India to Increase HIV Treatment Centers.

India to Nearly Double Treatment Centers Providing Free HIV/AIDS
Drugs by End of Year

By NIRMALA GEORGE

NEW DELHI Sep 29, 2006 (AP)— Indian authorities plan to nearly
double the number of treatment centers providing free drugs and
medical care to people battling HIV/AIDS, a senior official said
Friday.

The National AIDS Control Organization, part of India's health
ministry, hopes to reach about 85,000 people with drugs and
treatment once all the treatment centers open.
India has come under increasing criticism from international health
groups for failing to meet the National AIDS Control Organization's
own goal of getting free AIDS drugs to 100,000 people by the end of
2005.

The U.N. AIDS organization said in May that India's 5.7 million
infections meant the country has the highest number of people in the
world living with HIV. India has more than 1 billion people.
The National AIDS Control Organization has increased the number of
health centers providing AIDS medicines from 54 to 91 this year,
with nine more centers to open by the end of October, said Sujatha
Rao, who heads the organization.

"Our first priority now will be to launch a massive publicity
campaign to let people know that free anti-retroviral drugs for
HIV/AIDS are available at these centers and that they should reach
out for free treatment," Rao said. "We also have drugs available for
10,000 children and have begun a state-by-state search to identify
children suffering from HIV/AIDS."

Ignorance and the stigma surrounding HIV/AIDS have meant that many
infected people do not get the drugs even when they are free, she
said.

The campaign was expected to include newspaper, television and radio
advertisements, and posters at primary health centers across the
country giving details about the network of treatment centers.
Budget constraints for the AIDS prevention programs also are a
problem. Health authorities in Indian have earmarked $200 million
for the financial year 2006-2007.

"This is not enough. But we have to balance what we are spending on
AIDS with other health priorities," Rao said.

Most of the centers are concentrated in Maharashtra, Tamil Nadu,
Andhra Pradesh, Manipur and Karnataka all states with a high
incidence of HIV/AIDS. All the centers are to have specially trained
doctors, counselors and laboratory technicians.

http://p20.news.re2.yahoo.com/s/ap/20060929/ap_on_he_me/india_hiv

Charges in Kazakh HIV scandal

Several Kazakh officials have been charged with criminal negligence
over a blood bank scandal that has seen five children die of Aids-
related illnesses.

At least 61 children have tested positive for HIV after receiving
blood transfusions at a paediatric clinic near Shymkent in the
country's south.

A further 12,000 children are now being screened for exposure to the
virus.

Kazakhstan's health minister and the regional governor were both
fired over the scandal last week.

Donors paid

The children are thought to have been infected either through
unsterilised equipment or through contaminated blood.

The BBC's Stephanie Irvine said that donors are paid for their blood
transfusions in Kazakhstan and local authorities are searching for a
number of donors who may be HIV carriers.

The first cases emerged in July and all those infected were between
two months and 10 years old.

According to the Kazakhstan Today news agency, charges have been
brought against the former regional health director, two of his
deputies and five doctors.

Investigations are also taking place into the forged signatures of
six donors who had been paid for their blood, the agency reported.

HIV prevention officials in Shymkent told Agence France-Presse that
at least 2,700 children may have come into direct contact with the
virus.

http://news.bbc.co.uk/2/hi/asia-pacific/5382494.stm

Dear Forum

Introducing 'Infectious Agents and Cancer' a new online journal.

It has just be launched a new online journal open access on
Infectious agents and Cancer published by BioMed Central and freely
accessible at www.infectagentscancer.com.

The aims of the journal are outlined in my opening Editorial entitled
Introducing Infectious Agents and Cancer , where I am stressing the concept of
the heavy burden of Infectious diseases and pathogen-related Cancers in
Developing Countries and the need to make scientific information available to
scientists and clinicians, in particular those in developing countries where the
fight against pathogen-related cancers is of the utmost importance.

I would like to take this opportunity to attract you attention on the article
focused on HIV clades in Iran.

If possible, it would be useful to receive your comments.

Thanks for your attention.

