INVITATION  AIDS_ASIA e FORUM.

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Please review the archived messages on the following url

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Dear FORUM,

Dr. Kamarudheen raises some important questions, but I think his premise is
faulty.

Condoms are proven to drastically reduce the risk of HIV infection.
Clearly, encouraging people to make understand the choices they have, creating a
sense of self-empowerment, can help those who wish to to reduce the number of
partners, be faithful and so forth. The premise that no one is suggesting
partner reduction is false.

The problem comes in when "abstinence only" or "guilt-tripping" are the
policies. These are foolish and largely ignored by the very audience they are
intended to affect. "Just say No" as a "policy" for substance abuse (whether
cigarettes or heroin, etc.) does not work. Harm reduction does.

Dr. Kamarudheen also raises an extremely important point with regard to the 
rights and challenges of women (and men) in many societies. Many women (and men)
do not choose or wish to be sex workers. Nor do many wish to be in sweat shops,
whether in India, the United States, Jordan or anywhere.

On a global level, FAIR trade agreements that assure workers' rights and safety
should be the basis of the New Global Economy. This includes protecting, not
prosecuting, sex workers. Criminalizing the trade only makes it more lucrative
for the unscrupulous. Encouraging trade unions can protect sex workers and
provide opportunities for women (and men) who wish to find other careers and
life opportunities.

They also can give more strength to encouraging that male clients of women (and
men) sex workers use condoms.

These are rational approaches. However, there is a squeamish, often
propelled by misconstrued attitudes that arise in most faiths of the world that
the "sins" must be condemned. Such condemnation merely acts, sadly, as fuel to
the fires that retain the concept of these activities as sins.

And the cycles of pain, abuse and infection spiral and persist.

I hope you will consider these ideas--

George M. Carter
e-mail" <fiar@...>

Dear FORUM,

Dr Kamaudeen asked a very reasonable question. "Why  nobody is promoting safe
sex by avoiding it with strangers and avoiding
multiple partners so that the disease rate can be reduced to a vast  amount?"

Good question. You are talking about primary prevention as distinct from  risk
reduction. Both approaches are obviously needed, but the former has been
curiously absent in global AIDS prevention until very recently, when some
prevention activists began agitating for the inclusion of programs to discourage
having multiple, concurrent sex partners. (I won't even mention abstinence for
youth because too many people will stop reading this note if they see  the
controversial A-word...)

Here are some papers (and a book) to  read:

True, this literature is mostly about Africa, but the  findings pertain to  the
general (not-currently-at-risk) populations of  Asia, and everywhere Expect 
denunciations of this e-mail to follow; expect primary prevention to be called 
"abstinence-only," and "bad for women" and "impossible for real people," but I 
urge you to read the literature and decide for yourself.

Edward Green
Harvard Univ.
E-mail: EGreendc@...




Halperin, DC, M Steiner, M Cassell, EC  Green, D Kirby, N Hearst, H. Gayle "The
Time Has Come for Common Ground on  Preventing Sexual Transmission of HIV."

The Lancet. Vol. 364 November 27, 2004,  pp 1913-1915; 
_http://www.iasociety.org/images/upload/Lancet%20HIV%20prevention.pdf_

(http://www.iasociety.org/images/upload/Lancet%20HIV%20prevention.pdf)

(Kaiser  summary at:
_http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=1&DR_ID=26931_
(http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=1&DR_ID=26931)

Green, E.C., Rethinking AIDS Prevention. Westport,  Ct.: Praeger (2003).
_http://www.greenwood.com/books/BookDetail.asp?dept_id=1&sku=T316&imprintID_
(http://www.greenwood.com/books/BookDetail.asp?dept_id=1&sku=T316&imprintID) =

Shelton, J.D. (2005). Partner Reduction  Remains the Predominant Explanation.
(Letter) BMJ March 9,  2005, p. 496.
_http://bmj.bmjjournals.com/cgi/eletters/330/7490/496-a#99730_
(http://bmj.bmjjournals.com/cgi/eletters/330/7490/496-a#99730) ; Uganda MOH.
(2005).

Shelton J.D., Halperin D.T., Nantulya  V., Potts M., Gayle H.D., Holmes K.K.
Partner reduction is crucial for balanced "ABC" approach to HIV  prevention.
British Medical Journal, 328(7444):891-94
(http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7444/891)

Green, E.C. and Kim Witte, Fear  Arousal, Sexual Behavior Change and AIDS
Prevention. Journal of Health  Communication 11:245-259, 2006, pp 245-259)
_http://www.gwu.edu/~cih/journal/JHClink/v11n3_green.pdf_
(http://www.gwu.edu/~cih/journal/JHClink/v11n3_green.pdf)

Green, E.C. and A. Herling,  The ABC Approach to Preventing the Sexual
Transmission of HIV Common Questions and  Answers. Washington, D.C.: May 2006
Christian Connections for  International Health,
_http://www.ccih.org/Primer%20on%20ABC/ABCdocFINAL5.26.06.pdf_
(http://www.ccih.org/Primer%20on%20ABC/ABCdocFINAL5.26.06.pdf)

Green, E.C., D.H. Halperin, Vinand Nantulya, Janice Hogle.  “What Happened  to
Reduce HIV Prevalence in Uganda? AIDS and Behavior, May  2006.
_http://springerlink.metapress.com/(1dft0c55xtqmy4j0w03em545)/app/home/contrib
ution.asp?referrer=parent&backto=searcharticlesresults,1,2_
(http://springerlink.metapress.com/(1dft0c55xtqmy4j0w03em545)/app/home/contribut\
ion.asp?referrer
=parent&backto=searcharticlesresults,1,2) ;

Green, E.C., “Culture Clash and AIDS Prevention.” The Responsive  Community.
  Vol. 13(4); 4-9  2003.
_http://www.aidsuganda.org/pdf/Comments_on_ABC1.pdf_
(http://www.aidsuganda.org/pdf/Comments_on_ABC1.pdf)

Green, E.C., R. Stoneburner, N. Hearst. (2004). Evidence that Demands  Action.
Introductions by Secretary, DHHS, the Global AIDS Coordinator, and  the CDC
Director.  Dallas, Tex., The  Medical Institute for Sexual Health. (reprinted
2005)
_http://www.medinstitute.org/evidencemonograph.pdf_
(http://www.medinstitute.org/evidencemonograph.pdf)

Green, E.C., Faith-Based  Organizations: Contributions to HIV Prevention.
Washington, D.C.: USAID/Washington  and The Synergy Project, TvT Associates,
Washington, D.C. (Sept. 2003). USAID  Contract Number: HRN-C-00-99-00005-00.
_http://www.synergyaids.com/documents/FBOpaperFINAL.pdf_
(http://www.synergyaids.com/documents/FBOpaperFINAL.pdf)
Hearst, Norman and Sanny Chen, Condom  Promotion for AIDS Prevention in the
Developing World: Is It Working? Studies In  Family Planning 2004;35 [1 ]:39
-47);
_http://www.usp.br/nepaids/condom.pdf_ (http://www.usp.br/nepaids/condom.pdf)

Stoneburner, Rand L. and Daniel Low-Beer,  "Population-Level HIV Declines and
Behavioral Risk Avoidance in Uganda." 30  April 2004 Vol 304 Science, Pp
714-18;
editorial by Dr.  David Wilson, in the British Medical Journal:
_http://bmj.bmjjournals.com/cgi/content/full/328/7444/848_
(http://bmj.bmjjournals.com/cgi/content/full/328/7444/848)


article on partner  reduction/the "missing B in ABC" (co-authored by King
Holmes, Helene Gayle,  et al), also in BMJ, that Wilson comments on:
_http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7444/891_
(http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7444/891)
Helen Epstein, "The  Fidelity Fix";
_http://www.nytimes.com/2004/06/13/magazine/13AIDS.html_
(http://www.nytimes.com/2004/06/13/magazine/13AIDS.html)
(NY Times)

Hayes,  Richard and Helen Weiss, “Enhanced: Understanding HIV Epidemic Trends
in  Africa.”
_http://www.sciencemag.org/cgi/content/full/311/5761/620?maxtoshow=&HITS=10&hi
ts=10&RESULTFORMAT=&fulltext=zimbabwe&searchid=1138923040026_15772&FIRSTINDEX=
0&journalcode=sci_
(http://www.sciencemag.org/cgi/content/full/311/5761/620?maxtoshow=&HITS=10&hits\
=10&RESULTFORMAT=&fulltext=zimbabwe&searchid=113892304002
6_15772&FIRSTINDEX=0&journalcode=sci)

Green, E.C. and A. Herling, "Controversies over the ABC  Approach to AIDS
Prevention." Journal of Medicine and The  Person.
Kajubi P, Kamya M, Kamya S, Chen S, McFarlandW, Hearst N.  Increasing condom use
without reducing HIV risk: results of a  controlled community trial in Uganda. 
J Acquir Immune Defic Syndr 2005;40:77-82.

Low-Beer, D. (2002, November 30). HIV-1  incidence and prevalence trends in 
Uganda [Letter]. Lancet, 360 (9347): 1788;
Okware, S., Opio, A., Musinguzi, J., &  Waibale, P. (2001). Fighting
HIV/AIDS: Is success possible? Bulletin of the  World Health Organization, 79,
1113-20.

Okware, S ., J Kinsman, S Onyango, A Opio and  P Kaggwa, Revisiting the ABC 
strategy: HIV prevention in Uganda in the era of antiretroviral therapy.
Postgrad. Med. J. 2005;81;625-628.

Richens, J., Imrie, J., H. Weiss (2003). Sex  and death: why does HIV  continue
to spread when so many people know about the  risks?  J. of  R. Statist Soc
A 2003;166, 207-215;

Richens, J., Imrie, J., & Copas, A.  (2000). Condoms and seat belts:  the
parallels and the lessons. Lancet, 29, 400.
Moore, David M and Robert S Hogg, "Trends in  antenatal human
Immunodeficiency virus prevalence in Western Kenya and Eastern  Uganda: evidence
of differences in health policies?" International Journal of  Epidemiology
2004;33:542-548;

Halperin, DH, and Helen Epstein, “Concurrent  sexual partnerships help to
explain Africa’s high HIV prevalence: implications  for prevention.” The
Lancet Vol  364 July 3, 2004, pp. 4-6;

Muhwezi,J., “Uganda HIV/AIDS  Sero-Behavioural Survey 2004-05 Preliminary
Report.” Ministry of  Health, Kampala, Uganda, June 2005.

Kajubi P  et al. Increasing condom use without reducing HIV risk: results of a 
controlled community trial in Uganda. J Acq Immune Defic Syndr 40 (1): 77-82,
2005.

Gregson, Simon, Geoffrey P.  Garnett, Constance A. Nyamukapa, Timothy B. 
Hallett, James J. C. Lewis, Peter R. Mason, Stephen K.  Chandiwana, Roy M.
Anderson, "HIV Decline Associated with  Behavior Change in Eastern Zimbabwe"
Science 311,  664  (2006).

Asian NGO delegates report  to the UNAIDS PCB

18th UNAIDS Program Coordinating Board (PCB) meeting opened in
Geneva to review the work of the UNAIDS for the last year and to
plan for the next "25 years".

UNAIDS is guided by a Programme Coordinating Board (PCB) which serves as its
governing body.  The PCB has representatives of 22 governments from all regions
of the world, the ten UNAIDS Cosponsors, and five nongovernmental organizations
(NGOs), including associations of people living with HIV/AIDS. UNAIDS is the
first United Nations programme to include NGOs in its governing body.  The PCB
holds a regular session once a  year in Geneva, and in alternate years holds
thematic sessions outside Geneva, as requested by the members. The 18 th PCB is
meeting  in Geneva, switerland  27-28 June 2006. The following is the relevant
excerpts from the Asian NGO delegates report  to the UNAIDS PCB.  [Moderator]

Introduction

The nongovernmental organization (NGO) Delegation of the UNAIDS
Programme Coordinating Board (PCB) presents to the 18th meeting of
the PCB this annual report highlighting the major concerns and
recommendations regarding HIV and AIDS. It is requested that the PCB
takes note of this report and takes specific steps to manifest the
recommendations outlined in each region.

