, including Thailand and Indonesia, do not
allow people on sex offender registers to travel into their
countries.

"They would not give them a visa or they would turn them away at the
airport."

The Australian Federal Police, who are responsible for relaying the
information to overseas authorities, would not release details of
specific cases nor confirm whether they had notified their
Indonesian and Thai counterparts.

An AFP spokesman said the organisation regularly passed information
about pedophilia to police forces within the region. The Weekend
Australian understands that although the AFP relays the information,
it is not always made aware of the outcome of its advice.

Child Wise national director Bernadette McMenamin said she was
delighted Australian authorities were working to prevent child abuse
at home and overseas.

"The register is great," she said. "This is such an improvement but
I would like to see it go further."

"If the offenders are considered to be very high risk they should be
refused the right to leave the country."

Ms McMenamin said Child Wise and other international child
protection agencies held grave fears for children left orphaned and
homeless after the tsunami. "There's no doubt the children are
extremely vulnerable and there has been an increase in trafficking,"
she said.

Under the rules of the national register, convicted pedophiles are
required to tell police where they live and work, what car they
drive, when and where they plan to travel and to what clubs or
associations they belong.

The maximum penalty for failing to register is a two-year jail
sentence and a $12,000 fine.

People must report to police within seven to 28 days of leaving
custody, depending on the state in which they live.

NSW, which was the first state to establish a register, has 1800
pedophiles on its list, while Western Australia has 140, Victoria
138, Queensland 58 and the Northern Territory six.

Police expect 15,000 pedophiles to be registered nationally by the
end of the year.

Only people who were in custody for child sex offences or convicted
of pedophilia when their state legislation was enacted are required
to register. However, the West Australian Government has moved to
expand the state register to include anyone convicted of pedophilia
in the past eight years. Detective Senior Sergeant Voyez said most
pedophiles readily complied with the registering and reporting
obligations.

"Pedophiles are notoriously compliant," he said.

Many recognised the need for a register and some who were not
legally required to provide their details to police had done so
anyway.

"Pedophiles are at high risk of re-offending," he said.
"A vast majority will reoffend. If they are aware they are being
monitored and managed, that's a deterrent. In itself it is not going
to stop people re-offending but it will minimise the risk."

The information on the national register is available only to a
limited number of specialist police. Authorities decided not to make
the information public to avoid vigilantes targeting people with a
history of pedophilia.

http://www.theaustralian.news.com.au/common/story_page/0,5744,1287146
6%255E2702,00.html

[7th ICAAP: Scholarship Announcement]

We,  the Scholarship Committee of the 7th ICAAP to be held in Kobe Japan between
Friday, July 1 and Tuesday, July 5, are pleased to inform you that the results
of  the scholarship selection were sent to applicants by  e-mail, fax, or postal
mail last week.

Scholarships are meant to support and promote participants to join
the opportunities to share ideas and experiences, learn skills and best
practices, and bring what they obtained at the conference
back to their communities and fields.

In the selection process, we tried hard to be very sensitive for applicants'
vulnerability such as HIV status, gender, sex workers, drug users, indigenous
people, and sexual orientation.  And the results reflect them, we believe.

We have been trying hard to secure as many scholarships as possible to  make its
meaning possible. However, we would like you to know that we haven't been able
to award so many scholarships due to the following difficulties:

-Total budget/income of the conference is not so high so far and the
Local Organizing Committe is still in difficulties to raise money.

-Cost of the expenses for scholarship in Japan is very expensive.

So, we tried our best to make the number of awardees biggest by doing
the following action.

*In the beginning, we set 20% percentage of the total budget, which
is likely same as 6th and 5th ICAAP for scholarship budget.  And at
last we hit the target.

*By having negotiations with agencies many times, we discounted
some items of scholarship, and finally we increased 30 awardees more
at last minute.  Also, we prioritize for providing FULL scholarship to
make sure awardess can stay without worries.

We have about three months to have the ICAAP, and we look forward
to welcome all the people and to have honor of your attendance at
this exciting and informative congress in Kobe.

Cordially yours,

Masao Kashiwazaki
Chair, 7th ICAAP Scholarship Committee
E-mail: <icaap7@...>