Best regards

Franco

Franco M. Buonaguro
Viral Oncogenesis and Immunotherapy, Dpt of Experimental Oncology, Ist. Naz.
Tumori “Fondazione Senatore
G. Pascale, Via M. Semmola n.1, 80131 Napoli, Italy
e-mail: <irccsvir@...>

ANNOUNCEMENT OF SELECTED CANDIDATES TO REPRESENT CIVIL SOCIETY
AT THE INTERNATIONAL DRUG PURCHASE FACILITY (IDPF/UNITAID) BOARD

The Call for Nominations was announced on September 5, 2006 to solicit
nominations for the positions of civil society representatives at the
IDPF/UNITAID Board:
· 1 Board member and 1 Alternate from communities living with
HIV/AIDS, TB and malaria;
· 1 Board member and 1 Alternate from NGOs fighting the diseases;

THE SELECTION COMMITTEE IS PLEASED TO ANNOUNCE THE RESULTS: Communities living
with the HIV/AIDS, TB and Malaria:

Board member from communities living with the diseases: The Selection  Committee
decided to extend the application deadline until Friday October 6 for this
position. The tight schedule of selection process did not allow soliciting
sufficient number of applicants before the 1st UNITAID Board meeting on October
3-4.

Therefore, the Alternate member as below will represent communities at this
meeting while the selection process for the Board member will continue until
mid-October. The Call for Nominations for
this position will be posted again in the coming days.

Alternate Board member: Ms Carol Nawina Nyirenda, (email:
carolnawina@...) A person living with HIV, a treatment activist as part of
Treatment Advocacy and Literacy Campaign, Zambia (TALC); has extensive
experience as community worker involved in issues pertaining to universal access
to treatment. Carol has significant experience in project management, from
co-ordinating activities of Zambia Federation of Associations of Women in
Business to designing, implementing and managing grassroots community projects.
Carol will maintain a link between the IDPF and the intended end  users to
ensure that the needed drugs are purchased and made available to the most
affected.

NGOs fighting the diseases:

Board member: Mr. Khalil Elouardighi, (email: gerrold@...)

Advocacy officer for international affairs with extensive experience in
advocating for universal access to HIV/AIDS care and treatment, as part of
French PWA-based activism group Act Up-Paris. He has strong relations with
groups in the South (e.g. the PLAnet Africa network) and many other members of
the international AIDS fight community. He maintains close contact with the NGO
delegations at the Global Fund Board. Khalil has been working on IDPF initiative
since December 2005, especially on lobbying the French government towards
ensuring the highest possible outcome of this initiative for universal access to
HIV/AIDS care and treatment.

Alternate Board member: Mohga Kamal Yanni, (email:
mkamalyanni@... )

Senior health and HIV policy advisor at Oxfam UK, provides strategic
direction and support for health and HIV/AIDS policy development,
programmes, and advocacy; a member of the Oxfam International HIV group, through
which she led the development of the first Oxfam International HIV advocacy
strategy; an active member of the Developed Country NGO Delegation at the Global
Fund Board. Her background is a medical doctor from Egypt. Recently, Mohga has
been involved in the development and advocacy of NGOs position on UNITAID
providing technical and policy input.

Selection Committee members:

1. Asia Russell, HealthGap, USA
2. Lydia Mungherera, The AIDS Support Organization (TACO), Uganda
3. Shaun Mellors, International HIV/AIDS Alliance, UK

The Selection Committee wishes the new members courage and strength in their
challenging and rewarding roles at IDPF/UNITAID Board.

International Council of AIDS Service Organizations (ICASO)
65 Wellesley St. E., Suite 403
Toronto, ON M4Y 1G7
CANADA
Tel: + 1-416-921-0018
Fax: + 1-416-921-9979
E-mail: icaso@...
Web site: www.icaso.org

Foreign laborers must get medical exams: Health Minister

Kurdistan (Occupied Territory of USA)The Kurdish Globe, Septermber
25, 2006

Kurdistan Health Minister Dr. Zryan Osman stressed that foreign
workers entering Kurdistan must undergo medical examinations and
AIDS tests.

"We have discovered four positive AIDS cases so far in individuals
from India, Iran, Turkey, and Lebanon," said Dr. Osman. "Whoever
wishes to work in Kurdistan must obtain an AIDS test.

For those who do not undergo a medical test, we as Ministry of
Health will take a test for him or her, and if the test is positive
then we shall inform the Ministry of Interior to deport them back to
their countries."

Dr. Osman said the four people who tested positive for AIDS have
already been sent back to their country of origin. According to the
immigration law, tests must be taken within three months of entering
Kurdistan. It is expected that many foreign companies may come to
Kurdistan following the approval of the investment law in Kurdistan.

http://www.kurdishaspect.com/doc925103.html

Re: Regular, routine HIV test for all between 13-64 year old. CDC
(Combined responses)

1) 1) It is the kind of thing, though, that we come to expect from
the single worst administration in US history.

George M. Carter
USA

2) It is a fact that women are being tested in a routine manner in
the pre natal tests.

Winnie Singh
New Delhi, India

3) I don't think the CDC proposal is for 'mandatory testing'.