It is our intention to communicate to this high level forum, the
identified trends around HIV and AIDS and highlight the main
problems and obstacles faced by people living with HIV and their
organizations.

Through a call for responses, civil society representatives from the
five regions identified key issues around stigma and discrimination,
policy towards HIV and needs around partnership and sustainability
affecting their work progress.

With the five-year review of the UNGASS Declaration of Commitment on
HIV/AIDS in 2006, this is a key year in AIDS policy definition. It
represents a challenge but also a unique opportunity to reinvigorate
the necessary commitment and support to fight the pandemic.

We believe that a capable and sustainable global response to the
AIDS epidemic is not possible without the incorporation of the
voices, vision and full participation from those who are directly
affected by the pandemic and their representatives from civil
society.

Nothing here is particularly new. We are all too familiar with the
vast majority of issues, trends, obstacles and shortfalls we report
year after year.

Almost all of the progress made each year is quickly subsumed or
overcome by increases in infections or infection rates and the
number of deaths globally. With rare exception governments the world
over miss progress targets and commitments for financial support
year after year.

What would be new to report is that every leader of every nation had
the political will to rally his or her government and people to
address the realities of their respective epidemics. Sadly, this is
still widely and sorely lacking in many parts of the world.

We all already know the challenges and, for the most part, know how
to solve the problems. What persists�and is almost never measured or
reported�is the lack of political will of our leaders to honestly
face the realities of HIV and AIDS, publicly confront stigma and
discrimination, and finance the implementation of what we already
know works.

In 2004, more than 3 million lives were tragically and unnecessarily
lost. Until we all�nongovernmental organizations, governments, and
international institutions alike�truly work together, this will
continue to be the case.

Asia Pacific regional report

Epidemiological situation

At the end of 2005, 8.3 million people were infected with HIV in the
Asia Pacific region, representing 20% of the total number of people
living with HIV in the world. Out of this number, half a million
people died in 2005 and 1.1 million people became newly infected.

This region makes up 60% of the world's population, of which China
(20%), India (15%)and Indonesia (4%) are predicated to be countries
with generalized HIV epidemics if effective prevention measures are
not scaled up. India, which has an estimated 5.1 million people
living with HIV and China, which could have an estimated 10 million
people living with HIV by 2010�will overtake Africa with the most
compelling problem if the risks are not mitigated. Moreover, the
epidemic has yet to emerge as a menace in areas such as the pacific
islands, but holds great threat to the sustainability of the
response due to the lack of funding because of the ostensible size
and scale of the situation.

HIV is a long-term threat to economic growth and development, and if
infection trends continue to rise, it will have an immense impact on
the economic growth of the region. A joint UN-Asian Development Bank
study estimates economic and financial annual losses could reach US$
17.5 billion by 2010.

In all affected countries in the region, the epidemic adds
incremental pressure onto the health sector of developing countries
(China and South-East Asia), which has had to cope with the SARS
outbreak in 2003, and more recently the Avian Flu.

The ambitious "3 by 5" plan of WHO and UNAIDS of treating 3 million
people living with HIV by the end of 2005 was not fulfilled;
however, significant improvements (with the exception of prevention
of mother-to-child transmission services) extending prevention and
care for sexually transmitted infections, counselling and testing,
and HIV treatment and care, strains health budgets, infrastructures
and systems.

As the epidemic moves from localized areas to becoming more
generalized, the urgency for prevention is still far from being
realized in many populations including young people, women
(especially since a significant proportion of new infections occur in
women who are married and infected by husbands, and mother to child
transmission), injecting drug users, sex workers and their clients,
men who have sex with men, and migrant workers.

Stigma and discrimination against people living with HIV remain the
greatest obstacles to a successful response 25 years into the
epidemic. The confidentiality breaches of people living with HIV's
in health-care settings, and the refusal of medical treatment by
healthcare personnel upon learning the HIV-positive status of
individuals, deter many from accessing the services they need.

Intervention and information programmes which mitigate prevention,
treatment and care services for marginalized populations continue to
be few. Meaningful involvement of people living with HIV is at least
equally rare.

Moreover, commitments on paper frequently do not translate into real
protection for HIV-positive people. While an estimated one half of
countries surveyed in the region has adopted legal frameworks to
prevent HIV-related discrimination, only one third has legal
measures in place prohibiting it. Furthermore, most countries lack
institutionalized human rights monitoring systems capable of
routinely detecting and reporting violations to national authorities.

Recommendations

A better collaboration is needed between WHO, UNAIDS, bilateral
donors and funding donors, with clear assignment of responsibilities
and detailed national plans for treatment scale-up with the
inclusion of governmental commitment and leadership�to move from
commitment to action.

There is a need to improve in-country visibility of WHO and UNAIDS
and the limited coordination with civil society. This includes the
scale up of resources and technical support required, from
organizational development, monitoring and evaluation, to programme
implementation of civil society organizations.

Reform laws that collide with current National AIDS policies, with
alignment to access vulnerable populations or they will disable core
principles and values of empowerment and participation of the
marginalized groups;

The response to AIDS in Asia and the Pacific should become an
international priority with milestone-driven action plans to
accelerate intergovernmental cooperation, development and
implementation of strategic plans to strengthen the regional
response, and mobilization of financial and technical resources.

Recognize that women are most vulnerable to HIV by incorporating and
fully integrating gender equality and equity across all programme
areas, and through advocacy and political commitment, financing and
resources, human rights, commodities, services and partnerships,
with resources made available for continued research and development
of new preventive technologies such as microbicides.

Accountability at all levels�government, civil society and donors�
has to be clearly defined, with current mechanisms strengthened or
developed, tracking the efficiency of funds.

Scale up the provision of care, treatment and support to people
living with HIV at all levels and to all groups, including
antiretroviral treatment as well as treatment for opportunistic
infections.

ASIA/PACIFIC NGO representatives to UNAIDS PCB

Main NGO representative.

Ms Rachel Ong
Asia Pacific Network of People Living with
HIV/AIDS (APN+)

C/o UNAIDS Office
1-162 Tayun Diplomatic Office Building
14 Liangmahe Nanlu, Dongwai Daijie
Beijing 100600, CHINA
Email: rachel.ong.pcb@...


Alternative NGO representative
Mr Bhawani Shanker Kusum
Gram Bharati Samiti (GBS)
Secretary and Executive Director
Amber Bhawan, Amber 303 101
Jaipur, INDIA
E-mail: gbsbsk@...

http://data.unaids.org/pub/Report/2006/PCB_18_06_4_en.pdf

Dear FORUM,

I have some importan questions?

Everybody is promoting use of condom for prevention of AIDS- and weeps about the
failure that some are not using it on every occasions.

Why nobody is promoting safe sex by avoiding it with strangers and avoiding
multiple partners so that the disease rate can be reduced to a vast amount? Is
sex with multiple partners and sex with prostitutes a must for males? Is sex  a
"matter" of concern only of males? If there are female sex workers, why there
are no male sex workers to sastisfy the "thirst" of poor female community?

It means that free sex is a requesit of male community. Nobody is ready to find
the "evil" of free sex and compelling females as sex workers. I know females who
had ambitions to be doctors, teachers, accountants, pilots, drivers and computer
experts and so on...not yet come across with a single girl having ambition to be
femelae sex worker... most of them are trapped into this "profession". Yet we
promote it and help to spread the disease and are moaning out side the compond
wall. Why can't we fight against two evils at a stretch- female victimisation
and AIDS?

Dr. Kamarudheen A.I,
Kerala, India
E-MAIL- <drkamaru@...>

JOB DESCRIPTION:  HIV/AIDS TECHNICAL ADVISOR FOR CHINA
CATHOLIC RELIEF SERVICES

SUMMARY

Catholic Relief Services (CRS) requires an HIV/AIDS Consultant Technical Advisor
to provide on-site technical accompaniment to three CRS project partners in
mainland China to ensure that HIV/AIDS care and support services and prevention
education activities are consistent with global best practices.

RESPONSIBILITIES

With each of the three project partners, the Consultant Technical Advisor will
accomplish the following:

* Work with program staff to develop client-focused care and support programs.
* Develop detailed implementation plans and monitoring and evaluation plans.
* Develop all documentation associated with care and support services and
prevention education activities.
* Build skills of staff in counseling PHAs and their families.
* Build the capacity of program staff in developing and expanding strong support
networks for PHAs and their families.
* Build the capacity of program staff in setting up and managing outreach
visiting teams.
* Build the capacity of program staff in the clinical side of HIV/AIDS to better
serve clients.
* Build the skills of medically-trained program staff to conduct medical
check-ups of PHAs during home visits.
* Build the capacity of program staff in setting up and managing strong local
referral systems.
* Build the capacity of program staff in project planning, project management,
monitoring and evaluation and reporting.
* Conduct training needs assessments of program staff and develop customized
training plans based on results of the assessments.
* Build the capacity of program staff in conducting effective HIV/AIDS
prevention education.

LOCATION

Shijiazhuang, Hebei Province, PRC
Shenyang, Liaoning Province, PRC
Jilin City, Jilin Province, PRC

TRAVEL REQUIRED

The Consultant Technical Advisor  will spend at least 2 weeks on-site with each
of the three project partners every quarter.  Therefore, over a period of one
year, the Consultant Technical Advisor  will spend at least 24 weeks inside
China providing on-site technical assistance to CRS partners.

DURATION

This is a one year consultancy with an option to extend to three years upon
successful completion of the first year.

QUALIFICATIONS

* Extensive experience developing and managing client-focused support programs
for PHAs and their families.
* Extensive experience counseling PHAs and their families.
* Experience developing strong monitoring and evaluation systems.
* Cultural sensitivity.  Ability to build strong relationships.
* Experience with capacity building and mentoring others.
* Masters of Public Heath
* Medical Background:  Registered Nurse or Doctor
* Language:  High degree of fluency in spoken and written Mandarin Chinese and
English preferred.

CONTACT INFORMATION

Please send your CV together with an application letter by email to Elizabeth
McMahon at:  mcmahonelizabeth@...

Catholic Relief Services is the overseas relief and development agency of the
United States Conference of Catholic Bishops (USCCB) and the US Catholic
community.  It was founded in 1943 by the Catholic Bishops of the United States.
Currently, CRS reaches out to people on five continents and in 99 countries
around the world to alleviate human suffering and promote peace for poor and
disadvantaged people.


Natalie Kruse
e-mail <nkruselevy@...>

Exchange and Learning Workshop for Field Workers in HIV Prevention
Projects for Men having Sex with Men (MSM) in the Greater Mekong Sub-
region, 5-7 September 2006, Lao PDR

Introduction

Recently, several donors and international organizations (including
FHI, CDC, PSI, USAID, TREAT, POLICY, UNESCO and UNAIDS) have started
working together to better integrate and share lessons learned in
responses to the HIV epidemic among Men having Sex with Men (MSM) in
the region. A standardized 'comprehensive package of interventions'
was developed and agreed upon, a regional strategy paper and work
plan were developed and a regional Secretariat was established. To
date these efforts have focused on the programmatic and 'strategic'
level. Complementary to these immensely valuable efforts, UNESCO
would like to conduct a workshop bringing together field-level
volunteers, peer educators and outreach workers to explore what they
can learn from each other, and to provide some additional training,
if needed.

This workshop aims to bring together the men making MSM
interventions 'tick' - those who personally reach MSM at risk of
HIV/STI or caring for MSM already infected.

The workshop is an initiative of UNESCO. It is in line with the two-
year vision developed during the CDC/FHI/USAID regional MSM workshop,
in which UNESCO played a major role. It will be held in Vientiane,
Lao PDR, and will be logistically supported and organized by the
Burnet Institute. Funding support is provided by CDC and UNAIDS.

Objectives

� To share lessons learned, identify obstacles and propose solutions
in the work of field workers in MSM programs
� To discuss the issue of 'AIDS fatigue' and brainstorm about ways
to 'repackage' messages related to HIV prevention, promotion of VCT
and related to ART treatment
� To provide training and an update of the latest developments in
HIV/AIDS (including epidemiology in the region and new knowledge
about treatment and vaccine research, an update about theories of
behavior chgange supporting peer education and implications for the
field, different types of intervention, etc)
� To field-test a standardized set of test questions, which UNESCO is
now developing, that will be used as an examination tool for future
outreach workers and peer educators.