Prof. Prof. Glen Mola
Papua New Guinea

4) Mandatory (routine) HIV Testing vs Voluntary Testing has always
been a hot and controversial debate.

Dr. Arvin Chaudhary
Fiji


5) What applies in the US does not necessarily will or should also
be applicable in other countries/societies

Mr. Kartono Mohamad
Indonesia

____________________________


1) It is the kind of thing, though, that we come to expect from the
single worst administration in US history.

Dear all,

"We really need to debate this. I am totally against this `routine
testing' proposed by US CDC."  I agree completely with all the very
well-articulated points raised!

As I understand it, this "routine testing" is NOT mandatory.
However, the "voluntary" bit of it is watered down with this
unprecedented method. As far as I know, no other disease
is "routinely" tested with a kind of 'opt-out' rather than 'opt-in'
approach that this appears to be.

Another extremely upsetting and despicable piece of this "test,
test, test" nonsense is that it seeks to destroy the extremely
critical "counseling" piece of testing.

It is the kind of thing, though, that we come to expect from the
single worst administration in US history.

George M. Carter
USA
George M. Carter" <fiar@...>
__________________________________

2) It is a fact that women are being tested in a routine manner in
the pre natal tests.


I endorse the views of Meenu that routine testing needs to be
debated. It is a fact that women are being tested in a routine
manner in the pre natal tests. There is a need for voluntary testing
with full support of counselling services available. In absence of
the counsellors, it can be extremely traumatic for a person who has
little or no knowledge about HIV to deal with the information that
he/she is HIV+.

In case we were equal opportunity employers it would be  different
story if the employer gets all employees tested for all possible
easily detectable diseases that he is looking at providing medical
benefits through insurance or otherwise but if it is to deal with
discrimination and not give him a job opportunity if he is found to
be HIV+ then it is not justifiable because people sitting in key
positions of power are still not informed that a PLHIV can lead a
perfectly productive and healthy life. We first need to eal with the
myths before contemplating routine testing.

Winnie Singh
New Delhi, India
e-mail:  winnie.singh@...
________________________________________________

3) I don't think the CDC proposal is for 'mandatory testing'.


Dear Colleagues

I don't think the CDC proposal is for 'mandatory testing'. I think
you  have misread their proposal. It is rather a sort of opt-out
approach. In  these circumstances group counseling can be
appropriate, or for  individuals notice is given that HIV is one of
the tests that is proposed for the blood sample and if you don't
want your blood tested  then you need to say so.

There will never be any approval anywhere for uninformed 'routine'
testing. Better if you concentrate on the wrong things that are
happening in India rather than trying to sabotage a good proposal
from CDC.

In some circumstances this is an appropriate approach to HIV testing
in developing countries, - certainly it is in my country (Papua New
Guinea). But obviously not in the situation where a person presents
to discuss the possibility of testing, - then the full pre-test
individual counseling needs to be done.

However, if we are ever going to control (and treat) HIV more
people  have to find out their HIV status before they are - terminal
with AIDS - have spread the infection to the rest of the community
for the  previous 10 years not knowing that they are positive.

Sincerely,

Prof. Glen Mola

Professor of Obstetrics & Gynecology
Chief Obstetrician Gynecologist for the Ministry of Health (SSMO O&G)
School of Medicine and Health Sciences, UPNG
box 1421 Boroko NCD
Papua New Guinea
Tel;work:3256022/3248310
Fax:3258212/3258807
Email: glenmola@...

__________________________________________________
4. Mandatory (routine) HIV Testing vs Voluntary Testing has always
been a  hot and controversial debate

Hi,
Mandatory (routine) HIV Testing vs Voluntary Testing has always been
a  hot and controversial debate.

Some basic question needs to be answered before any Government or
Agency  commits to Mandatory testing is "who is going to benefit
from the  test?" "what is going to be done with positive clients?"
So far no agency has come up with a satisfactory answer. The closest
they got was to increase awareness in public.

BUT one must understand the window period of HIV. testing someone
for HIV  and finding he or she is negative (where as they could be
having HIV but  in window period) and if we give them the clearance
and they go and mess  themselves up then we will be taken to task
under malicious spread of HIV  crime.

On other hand, if the HIV testing is to prevent mother to child
transmission, then this test should be readily offered [and not
forced]  and each and every expectant mother must be given
counseling and  education so she can make an informed decision on
the test. Taking into account that a woman has the right to refuse the test.

Dr. Arvin Chaudhary
Senior Medical Officer In-charge
Sexual Health, STI and HIV/AIDS Medicine
Western Health Services
Lautoka, Fiji
Ph work: (679) 6660 411, 6640 243
Ph mobile: (679) 9954390
Fax: (679) 6652476
Fax:(679) 6652476
e-mail:  achaudhary@...