Geographical scope

The workshop will invite 10 peer/outreach workers from each of the
following 4 countries: Thailand, Lao PDR, Vietnam and Cambodia . It
is expected that there will be 2 lead facilitators, and a maximum of
5 observers, bringing the total number of participants to 47.

Translation
The language of communication is English. Since it is expected that
most participants will have limited English, translation facilities
will need to be available (Vietnamese, Khmer, Thai and Lao).

Date and venue
It is proposed to hold this workshop during the first week of August
2006.

Program
A detailed program will be developed soon, after inputs on these ToR
have been obtained from partner organizations.

For more information, please contact UNESCO Bangkok: either Srisuman
Sartsara (Kik) at s.srisuman@... or Jan Wijngaarden at
jwdlvw@...
..........
Posted By :Emdad Sheadhar
NeC,AIDS ASIA e News Letter
Bangladesh
e-mail: sheadhar_bd@...

Sub: Vote on amendments of the IAS Bylaws

The International AIDS Society (IAS) recently invited all IAS
members to vote on the proposed amendments of the IAS Bylaws.

It appears the bylaws presented by the Governing Council is not
adequate enough to ensure that IAS would remain as an apex agency
representing the best interest of Global AIDS response and to ensure
that this venerable agency will not be abused by any unscrupulous
governing council members or the administrative staff.

To strengthen the governance of IAS I would like to propose the
following amendments. IAS members who will be present at the XVI
International AIDS  Conference in Toronto in August are invited to
cast their votes on the following, proposed  amendments at the
General Members Meeting which will take place during the conference:

Date: 16 August 2006, Time: 20:15�21:45

Place: Session Room 9, Level 100, North Building of the Metro
Toronto Convention Centre (MTCC)

Or you may write to the IAS president Dr.Helene D. Gayle, By e-mail.
<info@...>

Proposed amendments:

1) Proposed article 6.5. IAS membership will note be terminated
without the benefit of `a due process'.

2) Proposed article 5.9. All the Governing Council members and staff
of IAS must declare their conflict of interest. In particular, their
interest with the Pharmaceutical industry.

3) Proposed article 7.2.1) All the beneficiaries of IAS (who receive
a benefit of more than $ 1,000 as benefit in the form of
scholarship, travel and consultancy fees) must be listed as a public
record

4) Proposed Article 6.6 IAS Governing council election must me
supervised by an impartial returning officer nominated by the
Governing Council

5) Proposed article 6.7 An detailed IAS Governing council election
procedure should be presented to the next IAS meeting.(Such as
preparation of a list of all eligible voters, proper demarcation of
the regions and appeal process)


Notes on the proposed amendments

1) The statement (6.5) "membership may be terminated without
indication of reason, by the recommendation of the Executive
Committee.�" is high hand and against the sprit of a professional
organization. This is only meant to stifle any genuine criticism.

2) Currently, there is no clause on "conflict of interest' which
bounds the conduct of the IAS leadership.

3)  As a matter of promoting greater accountability all the
beneficiaries of IAS needs to be identified and it should be a
public record

4) Currently the IAS Governing council election is mostly supervised
by a computer technician and the office staff of IAS. This would
lead to potential abuse and the violation of the privacy of the IAS
members

5)  Currently, the IAS Governing council election is conducted on an
arbitrary and flippant manner, mostly supervised by the office staff
of IAS. There are no specific details of the demarcation of the
region, list of eligible voters, right to canvas for votes.


Sincerely,

Joe Thomas
Moderator
AIDS AISA eFORUM

Links:

Current IAS Bylaws: http://www.iasociety.org/page_2.asp?pageId=1220
IAS Rules & Procedures: http://www.iasociety.org/page_2.asp?
pageId=1230

New sub type of HIV virus 'no cause for panic'
APINYA WIPATAYOTIN

News reports about a Thai woman contracting a new strain of HIV
virus is no cause for panic as it is a common occurrence, said
medical experts yesterday. ''Please don't panic about the new form
of viral combination. HIV/Aids can't harm you, if you know how to
prevent it. However, we have to closely monitor the viral
combination to prevent its spread,'' said Dr Prasert Tongcharoen,
the winner of this year's Mahidol University-B Braun award for
outstanding public health service.

Dr Prasert made the comment following local media reports that a
Thai woman, who was forced to offer sex services in Africa, was
infected with the new combined strain of the A/E and C viruses. The
finding, the country's first, has prompted the Department of Disease
Control to closely monitor the situation.

Dr Prasert added that the new combined strain was no more dangerous
than other strains. However, the country might be burdened with
extra expenditure for the development or purchase of effective anti-
viral drugs to fight the new strain.

Disease Control chief Dr Thawat Sundrachan also expressed concern
about the impact of the new strain on vaccine development. The
discovery of a new HIV strain in a Thai citizen was a warning sign
to health authorities that they not let their guard down against the
disease, he said.

''However, the viral combination might have an impact on our vaccine
production plan. Our current stock of vaccine was designed to be
active against only the HIV/Aids strains A/E and B. If we have new
viral strains, it might take longer to produce a vaccine for them,''
he said.

The A/E strain is the most widespread in Thailand affecting 98% of
the HIV/Aids patients, followed by the B strain. The C strain is
mostly found in Africa, China and India.

http://www.bangkokpost.com/News/21Jun2006_news15.php

[Moderators note: This study is being conducted with the active support of the
moderator.  Your participation in this study, though, it is voluntary, will be
appreciated. The result will be shared with the FORUM. Thank you]

Re: Research project trust and support in online communities

Dear member of the community AIDS ASIA e FORUM,

I would like to ask for your participation in a research project of the
Eindhoven University of technology (The Netherlands). This project analyzes the
exchange of support and the development of trust in communities on the internet.
You can be assured of complete confidentiality of your answers, which will
moreover be used for this research project only. Note that I would appreciate
your participation, even if you are an inactive user of the community.

Completion will take anywhere between 10-20 minutes. This is valuable time. But
it is not lost. The results of this project will be of use to every community
member interested in enhancing the development of trust between members. If you
would like to receive a short report of the results, please indicate this during
the filling out of the questions.

You can find the questionnaire at the following web site:
http://www.stkw.nl/communities/index.php?comm=78

When you enter the site, please copy and paste the following code: 78000

If you have any comments or questions, do not hesitate to contact me. I am ready
to reply and answer them. If you want to have background information about the
project, please have a look at
http://www.tue-tm.org/soc/matzat/teach/mgo3/communities.htm

As an appreciation of your support we will draw five lots for 10$ Amazon
email-vouchers among those who complete the questionnaire. Thank you very much
for your assistance.

Sincerely,
Marieke Kleemans
Faculty of Technology Management
Eindhoven University of Technology
The Netherlands
e-mail: M.A.A.Kleemans@...

Dear FORUM,

Rape and other forms of coercive sex are serious concerns worldwide. Some
countries have apparently very high levels of sexual violence. Well-sampled
studies are relatively few so it is difficult to make accurate comparisons.
Where levels of HIV are high and rape of vulnerable women, men or transgendered
people is common, we can expect that rape itself can become a risk factor for
HIV.

We are pleased to announce the publication of a study of sexual violence among
sex workers in Cambodia entitled �Violence and Exposure to HIV among Sex Workers
in Phnom Penh Cambodia�. It is available to be downloaded at:

http://www.alternatevisions.org/publications.htm

Carol Jenkins, PhD
Director
Alternate Visions
Krystal Court 10-2
23 Sukhumvit Soi 7
Bangkok 10110, Thailand
cell 66-(0)95103955
home/fax:66 (0)2-6550732
www.alternatevisions.org
e-mail: <hagahai@...>

Global Fund Partnership Forum, Durban, South Africa, July 1-3
Request for information on ARV access components of GFATM projects

The Global Fund Partnership Forum in Durban brings together about
400 Civil Society and government key actors participating in local
projects from around the world, as well as Global Fund regional
staff, and at least some Board Members from the Fund as well.  The
Global Fund is a key source of financial support for scaling up anti-
retroviral access worldwide.

The Partnership Forum meets every two years, gathering together a broad range of
global stakeholders to discuss Global Fund performance and to make
recommendations on its strategy and effectiveness. The Global Fund�s second
Partnership Forum will take place in July 2006.

The first was held in 2004 in Bangkok. Participants represent grant recipients,
civil society, donor and recipient governments, Board members, development
agencies, technical and research agencies, foundations, and the private
corporate sector. The aim is to engage both those who are closely linked to the
Global Fund's architecture and those who are not.

To focus stakeholder discussion and input, the 2006 Partnership Forum will have
four themes:

1. Global Fund architecture
2. Acceleration of grant performance
3. Harmonization of grants with national priorities and other development
partners
4. Sustainability of the Global Fund model and its funding

I will be attending the Durban meeting  and am very interested
in "Progress reports," especially from those who cannot attend,  but
also from those who will be attending,  about implementation of
GFATM projects in your country, and specifically focused on the
TREATMENT ACCESS components of the project.

Some questions include:

1) How many people are on treatment in your country (name your
country)  with Funds provided by the Global Fund?

2)Can you estimate how many need treatment in your country  but
don't have it?

3)  How much money has been allocated by the Fund for ARV access in
your country's project?  For which years of the project? When did
the project begin and in which phase is it.  First two years, or
second phase which is the following three years.

4)  How much has been utilized, and how much is still either in
Geneva or in the country, but not being utilized.

5) How many people are on treatment from other sources in your
country and what are these sources, i.e. PEPFAR, government funding,
private donations, etc.

6)  If there are problems, what seem to be the key obstaces that
exist with respect to your country's project in terms
of rapid implementation of the treatment access component in your
country.
a) slow procurement procedures by the Principal Recipent and/or
primary procurement agent(s)
b) high prices for certain products
c) lack of motivation by the CCM or Principal Recipient to
prioritize the treatment access component
d) intellectual property issues,  i.e. patents, free trade
agreements, etc.
e) lack of response/support from Global Fund core staff supervising
your project.
f) lack of Health Care "infrastructure" to deliver ARV's to the
target populations, such as lack of nurses and trained Doctors
g) "gaps" in the project, such as lack of funds for CD4 or Viral
Load testing
h)  co-payment  fees, also known as "user fees"  that may discourage
some PLWA's from going to treatment sites.
i)   delays in obtaining results of CD4 and Viral Load Testing
j)  lack of de-centralization, access only in urban areas.
k) government interference in implementation procedures (describe
how and what)

l)  local "licitation" legal requirements that override GFATM' s own
procedures
m) stigma and discrimination issues, not adequately addressed by the
project
n) temporary stock-outs of ARV's
o) discrimination against vulnerable populations: MSM, IV drug
users, women, sex workers, etc.
p)  other issues not mentioned above

Answers and/or  comments can be sent to me at rastern@....
Please indicate in the subject line: Re: GFATM.

My goal is to bring concerns about specific projects to the
attention of those present at the Partnership Forum, and I will work
with Civil Society Board members in order to do so, but, in any
case, I will look for the most appropriate methodology to
present these concerns in Durban.

If you want you can also just send your responses to me,
confidentially at this e-mail address.  I would of course like to
use the information that I receive, but would not mention the source
of the information if I am requested not to do so.

If you cannot answer some or even any many  of the questions, please
don't worry, just answer what you know about.  Or just send your
impressions or comments.

Sincerely,
Richard Stern
Director
Agua Buena Human Rights Association
San Jose, Costa Rica
Tel/Fax 506-280-3548
e-mail: rastern@...

Australian HIV cases on the rise: UN

By Tamara McLean, May 31, 2006

AUSTRALIA'S AIDS epidemic is not easing, with the number of annual
HIV diagnoses reverting to the alarming levels of the early 1990s, a
United Nations report has found.

The UNAIDS 2006 report, released today, estimated 16,000 adults and
children were living with HIV in Australia in 2005.

Annual new HIV diagnoses declined in the late 1990s but are now
approaching earlier levels, with 820 diagnosed in 2004, the report
said.

Unprotected homosexual sex was largely responsible for the rise in
new infections.

"While HIV infection levels remain low across Oceania, Australia's
long-established AIDS epidemic is not dissipating," the report
states.

"Newly-acquired HIV infections, largely attributable to unprotected
sex mostly between men, are increasing, which plausibly reflects a
revival of sexual risk behaviour."

National HIV infection trends appeared to be similar among
indigenous and non-indigenous people.

However, the report cited a recent study which revealed
notifications among indigenous Australians in Western Australia
increased in 1985-2002 and decreased for other groups.

Indigenous women were found to be 18 times more likely to be HIV-
infected than non-indigenous women, and three times more likely than
non-indigenous men, it said.

Unsafe drug injecting was responsible for one in every five HIV
diagnoses in indigenous Australians, compared with two per cent for
non-indigenous people.

"These trends underline the need to revamp prevention, diagnosis and
treatment efforts so that they reach all at-risk and affected
sections of the population," the report said.

Australia's HIV trend contrasted with the rest of the Oceania
region, where levels remained low.

Annual new diagnoses in New Zealand had more than doubled since
1999, from fewer than 80 to 183 in 2005, but adult HIV prevalence
remained very low at under 0.2 per cent, the report said.

Papua New Guinea showed "alarming rates", accounting for more than
90 per cent of HIV infections when Australia and New Zealand were
excluded.

Gabe McCarthy, president of the National Association of People
Living with HIV/AIDS (NAPWA), said the report was internationally
embarrassing for Australia.

Increased rates of HIV were largely due to a new cultural
conservatism which has left many Australian less likely to access
information needed to engage in safe sex, Ms McCarthy said.

"And we must not forget that since the advent of effective
treatments for HIV there are more people with HIV living than ever
before, so the number of occasions when an accident could happen are
increased," she said.

But social research did not indicate that sexual promiscuity and
carelessness were necessarily on the rise, she said.

NAPWA believed both commonwealth and state governments had not shown
enough commitment to the AIDS problem.

"We need an active partnership with the affected communities but
that's been significantly eroded over the last few years," Ms
McCarthy said.

Last year, the commonwealth and state governments signed an $812
million national public health agreement to fund programs dealing
with drug misuse, sexual health, HIV/AIDS and blood-borne diseases.

http://www.theaustralian.news.com.au/story/0,20867,19317866-
23289,00.html

Dear Forum,

Please see this letter to the editor of the Washington Post in response to this
article. Thank you - Peg Willingham, International AIDS Vaccine Initiative

Washington Post, Wednesday, June 7, 2006; A22
An AIDS Vaccine Is Still Worth Seeking

The Post's coverage of AIDS vaccine research and development ["AIDS
Vaccine Testing Goes Overseas," front page, May 22] represents the kind of
healthy debate that benefits the field overall. Clearly, with the number of new
HIV infections climbing to 4.1 million each year, a vaccine remains the best
hope of reversing the pandemic.

Yet while I agree that HIV is often an underestimated adversary, I take issue
with the article's general premise that the virus is unassailable and that
efforts to find new technologies to stem its spread are futile.

Today scientists think that an AIDS vaccine is challenging yet possible.

More than 30 vaccine candidates are undergoing early trials on four
continents. We've found that AIDS vaccines can protect monkeys from the simian
equivalent of HIV and that virtually all persons' immune systems can keep the
virus in check for a number of years, some for more than two decades.

Thanks to increased political and financial commitments, new scientific
consortia formed by leading HIV researchers are tackling the most crucial
scientific questions. One involves designing vaccines that can elicit antibodies
that neutralize the virus. Detailed structural analyses of these antibodies and
their targets -possible only in the past few years--are giving us important
clues for new vaccine designs.

AIDS vaccine research -- similar to the search for new antiretrovirals to
address growing resistance to current therapies and for new diagnostics to
identify infection -- is crucial if we are to beat back the pandemic. For the
millions of people throughout the developing world who are key constituents for
an eventual vaccine, The Post's story highlights the need for greater attention
to and resources for AIDS prevention.

SETH BERKLEY

President and Chief Executive
The International AIDS Vaccine Initiative
________________
Peg Willingham
Senior Director
Public Sector Development
International AIDS Vaccine Initiative
110 William Street, New York, NY 10038
cell 703-403-1421, fax 212-847-1113
NY tel 212-847-1055
e-mail: <PWillingham@...>

AIDS Vaccine Testing Goes Overseas

U.S. Funds $120 Million Trial Despite Misgivings of Some Researchers

By Ariana Eunjung Cha, Washington Post Staff Writer
Monday, May 22, 2006; Page A01

CHONBURI, Thailand -- Inside a ramshackle Buddhist temple here on
the country's southeastern coast, curious villagers gathered last
fall as part of the United States' biggest gamble yet on stopping
the AIDS pandemic.

The informational meeting was almost like a game show as attractive
young hosts revved up the crowd, working up to the big question,
boomed out over loudspeakers: Would the audience be willing to
volunteer to test an experimental HIV vaccine?

  Buy This Photo

A nurse prepares a syringe with an experimental AIDS vaccine at a
clinic in Bangkok. The U.S.-funded trial will involve 16,000 test
subjects. (By Lois Raimondo -- The Washington Post)

Video
Cambodian Sex Workers Protest
Yunang Soma joined other Cambodian sex workers in November 2005 to
protest a drug trial for tenofovir, a possible AIDS vaccine. "If the
trial is so good, why don't they get sex workers from their own
country? Why do they come to a poor country?" asked Soma. The
protest led Cambodia's leaders to cancel the trial and oust
researchers from the country.

The villagers hesitated. No one moved for a full 60 seconds. Then,
tentatively, they approached the three stands set up at the front,
marked "Join," "Not Join" and "Unsure."

For the past three years, such gatherings have been held all over
Thailand, exhorting young adults to take part in the largest, most
expensive, most resource-intensive AIDS vaccine trial ever. Funded
by the National Institutes of Health, it ultimately will involve
16,000 people and last 3 1/2 years.

But as the trial moves forward, at a cost of more than $120 million,
some researchers are raising questions about its validity. They
disparage its science, question its ethics and doubt its efficacy.

One of the chief dissenters is Robert C. Gallo, who helped discover
the human immunodeficiency virus. He scoffs at the notion that the
trial will be successful. "I thought we'd learn more if we had
extract of maple leaf in the vaccine," he said derisively.

NIH scientists defend the study, arguing that even if the vaccine
doesn't work, the trial may reveal new things about HIV. "With 5
million new infections each year, the luxury of time is absent,"
four researchers wrote in the journal Science.

Vaccine Is Elusive
-------------------------------------

When scientists identified HIV as the cause of AIDS 21 years ago,
they predicted that a vaccine to prevent the infection would be
ready long before a treatment for the symptoms could be developed.
The opposite turned out to be true. Many people today, especially in
wealthy countries, are keeping the virus in check with drugs, but a
vaccine, desperately needed in poor countries, has eluded modern
medicine.

Despite years of effort, investment in the billions of dollars, and
dozens of small tests in people around the world, there's still no
scientific proof that a vaccine is even possible. HIV is a
diabolical virus that disables the very immune responses a vaccine
needs to trigger in order to work.

And yet the need is so urgent that scientists have gone forward with
preliminary human tests of many vaccines on the basis of data they
acknowledge is weak. The one in Thailand is the largest.

The fact that no one has ever been cured of AIDS increases the
urgency of finding a vaccine. "In contrast to virtually every other
microbe we've come across, there isn't a documented case of anyone
who . . . ultimately cleared HIV from the body completely. That's
why more and more research is being directed at trying to stop
infection from happening in the first place," said Anthony S. Fauci,
director of the National Institute of Allergy and Infectious
Diseases, part of the NIH.

The U.S. government last year spent 22 percent of its $3 billion
AIDS research budget on vaccines and other preventive drugs,
compared with less than 8 percent a decade ago. (Most of the rest is
devoted to developing treatments or a cure for those already
infected.) Meanwhile, the Bill & Melinda Gates Foundation this year
designated up to $360 million for AIDS vaccine research, and
Congress is encouraging more research with bills that would provide
liability protection and tax benefits for drug companies


But the science is daunting and subjects hard to come by. Scientists
have been forced to travel to remote corners of the world to find
communities where the infection rate is high enough to show results
in a reasonable amount of time.

Thailand, where AIDS is a leading cause of death, has been among the
most accommodating places. The NIH effort there involves two
vaccines that individually have been disappointing in previous
trials. One of them, developed by a once-revered scientist in the
AIDS world, flopped spectacularly after an expensive test funded by
private investors. The other showed little promise in early trials.
Researchers cling to the hope that using them simultaneously will
attack different aspects of the disease and prove effective.

Disappointing Trials

A vaccine is basically a trick: Take a germ or part of a germ, kill
it or alter it so that it doesn't cause disease, then inject it into
the body. The body thinks it is being attacked and produces an
immune response that will protect it when it is exposed to the real
thing.

But because HIV comes in 11 subtypes that constantly mutate, it must
be treated differently. Enter Donald Francis, a longtime government
researcher who is credited with helping to eradicate smallpox and
develop vaccines for Ebola and hepatitis B. Francis had great
credibility in the AIDS community. He was immortalized as an early
hero in Randy Shilts's book "And the Band Played On" because he
recognized the danger of AIDS long before it became an epidemic and
argued forcefully for government action.

In 1982, he left public service to work for biotechnology giant
Genentech Inc. and concentrate on AIDS full time.

His idea was to try to use the protein envelope that surrounds HIV
to try to trick the body into thinking the whole virus had invaded
it. When he injected it into a group of chimpanzees and then exposed
them to HIV, they were protected. Francis then injected the cloudy
liquid into his arm and became human research subject No. 1. There
were no side effects, or none that he could notice. When he drew his
blood he saw something promising -- a strong antibody response.
Antibodies, proteins that form in response to invaders, typically
protect a person against infection.

The big question was: Would that be enough to stop HIV infection?

Based on the preliminary trials, many scientists were skeptical.
Nine of the 499 U.S. volunteers who had received Francis's vaccine
subsequently became infected with HIV -- not from the vaccine but
from later sexual exposure to the virus. While Francis was not
concerned with those "breakthrough infections," other scientists
were. "It is not the fact of breakthroughs that is so disturbing,"
John P. Moore of Cornell University's medical college said at an
international AIDS conference in 1996. "It is the individual cases
where there was a good vaccine response but infection occurred
nonetheless." Researchers feared that the virus mutated so quickly
that antibodies were ineffective against it.

Other scientists turned to a new technique, using snippets of the
virus to promote a response from another part of the immune system,
which activates "T-cells" instead of antibodies to attack germs.
Most vaccine candidates in human trials today use that strategy.

Jay A. Levy, an AIDS researcher at the University of California at
San Francisco, said he believes that the cellular approach is the
only one that will work. "You aren't going to prevent HIV infection
by the classic vaccine model," he said.

But Francis was not dissuaded. He took his data to the NIH and asked
for funding to test his vaccine in a large group of humans. He ran
into a wall of opposition.

Moore and Dennis R. Burton of the Scripps Research Institute argued
in the journal Nature Medicine that funding for vaccine trials is
limited, that patient cohorts are precious resources, and that "a
social and political price" would be paid for a vaccine that failed
in a large-scale trial.

The NIH turned Francis down. Ever persistent, he decided to rely on
private funding. He persuaded Genentech to invest $2 million in a
spinoff company, VaxGen Inc., and embarked on a cross-country tour
that raised $150 million from other private investors.

With that money, the trial began in 1998, mostly in gay men in the
United States, Canada, Puerto Rico and the Netherlands and in
intravenous drug users in Thailand -- a total of 7,500.

Punnee Pitisuttithum of Mahidol University in Bangkok, who
coordinated the Thai portion of the study, remembers being holed up
in a San Francisco hotel room in 2003 studying reams of data. On the
fourth day, the computers spat out the final analysis. The incidence
rate for those who got the vaccine was 3 percent and the incidence
for those who did not get the vaccine was 3 percent. There was no
difference.

Punnee, 48, ran to her room and wept. "It took us nine years to find
out the VaxGen vaccine did not work," she said.

Still, Francis latched on to an interesting blip in the analysis of
African Americans. Fewer of the patients who got the vaccine were
infected with HIV, but there were too few volunteers to draw any
conclusions. For Francis it was a signal that perhaps the vaccine
was indeed doing something to help prevent infection, if only in one
segment of the population.