____________________________________________

5) What applies in the US does not necessarily will or should also
be applicable in other countries/societies


Dear Meena,

I can understand your rejection to the US CDC policy on routine HIV
testing.

But let's keep in mind that what applies in the US does not
necessarily will or should also be applicable in other
countries/societies.

The level of "feeling of emergency" and the level of education of
the people are different. Stigmatization on HIV/AIDS/People with
AIDS is still strong in many developing countries. The level
of "feeling of emergency" among political as well as community
leaders about HIV pandemic in developing countries are still very
low. So let CDC decides what they feel necessary for US, and we
decide what is necessary for our respective countries.

BTW: I can feel your worry on discrimination and stigmatization on
HIV in your message. Let those be one of our areas of high priority
to be dealt with.

Best regards

Kartono Mohamad
Indonesia
e-mail: <kmjp47@...>

Pacific islands call for help on HIV/AIDS

Small island nations in Pacific region called Friday for more
international support against HIV/AIDS.

The Premier and Health Minister of the tiny Pacific island of Niue
said his government now requires HIV testing for all visitors
staying longer than two months.

"It's only a matter of time before Niue gets its first case. We 're
only less than 2,000 people," said Young Vivian.

"If we are eradicated (by AIDS) from this world, wiped off the map,
I'm sure that you will miss us. It's absolutely scary as a leader of
a small island country," said Young Vivian.

About 600 new cases of HIV and 200 deaths occur daily in the World
Health Organization's vast Western Pacific region, Richard Nesbit,
the organization's acting regional director said at a week long
annual meeting in Auckland, New Zealand.

The 57th session of the WHO Regional Committee meeting of the 34
Ministers of Health and Directors of Health is discussing control
and intervention strategies, immunization, tobacco control and
environmental health. The WHO was also expected to discuss its
budget for 2008-2009.

In Fiji, despite growing concern over HIV infections over the past
decade, too few resources have gone towards monitoring the impact of
education and behavior change programs, said an official.

He said of the 10 HIV-related cases in the Northern Division of
Fiji, one person turns up at the clinic for medication, medical
officials see four during home visits while five have not returned.

Papua New Guinea is already facing a generalized epidemic, and its
health minister said earlier in the week that isolated pockets
within the country could have HIV rates as high as 30 percent.

The country, which shares an island north of Australia with
Indonesia's easternmost Papua province, is the hardest-hit in the
Asia-Pacific with an adult per capita infection rate of 1.8 percent,
according to UNAIDS figures.

Secretary of Health Nicholas Mann said rich countries need to pay
more attention to his poor island nation of 5.7 million people.

He said the United States, for example, has not offered his country
any funding to help fight the virus.

He said any assistance that does arrive must be directed properly in
order to make a difference in a diverse country where hundreds of
languages are spoken.

In a Friday's statement from WHO Western Pacific Region, it pledged
to scale up HIV/AIDS prevention and control activities in line with
the goal of universal access for HIV/AIDS treatment throughout Asia
and the Pacific by 2010.

It said the move follows the joint launching by WHO and UNAIDS of
the "3 by 5 Initiative" in 2003 to support the expansion of access
to antiretroviral therapy in low- and middle- income countries to 3
million people living with HIV/AIDS by the end of 2005. The
initiative has increased the lifespan of many people living with
HIV/AIDS.

WHO officials noted each country needs to determine its priority
strategies, targets, interventions and activities for scaling up
universal access.

WHO officials said UNAIDS and WHO are committed to support
countries, including small countries, in this process and will
continue to develop policies and guidelines to support countries in
expanding HIV/AIDS prevention and control activities.

Source: Xinhua
http://english.people.com.cn/200609/22/eng20060922_305325.html

Dear all,

We really need to debate this. I am totally against this `routine testing'
proposed by US CDC.

Since, USAID, and CDC has extensive influence on national HIV programs in this
region, they may try to coax the national HIV programs to adopt a routine HIV
test policy.

In the case of India, National AIDS Control Organization,(NACO),  has developed
a Voluntary Counselling and Testing (VCT) policy that states that "no individual
should be made to undergo mandatory testing for HIV" and that "no mandatory
testing should be imposed as a precondition for employment or for provision of
health care facilities during employment" (India's armed forces are exempt from
this condition).

NACO has also developed guidelines for VCT enters, which deal with consent and
confidentiality issues

But the truth is that most pregnant women in India  are ‘routinely’ administered
the test. Just like the CDC is now suggesting… one test among a list of others.
This is the procedure followed in Sangli district of Maharashtra, in India with
disastrous results.

Most young pregnant women are never told by the family and are left wondering
why they are being suddenly shifted to the public hospital for the delivery of
the child. The sudden discovery of ;

a. Infidelity of the partner
b. The cruelty of being denied treatment.
c. The coping of being in a new environment [marital home] and being sent back
in disgrace to the maternal home
d. AIDS happens to someone else – the disbelief
e. What is it?

Are some of the situations the young bride has to deal with! With counselling
she would at least have a sympathetic outsider who knows about HIV/AIDS and
about the various emotions she has to deal with and help to address some of
them. It is very cruel to suddenly discover that the joy of being pregnant is in
fact taken over by an overwhelming ‘positive test’. With pre –test counselling
at least she knows what is being done and is aware of the test and the
implications of the test.

The assumption that testing will actually provide treatment services is also a
misnomer. In the case of women who are pregnant private practitioners use it to
discriminate and to send them to the civil hospital.

It is not only pregnant women. Many Indians are tested for HIV without their
consent or knowledge. It has been reported that over 95% of patients listed for
surgical procedures are involuntary tested for HIV; for those who test positive,
their treatment/surgery is cancelled. Another issue for anyone undergoing an HIV
test is that his or her test will in most instances be neither anonymous nor
confidential. Some government officials (inc. legislators in Goa and Andhra
Pradesh) have even voiced their support of mandatory premarital testing for HIV
and are proposing related legislation.

I have nothing against early detection of HIV. But I find it very difficult to
deal with the test being administered when there is absolutely no need for it.
In resource poor settings so much money will be spent on the test, which just
helps the state to crunch a few numbers rather than test for the benefit of the
person being tested.

Sex Workers will be the first casualty. The HIV epidemic has singled out
people-in-prostitution and sex-work as `carriers and vectors of spread of HIV ’.
Apart from the stigma already attached to their work, society has further
marginalized them as core transmitters of HIV infection. Routine testing for
them within this frame will almost always be mandatory.  Propagating the myth
that people-in-prostitution and sex work are core transmitters of HIV serves the
purpose of `prostitution bashers’ imbued with the moral and judgmental attitude
that reinforces the prejudice that AIDS is an ‘impure’ disease that afflicts
immoral and evil persons.

The net result is to further target the women, which will only mean paying for
the test irrespective of the fact that they may not want it, or may not be ready
for it. Refusal to take the test will result in

• Increase in public and police violence against them;
• Decrease in their ability to assert themselves;
• Allow the state to demand and force them to give themselves up for the test

  It will only increase the rate of HIV and TB among sex workers, customers and
the families of the customers and, denies them access to health care services.

In solidarity,

Meena Saraswathi Seshu.
Sangli, Maharashtra, India
E-mail: <meenaseshu@...>

CDC: Regular, routine HIV test for all between 13-64. In a new
HIV/AIDS recommendation was published in the most recent issue of
the Morbidity and Mortality Weekly Report (MMWR) Reports and
Recommendations series, September 22, 2006.
________________
CDC backs HIV test for all between 13-64

By MIKE STOBBE, AP Medical Writer
ATLANTA - Federal health officials Thursday recommended regular,
routine testing for the AIDS virus for all Americans ages 13 to 64,
saying an Top of Form HIV test should be as common as a cholesterol
check.

The U.S. Centers for Disease Control and Prevention guidelines are
aimed at preventing the further spread of the disease and getting
needed care for an estimated 250,000 Americans who don't yet know
they have it.

"We simply must improve early diagnosis," said  CDC Director Dr.
Julie Gerberding.

Nearly half of new HIV infections are discovered when doctors are
trying to diagnose a patient who has already grown sick with an HIV-
related illness, CDC officials said.

"By identifying people earlier through a screening program, we'll
allow them to access life-extending therapy, and also through
prevention services, learn how to avoid transmitting HIV infection
to others," said Dr. Timothy Mastro, acting director of the CDC's
division of HIV/AIDS prevention.

Although some groups raised concerns, the announcement was mostly
embraced by health policy experts, doctors and patient advocates.
"I think it's an incredible advance. I think it's courageous on the
part of the CDC," said A. David Paltiel, a health policy expert at
the Yale University School of Medicine.

The recommendations aren't legally binding, but they influence what
doctors do and what health insurance programs cover.

However, some doctors' groups predict the recommendations will be
challenging to implement, requiring more money and time for testing,
counseling and revising consent procedures.

Some physicians also question whether there is enough evidence to
expand testing beyond high-risk groups, said Dr. Larry Fields, the
president of the American Academy of Family Physicians.