Critics brushed off that opinion, calling it a desperate attempt to
salvage something from all the years of work. Weeks after the
announcement that the vaccine had failed, VaxGen was hit with a
shareholder lawsuit that accused the company's officials of
continuing to make positive statements about their vaccine to
artificially pump up the company's stock price, despite mounting
evidence that it was not effective. The suit was dismissed last year
and VaxGen, under new management, remade itself into a biodefense
company.

"We were naively optimistic" back then, Francis said. "Our
understanding of the technology to create an AIDS vaccine is still a
black box and it's going to be a long haul."

In 2005, he quit his job as president of VaxGen and founded Global
Solutions for Infectious Disease, a nonprofit organization that aims
to develop an AIDS vaccine. Francis works in a basement office south
of San Francisco that looks more like a file room than a laboratory.
After VaxGen abandoned their project, he and his researchers struck
out on their own. Four of the five researchers work without pay,
draining their personal savings to pay for their research as they
apply for grants. Francis said recently that he expects funding from
a foundation in the coming month.

Hard Sell
----------------

Francis is no longer involved in testing the VaxGen vaccine. But the
failure of the big 2004 trial did not stop its inclusion in the
current trial, which was begun by the U.S. Army and subsequently
taken over by the NIH. Half a world away in Thailand, that effort
continues.

The Thai government has approached recruiting for the trial like the
U.S. government did for the military during World War II -- with a
call for patriotism and a plea for people to think of the greater
good.

"You! Your family! Your community! Join your hands together to
develop an HIV vaccine," said a yellow banner hoisted on storefronts
and government buildings. Another sign, featuring a smiling woman,
told young people to go to their nearest health center to get more
information.

The recruiters in December exceeded their goal of enrolling 16,000
volunteers. Test subjects will receive either a placebo or a
combination of two vaccines -- Francis's and one by Sanofi Pasteur
SA of Lyon, France, that targets T-cells. The study will conclude in
2009, after all participants have been followed for 3 1/2 years.

The idea behind the NIH trial is that maybe vaccines need to provoke
both antibody and T-cell responses to protect the body from AIDS.
Critics say that the potentially confusing inclusion of Francis's
vaccine muddies the issue and that it should be dropped from the
study.

Nearly two dozen prominent AIDS researchers wrote an opinion piece
in the journal Science in early 2004 calling Francis's
vaccine "completely incapable of preventing or ameliorating" HIV
infection and questioning "the wisdom of the U.S. government's
sponsoring" the Thailand trial. "There are adverse consequences to
conducting large-scale trials of inadequate [HIV] vaccines. . . .
One price for repetitive failure could be crucial erosion of
confidence by the public and politicians in our capability of
developing an effective AIDS vaccine."

Last summer, Sen. Tom Coburn (R-Okla.), a physician, and other
members of Congress began pressing U.S. officials to cut government
funding to the trial, to no avail.

While the controversy over the trial continues in scientific and
political circles in the United States, it has not been an issue in
Thailand. At the Buddhist temple that evening in November, nearly
all the 174 villagers eventually overcame their hesitation and said
they would be open to serving as human test subjects.

Jo, a 19-year-old mechanics student with a goatee and buzz cut,
signed up in the fall and brought eight friends to a clinic one
morning so that they could get more information to decide whether
they, too, wanted to be test subjects.

Jo said he doesn't care about the $7.50 he will be paid for each
visit or any personal benefit he will get from the trial. It's
important "to do something good for the community," he said.

That thought was echoed by Supachai Rerks-Ngarm, the principal
investigator for the vaccine study and an official with the Thai
Ministry of Public Health, who said that when it comes to
researching an AIDS vaccine, there's no such thing as wasting time
or money. "If we decide not to do it," he said, "we cannot explain
that we have done our best to help our people."


http://www.washingtonpost.com/wp-
dyn/content/article/2006/05/21/AR2006052100960_3.html?
referrer=emailarticle

Dear FORUM,

The Australian Research Centre in Sex, Health and Society (ARCSHS) has just
published the following report on MSM in Bangladesh, India, Thailand and
Indonesia:

"A review of knowledge about the sexual networks and behaviours of men who have
sex with men in Asia".

The report can be downloaded at:
http://www.latrobe.edu.au/arcshs/downloads/Reports/Asia%20MSM.pdf
and includes an annotated bibliography for each country.

Some report excerpts include:

BANGLADESH

There would appear to be at least three complementary ways to configure the
cultural forms of MSM activity:

1. Sex between men negotiated on the basis of exchange, e.g. in sex work (i.e.
sex for money), within emotional relationships (e.g. with �parik� or boyfriend
in relationships), and via coercion (i.e. to gain freedom from bullying or
violence at the hands of police or mastans); i.e. exchange does not necessarily
or always involve money;

2. Sex framed by familial, institutional and traditional relations, e.g.
intrafamilial and intergenerational sex in family homes and neighbourhoods, in
brothels or schools and related to other educational processes (e.g. among
university students), or with hijra (in their role as sexual performers and
dancers derived from earlier forms of South Asian gendered spiritual forms); and
there is some evidence of workplace-related sex (while we know nothing of
prisons in Bangladesh);

3. Occasional or 'casual' sex facilitated in part by a widespread cultural
practice of night time walking in parks, by rivers, in cool open spaces, in
markets, in a culture without large-scale mass entertainment infrastructure,
i.e. where the structuring of the sexual encounter is any of the above and about
opportunity and possibility, and where any of the categories mentioned above
might engage each other in variety of ways. For example, a kothi seeking sex
might accept payment, an older man seeking a younger one without payment, a
student seeking a casual partner etc.

And these are not mutually exclusive categories.

INDIA

The findings on sexual practice, partners and condom use offer a very complex
and varied picture of sex between men and the female sex partners of such men in
India. There is definitely a lot of sex between men occurring in India, but not
necessarily where it is looked for (the low frequencies for sex with men in the
truck driver studies are interesting). The widely varying number of partners and
differing frequencies of sex suggest that situational and contextual forces are
at work producing the opportunities, patterns and meanings within which sex
between men is taking place. And these are multiform and quite unpredictable.

The cultural analyses suggest any singular notion of an 'indian' MSM culture (or
even a 'South Asian' one for that matter) seriously underestimates the
variability and the diversity of social, historical and cultural forces that
produce the kinds of findings reviewed here and would mistakenly conflate
significant differences in the many MSM sex cultures noted here.

There is evidence of denser networks of MSM found particularly in the CBO-based
studies. The importance of cruising sites to the structure of these networks and
of the sexual practice they produce is not clear from these studies, as these
tend to mask potentially different sexual economies situated in the same
settings. What is also more difficult in India to assess is the
inter-relatedness of sex between men, masculine sexuality itself, and the place
of male erotics in any sexual and gender orders. The diversity of sexual
expression between men, marriage levels, sex with female partners,
exchange-based sexual practices, and the potential diversification of such
practices through a range of sociodemographic descriptors (age, ethnicity,
religion, sect, location, situation, occupation etc.) all confound the
possibility and utility of category of MSM itself.

THAILAND

The bulk of published research has been conducted on three distinct (but not
mutually exclusive) populations: kathoey; military conscripts; and male sex
workers (MSW). Each of these groupings brings its own strengths and limitations.
The cumulative effect of this pattern of research, however, particularly given
the position of male same-sex practice in Thailand, is to create a significant
silence on what may be the bulk of same-sex behaviour in the country.

What is clearly absent in the Thai material is any substantive investigation of
the social and sexual networks of MSM per se.

Networks are the dynamic systems of social and sexual relationality that not
only facilitate and/or constrain transmission of HIV, but also define the
pathways of social and educational influence. While some of the theoretical
material discussed may provide clues as to the structure and fluidity of the
social categories employed, the lack of systematic investigation of networks
prevents us from meaningfully integrating these analyses with the behavioural
data from other research.

The material discussed above does suggest that the majority of MSM sexual
practice does not take place within a population delimited by sexual identity.
The sexual relationality of MSM is intrinsically embedded in broader social
systems that include kathoey and women. Understanding these systems is critical
if any understanding of the place of MSM within the Thai epidemic is to move
forward.

INDONESIA

One configuration of sexual relationships in Indonesia that is critical to note
is the patterning of transactional sexual relationships. There is some evidence
that 'gay men'(homos in this case) are paying for sex with laki-laki asli (real
men), and the laki-laki asli are paying for sex with waria. When one considers
the available data on the sexual practices of waria with clients (i.e. waria
will often be the penetrative partner in anal sex) and homos with MSW, the usual
notions of bridging populations do not apply.

There are clearly complex systems of sexual patterning here that do not operate
within Western sexuality/gender configurations.

The few studies done so far offer some ideas on MSM sexual cultures operating
within several culturally and locally specific, fluid, and, importantly,
permeable contexts. What is clear from the material reviewed, is that MSM in
Indonesia do not sit as a culture apart, but a culture intrinsically embedded in
Indonesian social and sexual life. Indonesia is a vast country of many distinct
populations and cultures, and this makes any characterization of an Indonesian
MSM population impossible. Indeed, the ways in which MSM activity is
characterized in public and private forums, by class and by location, makes this
an impossible task. The anthropological evidence on the great diversity of
male-to-male sexual cultures among Melanesians alone (including West Papua)
prohibits any premature foreclosure of a singular MSM category or even related
MSM categories.
________________________
Joanna Grzelinska
e Correspondent, AIDS ASIA e FORUM
e-mail: <jo_grzelinska@...>

Most countries fall short of ensuring a safe blood supply But some
progress made

12 JUNE 2006 | GENEVA -- The world is making slow progress towards
the goal of 100% unpaid, voluntary blood donation, falling short of
ensuring the safety and the sustainability of blood supplies. Most
developing countries still depend on paid donors or family member
donors. However, some countries such as China, Malaysia and India
have shown progress in the last two years by applying stricter
principles within their AIDS prevention programmes.

On World Blood Donor Day, 14 June, the World Health Organization
(WHO) publishes findings from its most recent global survey on blood
collection and blood testing practices.

Regular, unpaid voluntary donors are the mainstay of a safe and
sustainable blood supply because they are less likely to lie about
their health status. Evidence indicates that they are also more
likely to keep themselves healthy. South Africa, for instance, has an HIV
prevalence of 23.3 % in the adult population but only 0.03% among its regular
blood donors.

The WHO survey shows that out of the 124 countries that provided data to WHO, 56
saw an increase in unpaid voluntary donation. The
remaining 68 have either made no progress or have seen a decline in
the number of unpaid voluntary donors. Of the 124 countries, 49 have
reached 100% unpaid voluntary blood donation. Out of those 49, only
17 are developing countries.

The number of donations per 1000 population is about 15 times greater in
high-income than in low-income countries. This is concerning because developing
countries have an even greater need for sustained supplies of safe blood since
many conditions requiring blood transfusions - such as severe malaria-related
anaemia in children or serious pregnancy complications - are still claiming over
one million lives every year. About 25% of deaths caused by severe bleeding
during delivery could be prevented through access to safe blood.

In the area of blood testing, 56 out of 124 countries did not screen
all of their donated blood for HIV, hepatitis B and C and syphilis.
Reasons given for this include scarcity or unaffordability of test
kits, lack of infrastructure and shortage of trained staff.

On the other hand, several countries have risen to the challenge. Of
the countries surveyed, St. Lucia made the biggest jump forward,
going from 24.39% of collected blood coming from unpaid volunteers in 2002 to
83.05% in 2004. Malaysia went from 50% in 2002 to 99% in 2004 and India from 45%
to 52.42%.

According to government responses to the WHO questionnaire, the
reason for progress is tied to stronger AIDS prevention programmes.

In China, government figures show that all donated blood in 2005 was
tested for the four infections. In the area of blood donation, China
has seen a rise of unpaid voluntary donors from 22% in 1998 to 94.5%
in 2005. China's progress is due particularly to its reduction of
commercial blood and plasma, thus minimizing the practice of
unregulated blood collection and provision throughout the country
while also strengthening HIV prevention.

The World Health Organization introduced the 100% unpaid, voluntary
blood donation policy in 1997. World Blood Donor Day, an annual event on June
14, is a day to help governments reach that target by
creating awareness of the need for sustainable supplies of safe
blood. It is also a day to thank existing blood donors for the
remarkable gift they make to those whose lives they have improved or
saved, and to encourage new donors to commit.