"Are doctors going to do it? Probably not," Fields said.

But the recommendations were endorsed by the American Medical
Association, which urged doctors to comply. The CDC said it's
difficult to predict how many doctors will.

Previously, the CDC recommended routine testing for those at high-
risk for catching the virus, such as intravenous drug users and gay
men, and for hospitals and certain other institutions serving areas
where HIV is common. It also recommended testing for all pregnant
women.

Under the new guidelines, patients would be tested for the AIDS
virus as part of the standard tests they get when they go for urgent
or emergency care, or even during a routine physical.

The CDC recommends everyone get tested at least once, but annual
testing is urged only for people at high risk.

Consent for the test would be covered in a clinic or hospital's
standard care consent form. Patients would be allowed to decline the
testing. The CDC's guidelines say no one should be tested without
their knowledge.

An American Civil Liberties Union official protested the CDC's idea
of dealing with HIV on standard consent forms, and the agency's de-
emphasis of pre-test counseling.

"By eliminating these safeguards, what they're calling 'routine
testing' will in practice be mandatory testing," said Rose Saxe, a
staff attorney with the ACLU AIDS Project.

The cost of the new policy is not clear. A standard HIV test can
cost between $2.50 and $8, public health experts say.

New rapid tests cost about $15. If an initial result is positive,
confirmatory tests can cost another $50 or more. Treatment for HIV
can cost more than $10,000 a year.

WellPoint, the Indianapolis company that owns 14 Blue Cross and Blue
Shield plans across the country, has not yet taken a position on the
CDC guidelines.

It also hasn't estimated what it will cost to expand HIV testing for
its 34 million members, but it traditionally covers tests
recommended by the CDC, said WellPoint spokeswoman Shannon
Troughton.

The recommendation, if fully implemented, could mean testing for to
100 to 200 million Americans, said Ron Spair, chief financial
officer of Pennsylvania-based OraSure Technologies, one of three
companies that sell rapid-result HIV tests in the United States.
The other companies are MedMira Inc. and Trinity Biotech. Standard
HIV tests are done through both public health labs and private and
commercial labs.

"This certainly expands the rapid HIV testing market," Spair said.
Identifying more HIV patients will place an added burden on public
health programs that pay for such care, some of which are facing
potential cuts under a proposal before Congress. But more diagnoses
may help win bolstered funding, said John Peebles, an assistant
branch chief over HIV programs at the North Carolina Department of
Health and Human Resources.

"If you don't know what you need, you can't make the argument for
resources," Peebles said.

The CDC has been working on the guidelines for about three years,
and got input from more than 100 groups, including doctors'
associations and HIV patient support groups.

http://news.yahoo.com/s/ap/20060921/ap_on_he_me/hiv_testing
____________________
Moderators note: Revised Recommendations for HIV Testing of Adults,
Adolescents, and Pregnant Women in Health-Care Settings, can be
viewed on-line or downloaded at
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm.

This report is also available in the Adobe Acrobat PDF file format
at http://www.cdc.gov/mmwr/PDF/rr/rr5514.pdf.

Smokers may have higher risk of HIV - study

Thu Sep 21, 2006 6:25 AM IST

LONDON (Reuters) - Smoking, already linked to several illnesses, may
also increase the risk of infection with HIV, the virus that causes
AIDS, researchers said on Thursday.

In a review of studies that looked at the association between
smoking and HIV, British doctors said five of the six studies they
analysed showed smokers had a higher chance of becoming infected.
Nine of 10 other studies in the review that tracked the progression
from HIV to AIDS found no link with smoking.

"The studies identified in this systematic review indicate that
while smoking might be independently associated with acquiring HIV
infection, it does not appear to be related to progression to AIDS,"
said Dr Andrew Furber, of the South East Sheffield Primary Care
Trust.

Furber and his colleagues, who reported the findings in the journal
Sexually Transmitted Infections, said tobacco smoke may increase
susceptibility to HIV infection by modifying a variety of immune
system responses.

Research has shown that smoking is a leading cause of preventable
death. It increases the risk of heart attack and stroke, respiratory
problems, lung and other types of cancer.

The researchers suggest in the study that public health measures
that encourage smokers to quit could also improve the effectiveness
of HIV/AIDS prevention programmes.

About 40 million people worldwide are living with HIV/AIDS. Nearly 5
million were newly infected in 2005 and more than 3 million adults
and children died of AIDS in the same year.

http://in.today.reuters.com/news/newsArticle.aspx?
type=worldNews&storyID=2006-09-21T061636Z_01_NOOTR_RTRJONC_0_India-
268577-1.xml&archived=False

Accountability:  Theme for World AIDS Day 2006

Dear Colleagues,

Below is a brief update on World AIDS Day 2006 and a request for
information about your event and activities plans on the day.