Commitment is the theme of this year's World Blood Donor Day; from
regular and potential donors, but also from governments and the
global community to maintain blood safety high on the agenda as a
vital factor in treatment and disease prevention.

The global celebration of World Blood Donor Day 2006 on June 14 will
take place in Bangkok, Thailand. It will be hosted by the WHO
Collaborating Centre for Training in Blood Transfusion Medicine and
the Thai Red Cross Society National Blood Centre. Over 100 other
countries will join in the celebrations.

World Blood Donor Day was established at the 58th World Health
Assembly in May 2005 by WHO's 192 Member States, to urge all
countries in the world to thank blood donors, promote voluntary,
unpaid blood donations and ensure safe supplies of blood for all.

For further information please contact:

Daniela Bagozzi
Communications Officer, WHO
Telephone: +41 22 791 4544
Mobile: +41 79 475 5490
Email:bagozzid@...
___________________________
Posted By :Emdad Sheadhar
NeC, AIDS ASIA
Bangladesh
e-mail: sheadhar_bd@...

AIDS: Asia-Pac the next frontier

Asia could surpass Africa in the number of people with virus
BANGKOK, Thailand (AP) -- When HIV first escalated in Africa and the
Caribbean, Asia remained virtually untouched and unaware. But the
world's most populous continent is catching up.

Today, 25 years into an epidemic that has claimed 40 million lives
worldwide, the Asia-Pacific region has the highest number of
infections after sub-Saharan Africa.

The big question now is: How far will it go?

"I don't think it will go the African way," where in some areas up
to a third of the population is infected, UNAIDS chief Dr. Peter
Piot said in an interview with The Associated Press. But "there's
slow but steady growth and with that kind of population denominator,
the numbers are staggering."

UNAIDS, the U.N. body leading the global war on AIDS, estimated 8.3
million people were living with the virus last year in the Asia-
Pacific -- and nearly 85 percent of those infected had no access to
antiretroviral treatment.

The disease, first identified in the United States in an
announcement by health officials on June 5, 1981, quickly went
global.

In Asia, a vast, diverse and mobile population has helped spread the
virus, starting with unprotected sex and dirty needles. It first
devastated Thailand's infamous sex industry, later reached millions
in India and has pushed once-isolated communist Vietnam to the brink
of an HIV explosion.

India is home to more HIV/AIDS-infected people than any other
country, according to new UNAIDS numbers. Its estimated 5.7 million
infections last year comprise more than two-thirds of all cases in
the Asia-Pacific region.

In a country of more than 1 billion people, that number shrinks to a
small fraction -- 0.9 percent of adults compared to South Africa's
almost 19 percent. But a small percentage can cause the problem to
be neglected.

"Because of this low percentage, the issue doesn't seem to be a
priority for political leaders and also for the man on the street,"
said Dr. Shigeru Omi, the Western Pacific regional director for the
U.N.'s World Health Organization.

India's epidemic is largely driven by heterosexual sex -- mainly
prostitutes and their clients who do not use condoms. In the
country's south, a recent report found, prevention campaigns
targeting sex workers have resulted in a 35 percent drop in new
cases among 15 to 24 year olds.

But there has been little progress in India's highly populated north
or drug-ridden northeast, said Prabhat Jha, of the University of
Toronto, one of the study's authors.

"It's too early and one wouldn't want to be the fellow on the
Titanic who said, 'All clear,' because the north is 70 percent of
the population," said Jha, who's spent a decade researching AIDS in

India. "If it explodes, you can imagine what would happen."
Chandi Sayeed, 39, of Mumbai's gritty brothel district, said she was
sold into prostitution at age 16 when she was already a mother of
two.

"The problem is most women don't use condoms with their husbands or
with customers they love," she said. "They only use it with men who
aren't regulars. They say, how can we use it with our lovers? But
women must think of their children and their family first."
PNG has region's highest per capita rate

Another trouble spot is Papua New Guinea, which shares an island
north of Australia with Indonesia's easternmost Papua province.
The country of 5.7 million is plagued by political instability,
poverty and rampant sexual violence against women. It has the Asia-
Pacific's highest adult per capita infection rate of 1.8 percent,
but the political will to tackle the problem is absent.

"Papua New Guinea is a very, very, very serious situation," Omi
said. It "needs some special attention, otherwise there's a
possibility that Papua New Guinea will become like Africa in the
future."

In China, the AIDS picture is still a bit unclear. But its sheer
size -- some 1.3 billion people -- is enough to worry experts.
In January, China and the United Nations lowered HIV/AIDS estimates
there, saying roughly 650,000 people were infected in 2005 -- nearly
200,000 fewer than an earlier projection.

Injecting drug users accounted for nearly half the infections in
China, where the government was accused of being slow to address the
problem. HIV took off in China in the early 1990s when farmers began
selling blood plasma to earn extra money.

AIDS activists and people infected with the virus have been
harassed, but top leaders have finally admitted publicly that a
problem exists.

In late 2004, President Hu Jintao was photographed shaking hands
with HIV-infected Zhang Hulin. It was a major step for the communist
government, but Zhang says he and his family suffered even greater
stigma and discrimination after the photos circulated.

Need to refocus campaigns

Still, he remains hopeful a cure will be found.

"It's one of these diseases that the whole world is concerned with
and doing research on," said Zhang, who tested HIV-positive in
1997. "So maybe it can be eradicated, but it's hard to say."

In Vietnam, the bulk of infections are among prostitutes and
injection drug users. But the virus has spread to all provinces and
cities, and the country is at a very critical moment, Omi said.
With prevention campaigns, "they may be able to avert transmission
into the community. But if they fail, they may end up having
widespread transmission among the general public," he said.

Vietnam is the only Asian nation among 15 countries selected to
receive emergency HIV/AIDS funding under a $15 billion Washington
plan.

Thailand and Cambodia, in contrast, have been hailed as two bright
spots in Asia. Both still have adult per capita infection rates over
1.4 percent, but the governments have largely reversed once-
devastating epidemics by promoting 100 percent condom use among
prostitutes working in brothels.

But both countries must refocus and refresh their prevention
campaigns, said Jeanine Bardon, regional director of U.S.-based
Family Health International.

Trends have shifted and HIV has latched on to new risk groups,
including men who have sex with men; young people with multiple sex
partners; injecting drug users; and monogamous women whose husbands
have sex outside marriage.

"It's not just sex workers and their clients. It's much more
complicated now," she said. "The new infections are now occurring
between the men who got infected (by prostitutes) in the 1990s and
their wives."

Children are among the most tragic AIDS victims. There were an
estimated 1.5 million children orphaned by AIDS in the Asia-Pacific,
with more than 120,000 of them infected in 2004, UNAIDS estimated.

Often, they are unwanted, said Joseph Maier, a Catholic priest who
runs Mercy Center orphanage, school and hospice in a Bangkok slum.

"Nobody's talking about, 'Come on, why don't we adopt some of these
kids?" Nobody's talking about, 'Hey, these kids are bright, they're
geniuses, there's poets among them,"' said Maier, known to everyone
as Father Joe.

Thailand has made cheap antiretroviral drugs easily available, which
has increased life spans but not reduced the stigma and
discrimination.

"We walk around to all the schools in this area here and say we've
got some kids with HIV/AIDS, we want you to take them in," Maier
said. "They wouldn't let them in."

If more isn't done to combat HIV/AIDS now, Asia could surpass Africa
in the number of people living with the virus, said Bardon. The
tragedy would be all the greater because today people know how to
prevent it.

"We'll have lost an enormous opportunity to avert thousands of
infections and eventually millions of lives saved," she said. "It's
not that we don't know what we're doing."

Copyright 2006 The Associated Press.
http://edition.cnn.com/2006/HEALTH/conditions/06/05/aids.asia.ap/

Number of Abstract Presenters by Country (Top 20)

AIDS 2006 LIVE- REPORTS

COUNTRY  AMOUNT

United States 2080
India         1101
Nigeria         906
Canada         709
South Africa 538
Brazil         527
Uganda         508
Kenya         383
United Kingdom 359
Thailand 333
China         276
Nepal         245
France         196
Mexico         184
Zambia         172
Bangladesh 164
Cambodia 159
Tanzania,  158
Argentina 143
Russia    141

Ref: www.aids2006.org

Posted By : Emdad Sheadhar
             NeC,AIDS ASIA
             Bangladesh
             e-mail: sheadhar_bd@...

A Guide To Primary Care For  People With HIV/AIDS, 2004 edition

What is the purpose of this guide?

This book addresses several important aspects of HIV/AIDS care and
treatment in a concise, accessible format; it is not meant to be a
comprehensive reference book. Recommended references and citations
are provided for the reader to be able to access in-depth
information on topics that are particularly important and/or
controversial. Appropriate use of antiretroviral drugs, treatment of
opportunistic infections, symptom management, treatment of
concurrent medical conditions, and other specific interventions to
treat HIV disease and its complications are addressed.

The format of this guide is designed to provide practical
information for the common questions that arise in the care of
patients with HIV infection. Recognizing the broader array of best
practices that contribute to effective clinical outcomes among
patients with a complex array of service needs, the authors also
address patient evaluation, adherence, mental health, substance
abuse, overall clinic management, and other factors that lead to
improved patient outcomes according to the Chronic Care Model. Last,
because the authors recognize the challenges of maintaining clinical
practices in the face of rapidly changing and ever more complex
treatment interventions, a chapter on sources for updated and in-
depth clinical information is provided. Pediatric HIV/AIDS treatment
is not addressed in this book.

Download the Complete Document (pdf 2.5MB) or by Chapters.
http://hab.hrsa.gov/tools/primarycareguide/

[Moderators note: If you have difficulty in accessing the document,
please feel free to contact the moderator for a pdf copy of the
guide]


Chapter: Introduction
Editors
Dedication
Acknowledgements
Contributing Authors
Abbreviations
Glossary of Antiretroviral Drugs

1. Primary Care As Chronic Care
What is a primary care approach to the treatment of HIV/AIDS and why
is it important?
What is the purpose of this book?
Who is the target audience?
What is the purpose of the pocket guide?
How will the guide keep track of the rapidly changing field of
HIV/AIDS treatment?
Key Points

2. Approach To The Patient
Basic Elements of Care
Stigma and Discrimination
Confidentiality and Disclosure
Patient Education
Risk Assessment and Counseling
Key Points
Suggested Resources

3. Core Elements Of HIV Primary Care
Initial Evaluation
Ongoing Care
Key Points
Suggested Resources

4. Prevention Of HIV In The Clinical Care Setting
Rationale for HIV Prevention in Primary Care
Interventions for HIV Prevention
Key Points
Suggested Resources
References

5. Antiretroviral Therapy
The Principles of Antiretroviral Therapy (ART)
When to Start Therapy
What to Start
When to Change Therapy
What to Change to
Resistance Testing
Key Points
Suggested Resources
Cases

6. Metabolic Complications Of Antiretroviral Therapy
Overview
Lipid Abnormalities
Lypodystrophy
Lactic Acidosis
Other Metabolic Complications
Key Points
Suggested Resources
References
Cases

7.Adherence To HIV Therapies
Overview
Assessment
Interventions
Key Points
Suggested Resources
References
Cases

8. Symptom Management
Workup of Symptoms
Medication-Related Issues
Nausea
Pulmonary Symptoms
Fatigue
Neu ropathic Pain
Dermatologic Symptoms
Mouth Lesions
Wasting
Myalgias
Diarrhea
Headache
Key Points
Suggested Resources
Cases

9.Management Of Opportunistic Diseases
Overview
Pneumocystis Jiroveci (Carinii) Pneumonia (PCP)
Mycobacterium Avium Comples (MAC)
Cytomegalovirus Infection (CMV)
Candida Esophagitis
Central Nervous System Diseases
Mycobacterium Tuberculosis
Malignancies
Key Points
Suggested Resources

10. Abnormal Laboratory Values In HIV Disease
Common Abnormalities
Hematologic Complications
Liver Disease
Renal Disease
Key Points
Suggested Resources
References

11.Postexposure Prophylaxis
Overview
Interventions for PEP in Health Care Settings
Interventions for Nonoccupational PEP (NPEP)
HIV PEP Treatment Recommendations
Hepatitis PEP Treatment Recommendations
Key Points
Suggested Resources
References
Cases

12. Family Planning And Pregnancy
Care of HIV-Positive Women of Childbearing Age
Preventing Mother-to-Child Transmission (MTCT)
Perinatal Care for Pregnant Women with HIV
Key Points
Suggested Resources
References

13. Management Of Substance Abuse
Assessment of Substance Abuse Problems
Treatment of Substance Abuse Problems
Medical and Pain Management Issues
HIV/AIDS Issues
Key Points
Suggested Resources
References

14. Mental Health Disorders
Overview
Disorders of Attention and Cognition
Personality Disorders
Mood Disorders
Anxiety Disorders
Suggested Resources
References

15. Palliative And End-Of-Life Care
Incorporating Palliative Care into HIV Care
Care at the End of Life
Key Points
Suggested Resources
References

16. Clinic Management
Patient Recruitment and Retention
Clinical Services Needed for HIV Care
Support Services and Linkages Needed for HIV Care
Key Points
Suggested Resources

17. Quality Improvement
Overview
Data Collection
Key Points
Suggested Resources

References

18. Keeping Up To Date:
Sources of Information For The Provider
Overview
Human Resources
Written Resources
Electronic and Web-based Resources
Integrating HIV Specialty into Practice
Key Points
Indexes
Index of Topics
Index of Drugs

http://hab.hrsa.gov/tools/primarycareguide/

ADB Launches Package of 11 AIDS Projects under Swedish Fund

MANILA, PHILIPPINES - ADB has launched a package of 11 grant
projects totaling US$8.17 million to step up the fight against
HIV/AIDS in Asia.