As you have hopefully heard by now the theme for World AIDS Day this
year is accountability. The theme and the materials to support it
have been developed by the World AIDS Campaign support team based on
their ongoing work around World AIDS Day. A number of lessons have
been learnt from previous work on World AIDS Day, and far more
energy was invested early in the year to make World AIDS Day 2006 a
success. The most significant aspect of this World AIDS Day is the
degree to which it has been based around the inputs of a wide range
of civil society partners.

During World AIDS Day 2006, we hope to achieve the following
objectives:

Enhanced accountability from political leaders on their promises on
AIDS.

Supporting a broad movement of civil society organizations
campaigning to develop their sense of

joint identity and common purpose.

Generating a greater public awareness of, and engagement with, the
problem of AIDS worldwide.

Efforts are being made to allow as much scope as possible for local
adaptation of the World AIDS Day theme. Specific country campaigns
can be decided on by local organisations within the overall theme of
accountability.

These campaigns may wish to utilise the World AIDS Day slogan, Stop
AIDS. Keep the Promise, as it stands on its own. Alternatively, they
may decide to develop a slogan that specifically addresses the local
issue and use it in conjunction with the World AIDS Day slogan. For
example, if a national campaign is run to address the lack of
concrete indicators in achieving Universal Access to Treatment, Care
and Prevention, the slogan could be: "Set the goals for Universal
Access: Stop AIDS. Keep the Promise."

To further promote the theme of accountability, we propose involving
the following schemes in World AIDS Day activities:

Red: Using the colour red in promotional objects, e.g. red ribbons,
t-shirts, banners, etc.

Targeting Leaders: To reinforce the notion of leader responsibility,
planning activities such as marches, advocacy, letter writing, etc.
Where possible, both schemes should be used simultaneously. For
example, if a campaign plans to march on a legislative body for
World AIDS Day, it would be encouraging and make more of an impact
if everyone wore red.

In order to assist in World AIDS Day campaigning, resources will be
provided by the World AIDS Campaign support team including: a CD-Rom
action pack with campaigning information and communications
materials, World AIDS Day posters, website with a World AIDS Day
events calendar, information and a web forum, a series of press
releases, World AIDS Campaign newsletters, networking opportunities
and a media pack.


World AIDS Day Action Packs, which include World AIDS Day posters in
a choice of English, Spanish, Russian or French languages,and a CD-
ROM in all four languages, will be ready in early October. They will
also be available to view and download on our website by the end of
the week.

If you would like to receive a copy of the Action Pack , please
contact us at worldaidsday@... and indicate your
preference in language. Please note, there are a limited supply of
materials and materials will be sent out on a first come, first
serve basis.

What are you doing for World AIDS Day?

Please let us know your plans for World AIDS Day so we can share the
information with colleagues around the world and post events on our
website .

To find out more about World AIDS Day 2006, please go to
www.worldaidscampaign.org

Health minister fired over baby AIDS deaths

Reuters, 20 Sep 2006 07:36:21 GMT

ASTANA, Sept 20 (Reuters) - Kazakhstan's health minister and a
regional governor were fired on Wednesday following the deaths of at
least four babies and the infection of at least 55 children with the
HIV virus, an official said.

The children, and one mother, were infected in the past few months
in a hospital in the south of the Central Asian state, apparently
after receiving transfusions of blood containing the virus.
"Due to serious shortcomings linked to this situation, the akim
(governor) of the (Southern Kazakhstan) region Bolat Zhylkyshiyev
and Health Minister Yerbolat Dosayev have been relieved of their
positions," Nurlan Abdirov, deputy secretary of the presidential
Security Council, told reporters.

On Monday, the Health Ministry said the cause of the infections had
been negligence in a blood transfusion centre in the southern city
of Shymkent.

The number of infected children, aged between two months and 10
years old, has been gradually rising as officials test children for
HIV in the region.

Police are investigating the deaths and infections but no charges
have yet been brought.

HIV/AIDS infection levels have increased dramatically across Central
Asia since the collapse of the Soviet Union, mainly among drug
addicts and in prisons

http://www.alertnet.org/thenews/newsdesk/L20827531.htm

AIDS is Political

By Rajiv Kafle The Kathmandu Post, September 16, 2006

Peoples' Liberation Army (PLA) and People living with AIDS (PLAs) do not only
share the same acronym but have many similarities with each other.