Financed by a special grant fund established last year by the
Swedish International Development Cooperation Agency (SIDA), the
projects will expand upon ADB's existing work on HIV/AIDS to develop
stronger responses to the epidemic at the country and regional
levels.

Asia is in the path of the global AIDS pandemic. With an estimated
8.3 million infected in the region (including about 1.1. million
newly infected in 2005), the disease could prove devastating both
socially and economically if its spread is not quickly checked.
"As a 2004 paper prepared jointly with UNAIDS showed, spending now
on HIV prevention and AIDS care is justified by the high returns �
both social and economic � that can be expected from the potential
lives that will be saved from death and suffering," says Jacques
Jeugmans, ADB Principal Health Specialist.

"With ADB's experience of working with a broad range of partners in
developing approaches that are systematic and multisectoral, we are
well placed to play an important role in identifying and
disseminating good practices in the fight against AIDS."

SIDA signed with ADB the agreement to establish the cooperation fund
in February 2005, with an initial commitment of $12.39 million
equivalent for four years.

Open to all other funding agencies, the fund aims to expand and
strengthen ADB's existing and planned AIDS related work, taking
three broad approaches.

� Expanding the knowledge base on HIV/AIDS by developing a regional
database, information services, and reports on trends, risk behavior
patterns, responses and economic impacts, and identifying and
disseminating best practices from within and outside the region.

� Strengthening the design and impact of HIV/AIDS elements in ADB
projects, and engaging a broad range of NGOs and community-based
organizations to conduct outreach and delivery of essential services
to the poor and vulnerable, and those at high risk. For example,
some $1.5 million of the budget will be for a project to promote NGO
initiatives in preventing HIV/AIDS.

� Supporting small projects to develop managerial skills in selected
national and regional organizations to undertake effective
interventions focused on high-risk groups. Skills, knowledge and
staffing within ADB will also be strengthened.

In addition to the SIDA fund, donors replenishing ADB's concessional
Asian Development Fund in 2004 earmarked 2% of ADF resources (about
$140 million) for grant assistance targeting HIV/AIDS and other
infectious diseases in eligible countries.

Under ADF, projects will strengthen HIV/AIDS prevention in ADB
projects, with physical infrastructure projects incorporating more
comprehensive HIV/AIDS components, and increasing attention given to
the issues of gender, human trafficking, and migration.

The list of projects

AIDS Projects under Swedish Cooperation Fund at ADB

South Asia

Bangladesh: HIV/AIDS prevention in urban local governments ($250,000)
Sri Lanka: National HIV/AIDS education program ($400,000)
Southeast Asia

Mekong: HIV/AIDS prevention in the infrastructure sector ($750,000)
Cambodia/Lao PDR: Combating HIV/AIDS among ethnic minorities
($270,000)
Philippines: Strengthening country response for high risk groups
($600,000)

East Asia

China: Building sustainable networks for local HIV/AIDS prevention
($500,000)
China: HIV/AIDS prevention and anti-human trafficking in the Guangxi
Road Development II Project ($1 million)

Central Asia

Regional training on mainstreaming HIV/AIDS in transport sector
initiatives ($250,000)

Regional
Increasing gender focus of ADB operation in HIV/AIDS prevention
($300,000)
NGO initiatives to prevent HIV/AIDS ($1.5 million)

Jointly with UNAIDS
Evidence-based advocacy ($2.8 million)
TOTAL: $8.17 million

Associate Director, China

Field Programs Asia and Pacific

Provides management and technical leadership to the FHI/China program
operating in Yunnan and Guangxi provinces in southern China.

Supervises staff based in offices in the two provinces in developing, monitoring
and evaluating HIV/AIDS prevention, care, support and treatment interventions
plus surveillance and strategic information work.

Coordinates closely with Chinese government officials as well as donor
representatives to assure that FHI's programs respond appropriately to the
HIV/AIDS epidemics in the provinces.  MS/MA in public health or related field,
and 5-7 years experience with international development programs; or BA/BS in
public health or related field, and 7-9 years experience with international
development programs.

Overseas field experience required. Experience in office and program management
and supervising others is required.

We encourage you to apply online at www.fhi.org <http://www.fhi.org>

<mailto:humanresources@...>

For positions outside the United States, please send resume with a cover letter
stating salary requirement to:

Human Resources, Family Health International
2101 Wilson Blvd., Suite 700, Arlington, VA  2220, USA
Fax +1-(703) 516-9036
or e-mail: humanresources@...

<mailto:humanresources@...>

Due to the volume of resumes received, we are unable to accept phone
calls.  Should your qualifications meet our requirements, we will
contact you.

"Graham Neilsen"
E-mil: <gneilsen@...>

On behalf of the International AIDS Society (IAS) and the
Australasian Society for HIV Medicine (ASHM) IAS 2007 Local Host, it
is our pleasure to invite you to the 4th IAS Conference on HIV
Pathogenesis and Treatment, to be held in Sydney, Australia, 22-25
July 2007.

The Conference will provide an opportunity to build on the biomedical prevention
agenda newly introduced at the Rio Conference, while maintaining the emphasis on
treatment and pathogenesis.

With epidemics in most countries of the region either limited or
concentrated in subgroups defined by behavioural or geographic
factors, the Conference will also provide a focus on this region,
which is home to 60% of the world's population and an estimated 19%
of people living with HIV infection.

Australia has maintained a solid commitment to HIV education,
prevention, treatment and research from the early years of the
epidemic. The Australian response to HIV/AIDS has always been a
collaborative partnership between the research, medical, government
and community sectors. Low rates of HIV incidence in most population
groups, and high levels of access to care and treatment for those
with HIV infection are the direct consequences of Australia's
strategic approach to HIV/AIDS. As a location for the IAS
Pathogenesis and Treatment Conference, Sydney is a worthy successor
to Buenos Aires, Paris and Rio de Janeiro.

IAS 2007 will be an important opportunity for people living with
HIV/AIDS, advocates, community leaders, scientists, health care
providers, funders, and policymakers to gather and focus on the key
challenges in our collective efforts to provide HIV care and
treatment and to prevent new infections.

We are inviting you to make the 4th IAS Conference on HIV
Pathogenesis and Treatment another milestone in the global response
to HIV/AIDS.

See you in Sydney in 2007!

From:http://www.ias2007.org/

Posted By : Emdad Sheadhar (Bangladesh)

14 Nations Will Adopt Airline Tax to Pay for AIDS Drugs
France leads the effort meant to provide greater access to
medicines.  The U.S. opposes the levy.

By Maggie Farley, Times Staff Writer
June 3, 2006

UNITED NATIONS �" A three-day AIDS conference set a goal Friday of
doubling  spending to slow the spread of the disease, and 14
countries announced an airline ticket tax to fund greater access to
AIDS drugs.

The special session on HIV/AIDS was marked by political haggling
over the mention of condoms, safe drug use and sex education.

Delegates agreed to cite condoms specifically, but language on drug
use and sex education is couched in euphemisms.

U.N. Secretary-General Kofi Annan pleaded with the assembled
representatives, who included African presidents, foreign ministers
from around the world and First Lady Laura Bush, to not let politics
derail progress.

"AIDS has inflicted the single greatest reversal in the history of
human development. The response has started to gain real strength"
but the epidemic continues to outpace us," he said. "This fight
requires every president, every parliamentarian to say, 'AIDS stops
with me.' "

Bush called for an international HIV testing day, modeled on the
United States' own, and praised the U.N.'s official anti-AIDS policy
called ABC "Abstinence, Be faithful and Condom use"  without
dwelling on the fact that U.S. funds focus on abstinence-only
programs, to the criticism of many activists who say that ignoring
condoms is unrealistic.

The U.S. sided with unlikely allies such as Syria, Yemen and
Pakistan in opposing "empowerment for girls" in birth control and
marital relations, and it fought to water down financial targets
despite its own substantial contributions.

The U.S. made a commitment in 2003 to spend $15 billion over five
years. But along with the European Union and Japan, it fears that
the largest donors will carry not only the greatest financial burden
of the new goals, but also the blame if they are not met, diplomats
said.

The summit is the follow-up to a watershed 2001 conference, which
resulted in $8 billion spent on fighting AIDS. This conference,
which concluded Friday, was designed to take stock of progress in
the five years since. There have been some successes, Annan said:
Seven times as many people now have access to AIDS drugs, and the
infection rate is declining in several African countries.

But a report released this week also says that the world has failed
to meet many of the 2001 goals: Only 9% of pregnant women receive
drugs to prevent the transmission of AIDS to their child, despite
a target of 80%.

The infection rate has grown rapidly in Asia, which is now second to
Africa in the number of HIV positive people.

The U.N. estimates that it needs more than $20 billion by the end of
the decade to provide preventive education and medicines to the
growing number of people infected.

But world leaders shied away from promising specific amounts at the
conference, and so far, the AIDS war chest has pledges for less than
half what is needed.

But a group of 14 nations, led by France, announced a new mechanism
to provide greater access to drugs, funded by a tax on airline
tickets that is expected to raise more than $258.3 million a year.

France has voluntarily imposed an economy class levy ranging from 1
euro (about $1.30) in Europe to 4 euros for longer flights. For
first and business class, the fee is 10 euros in Europe and 40
euros elsewhere.

The U.S. opposes the tax, but Brazil, Chile, Cyprus, Congo, France,
Gabon, Ivory Coast, Jordan, Luxembourg, Madagascar, Mauritius,
Nicaragua, Norway and Britain have pledged to implement it.

Starting July 1, France will collect the fee from all flights
entering or leaving France.

"Every person in the world who can afford to buy an air ticket can
afford this very mild, minimum-level tax upon it," said Erik
Solheim, Norway's minister for International Development.

The funds will go to buying AIDS drugs in bulk to help reduce the
prices, and to give incentives to drug companies to produce more
antiretroviral drugs for children, which are now more expensive and
less in demand than adult formulations.

http://www.latimes.com/news/printedition/asection/la-fg-
unaids3jun03,1,2690801.story?coll=la-news-
a_section&ctrack=1&cset=true

AIDS turns 25

AIDS has claimed the lives of 25 million people in the last 25
years. Today, AIDS continues to ravage developing nations, but the
outlook is different in the developed world.

Twenty-five years ago, when the world first became aware of AIDS,
the disease seemed confined to a relatively small group of gay men,
drug users and hemophiliacs who were unlucky enough to have received
contaminated blood. Today, nearly 40 million women, children and men
worldwide have AIDS.

The disease has taken its greatest toll in southern Africa (South
Africa, Swaziland, Zimbabwe and Botswana), where infection rates,
averaging around 35 percent, are the highest in the world. Twelve
million African children � 15 million children overall � have lost
one or both parents to AIDS and in many regions have a better than
even chance of dying of the disease themselves. And although the
number of Africans receiving life-prolonging drugs has increased
sharply in the last few years, only 17 percent of people needing
treatment actually get it.

In wealthy countries, the news is not as unrelentingly grim. There,
advances in treatment have changed AIDS from a fatal illness into
one that's chronic and treatable, much like diabetes or heart
disease. And simpler, less toxic regimens have made living with AIDS
more tolerable.

Stacey Vlahakis, M.D., an infectious disease specialist and AIDS
expert at Mayo Clinic, Rochester, Minn., answers some questions
about the complex, changing and inequitable face of AIDS.

Twenty-five million people have died of AIDS since 1981, and 5
million were newly infected in 2005. Have we made any progress at
all in the last 25 years?

The numbers are so staggering that it's easy to lose sight of the
strides we've made in taming this disease. But yes, there has been
progress. Just 10 years ago, there were few drugs to treat the
virus. Since then, we've developed many more medications. Today,
most people receive a combination of three or more AIDS drugs, a
treatment called highly active antiretroviral therapy, or HAART.

When HAART is effective, it can reduce viral load � the amount of
virus in the blood � to undetectable levels. To realize how
significant this is, you have to understand how the virus works.
HIV, the virus that causes AIDS, enters healthy white blood cells,
inserts its genetic material into the cells and makes copies of
itself. By hijacking cells and then replicating in them, the virus
can churn out billions of new HIV particles every day. It also
slowly � over a period of 10 years or more � destroys your immune
system so that your body loses the ability to fight infection. HIV
infection turns into AIDS when you develop a very low level of white
blood cells � usually less than 200 per microliter of blood. This
makes you vulnerable to certain cancers and opportunisitic
infections that your immune system would normally fight off.


We have several classes of drugs that target HIV at different points
in its life cycle. None of these drugs can cure HIV/AIDS, but for
many people, HAART can keep the virus and opportunistic infections
at bay and help preserve the immune system.


MORE ON THIS TOPIC. HIV/AIDS

Does this mean people on HAART will have a normal life span?
We've only had these combinations of drugs for a decade, so we have
no way of knowing that. One thing we do know is that AIDS drugs can
cause serious health problems, including high blood sugar, high
cholesterol and the redistribution of body fat. We can suppress the
viral load but at a high cost. Yet even that is changing. In 1996,
people treated with HAART had to take as many as 15 or 20 pills a
day at different times, and often with many side effects. Today, the
simplest regimens require only two pills, and the side effects are
becoming easier to tolerate. We now know that certain side effects
are specific to particular medications. Protease inhibitors, for
instance, cause metabolic problems, whereas the newer non-nucleoside
reverse transcriptase inhibitors have fewer side effects. Easier
regimens � with fewer medications and side effects � mean that
people are more likely to stick with treatment. And that, in turn,
means that we're better able to suppress the virus. For the first
time, we can talk about people "living with AIDS," rather than just
dying of it.

There seems to be a real disconnect between what you're talking
about: AIDS as a manageable, chronic disease � and the suffering the
pandemic continues to inflict around the world.

The disconnect is less apparent in the Western world, where most
people who want treatment receive it. That doesn't mean that
inequities don't exist. In the United States, women with AIDS are
less likely to receive combination therapy and to have private
health insurance to pay for treatment than men are. Women's ability
to take care of their own health is further complicated by the fact
that many have young children at home. But in general, people in
wealthy nations have received, and continue to receive, very good
care. This is not true in most low- and middle-income countries, in
spite of recent advances.

What kinds of advances?

For one thing, there has been a huge jump in global AIDS funding �
from $250 million in 1995 to $8 billion in 2005. And some
pharmaceutical companies have lowered prices, making AIDS drugs
somewhat more affordable. This has had an especially big impact in
Africa, where the number of people receiving AIDS treatment
increased eightfold in the last two years alone. But in spite of
that, only about 20 percent of people worldwide who need treatment
get it.

Why is that?

Many aspects of life in developing nations play a role: governments
that aren't equipped to distribute AIDS money and drugs; a shortage
of trained doctors and nurses; fragile health care systems;
instability and dislocation caused by war and natural disasters;
and, perhaps most important, social attitudes. From the beginning,
people living with HIV and AIDS have been feared and sometimes
ostracized. That's true everywhere, but attitudes about AIDS in
developing nations are particularly widespread and entrenched, and
the impact on women and children is tremendous. Women are often
already economically and socially disadvantaged. Add to this
traditional belief about sexuality and disease transmission, and you
have women who are afraid to admit they're sick or seek treatment.

All too often, people who are known to have HIV or AIDS are
abandoned by their families and communities and die for lack of
care. Meanwhile, some government leaders still refuse to admit that
AIDS even exists.

Do you think AIDS will continue to devastate developing countries?
Right now, India is on the brink of an AIDS crisis that may someday
equal the one we see in Africa. In a way, that doesn't make sense
because India has more resources than Africa does. It's a democracy
with a strong infrastructure, and excellent technology and doctors.
But the lack of knowledge about AIDS and the stigma attached to the
disease are tremendous obstacles to prevention and treatment. Ninety
percent of people in India with HIV don't know they're infected.

Many of these are women and young girls living in rural areas. And
there is no incentive for people to learn their HIV status because
if they have the infection, they're likely to be shunned and denied
treatment. India is making efforts to cope with this problem, but
changing thousands of years of social and cultural practices isn't
easy. The next five years will be critical.

Can anything be done? What about an AIDS vaccine?

An AIDS vaccine isn't imminent. And a vaccine may not help people
already living with AIDS. Instead, one of the major goals of current
research is to learn how to coax the virus out of hiding. You see,
what makes eradicating HIV so difficult is that although HAART can
effectively suppress the virus, it doesn't eliminate it because the
virus can hide in the DNA of infected cells, out of reach of both
the immune system and current medications. The cells act as a hidden
reservoir of the virus, which comes back as soon as the medication
is stopped. Now researchers are trying to develop new strategies to
prevent and eliminate these reservoirs. That might make treatment
more successful or allow people to stop taking medication
altogether. It may also make the virus less infectious. Of course,
we are hoping that this doesn't take another 25 years.


The greatest tragedy of all is that AIDS doesn't have to happen.

Unlike some diseases, we know how to prevent it. HIV could
theoretically be eradicated in a generation without a vaccine.


Yes, that's true. Consistent condom use and clean needles are the
definitive ways to prevent HIV spread. Unfortunately, even in the
United States there is still a great deal of denial and ignorance
about both. Complicating matters further are the efforts of some
special interest groups to limit sex education and condoms in
schools and government-sponsored programs. The result is that we're
seeing an increase in HIV among young people and minorities. There's
also an attitude that HIV "isn't that bad" because we have
medications to treat it, leading some people engaging in high-risk
activities to become lax about using condoms. In the developing
world, economic and social factors limit condom use � prophylactics
are expensive or they're not readily available. And many women won't
ask their husbands to use them because they're afraid of being
punished or forced to leave their village. So it is sad. There are
effective ways to stop

By Mayo Clinic Staff . Jun 5, 2006

http://www.mayoclinic.com/health/aids/ID00039

Dear Friends and Colleagues,

After years of leading UNDP's response to HIV and development issues in the Asia
Pacific region, it is now time for me to move on.

Being part of the committed responses to the HIV epidemic in Asia Pacific and
working closely with various stakeholders, that ranged from national governments
to networks of people living with HIV, has been a tremendously rewarding
experience for me. I will cherish the education, challenges and the exposure to
new realities and most importantly, the many friendships and partnerships that I
came across.

My warmest personal thanks to each one of you for your passion, commitment and
contribution and for what we have been able to achieve together. I am sure that
our paths will cross again and I
look forward to our continued collaboration. I will take up my new
assignment in August in Laos.

I also would like to take this opportunity to welcome and introduce Caitlin
Wiesen, who will replace me as the HIV Practice Leader and Coordinator of the
Regional HIV and Development Programme for Asia at the UNDP Regional Centre in
Colombo. Caitlin comes with an impressive track record, a deep commitment to
human development issues and fresh perspectives and energy that will no doubt
enhance the HIV and Development agenda and UNDP's work.

As you did to me, I have no doubt that you will extend your full support to her.

Warmest regards

Sonam Yangchen Rana
e-mail: <sonam.yangchen.rana@...>

Dear FORUM,

During 2005, the International AIDS Society undertook a consultation
around the International AIDS Conference, called "The Future
Direction". One outcome of that consultation is that the governing of the
conference should be more inclusive (for the whole report, see the IAS website
www.iasociety.org ).

The highest governing body for the International AIDS Conferences in
2008 will be the Conference Coordinating Committee (CCC), being
ultimately responsible for the theme, vision, policies and programme
of the Conference.

Two of the new seats on the CCC will be filled by Civil Society:

One global NGO with HIV/AIDS as a major activity
One NGO based in a resource-limited country working in several
countries or on a whole continent

We are now inviting organizations to apply for one of those seats.

The selected organizations will have the right to send one person to
the CCC meetings preceding the Conference, normally 5-6 meetings in
person, usually 1-2 days each time. All costs will be covered by the
Conference. A committee comprised of IAS, ICASO, ICW, GNP+ and UNAIDS  will
finally select the two new organizations.

We would like to get interested civil society organizations to fill
in the corresponding form and send it to

susanne.renberg@..., before June 15. The first meeting is
planned for end of October 2006.

http://www.iasociety.org/

Posted By : Emdad Sheadhar (Bangladesh)
E-MAIL: <sheadhar_bd@...>

AIDS plan 'a major step backwards'

NEW YORK, May 31 (UPI) -- AIDS organizations accused the United
States of weakening a U.N. proposal by removing target numbers and
making other changes, The Financial Times reported.

The administration of President George Bush also has diluted
references to condoms and other AIDS-preventing methods in the
proposed 2006 U.N. declaration, the newspaper said of draft
documents it had obtained.

The intent was to remove references offensive to religious groups,
the report said.

"This is a major step backwards," said Jodi Jacobson of Washington
women's health group Change.

"The U.S. doesn't want to commit to any targets by which it can be
held accountable, and it doesn't want anyone else to commit either,"
Jacobson told the newspaper.

Coincidentally, UNAIDS released a report that showed 21 countries
had met the U.N.'s 2001 target of providing medicine by 2005, but
progress lagged in many nations, including India, Nigeria and South
Africa.

The report also said the growth of AIDS may be beginning to slow,
but 40 million people are now living with HIV.

http://www.upi.com/NewsTrack/view.php?StoryID=20060531-062743-9192r

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 7,000 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/

UN General Assembly  declaration at critical stage. Need urget action

Dear Forum ,

During the last few days of deliberation at the UN General Assembly
Special Session on HIV/AIDS (UNGASS) and after reviewing the four
preliminary drafts on the political declaration, which are the basis
for the final version of the declaration to be adopted at the UN
General assembly,  I would like to suggest the following:

-  to ensure that at least  the commitment made in the 2001
declaration are not diluted .The strength of the negotiation teams
lies on the UN Secretary General Kofi Annan's   note which
explicitly mentions vulnerable groups like MSM, IDU, SW which  are
part of the solution. The vulnerable groups unfortunately are not
mentioned in the draft.  The Declaration  runs the risk of
being "regressive" which will be a failure .

- Unfortunately there is absolutely no reference to terms like "
Harm Reduction" in the draft document  Supplies like Condom ,
Needles and Syringes, Buprenorphine , Methadone substitution, needs
to be not only included and mentioned , but  target set for future
review .( Methadone has been included in the WHO essential drug
list )

- The subsequent  review process needs to be transparent   involving
the  Civil Society Organization (CSO)s

- Universal access giving equal opportunity for every one to access
education, information and prevention  including  more than 80%
coverage for access to treatment and care.

-Ensure adequate resources from the international donors as well as
national budgetary allocations for HIV/AIDS to reduce the resource
gap

Dr. S I Ahmed,
(APS, India )
Part of UNGASS Indian Delegation in UN ,  NYC ,
e-mail: <siahmed60@...>