To begin with the government does not know their exact numbers and
everything depends on guessing. Both have travel restrictions in some
countries, Both have lost many of their friends and families in a short span of
time. Both are hidden from the outside world and use a
pusedonym. Their origin in itself is similar. They took birth in
poverty, were fed with inequality and grew up in injustice. Both are
dependent.

One collects donations from the locals and the other is dependent on
International funding. One is already under UN monitoring and one will soon be.
Both live one day at a time hoping to see the next
day. Both die young with hopes that there will be a better tomorrow.

I have been an ardent supporter of the theory that "AIDS is a political crisis"
as soon as I started understanding that a shorter cure for TB does not exists
because majority of TB cases are in poorer countries that cannot afford to
invest in new drug development.

When I came to know that trade related intellectual property right (TRIPS) does
not allow generic drug manufacturing hence poorer countries will soon run out of
cheap drugs my beliefs strengthened.

I learnt in a course of time that if the democrats would have won the
presidential election in US lesser number of drug users would be infected with
HIV in my country.

I am now convinced that AIDS is political but many still take it purely as a
health issue and in the forefront is my government itself.

However I was amazed recently to hear comrade Hisila Yami, an
influential leader of the NCP Maoist talk about AIDS. In comrade Yami's words
the current house of representative is living with AIDS. "It looks like it is
healthy from outside but it is in its window period" she explained.

For a while I thought that she had also realized that AIDS is
Political. Comrade Yami's intentions may not have been to politicize AIDS but
mine are.

I was in Rolpa recently. Due to poverty people are forced to migrate to India
from many hilly districts and Rolpa is no exception. While in India many get
infected with HIV as the cheapest form of entertainment comes in a package -
alcohol and sex.

They return home once in a while and without knowing their own status end up
infecting their innocent wives and children. This is what our country is going
through these days. And in a way Comrade Yami is absolutely correct. The house
is living with AIDS because majority of the representative in the house also
represent those living with AIDS. Comrade Yami is also right in saying that the
house is in a window period because the representatives have not yet realized
that AIDS is a major issue in our country.

One study in 2003 among migrant workers in Achaam showed 8% HIV
prevalence. Recently a small study among families of migrant workers in Surkhet
showed 25% HIV prevalence. Comparing these two studies one can easily tell that
HIV is spreading much faster than one would imagine.

United Nations AIDS agency (UNAIDS) estimated that over 10,000 people
would die every year due to AIDS related illnesses in Nepal. However it does not
ring a bell amongst political leaders and policy makers.

It is obvious for me to go with Comarade Yami's argument that they themselves
are living with AIDS yet unaware of their own status. I hope that the house is
dissolved soon so that when the new house is formed people living with AIDS who
are aware of their status be part of it and resolve this political crisis of
AIDS.

  However, it does not ring a bell amongst political leaders and policy makers.
It is obvious for me to go with Comarade Yami’s argument that they themselves
are living with AIDS yet they are unaware of their own status.

I hope that the House will be dissolved soon so that when the new House is
formed people living with AIDS who are aware of their status be part of it and
resolve this political crisis of AIDS.

(Rajiv Kafle is an AIDS activist)

http://kantipuronline.com/kolnews.php?&nid=86281
__________________________________

"Sherry Joseph"
E-MAIL: <sjoseph@...>

18th International Conference on the Reduction of Drug Related Harm "Harm
Reduction Coming of Age"

IHRA, The Conference Consortium and ENDIPP are pleased to announce this
must-attend event, which takes place in Warsaw, Poland, from 13th to 17th May
2007. To find out more about the event, including abstract submission (deadline
23rd October 2006) and registration details, please visit the conference website
www.harmreduction2007.org

As of next Monday there will be regular updates of the conference programme on
the website.

Please note that the abstract submission deadline is 23rd October 2006.

Kind Regards

Artur Krol,
IHRC 2007 Conference Officer,
Conference Office & Secretariat
Wisniowa 50, IIIrd floor
02-520 Warsaw, Poland
Phone (UK): +44 208 123 99 81
Phone (PL):+48 22 640 82 71
Fax: +48 22 640 82 71
E-mail: management@...

HIV/AIDS / PREVENTION STRATEGY UNDER REVIEW: Married women a high-
risk group

APIRADEE TREERUTKUARKUL

The rate of HIV infections is on the rise among married Thai women,
health authorities have warned. Sombat Tanprasertsuk, director of
Aids, Tuberculosis and Sexually Transmitted Diseases Bureau,
yesterday said the rise in HIV infections among the ''indirect risk
group'' prompted the public health authorities to review its
HIV/Aids prevention strategy.

Officials believe the reason the disease was infecting more married
women was because they were engaging in unprotected sex with their
infected husbands, he said.

More than 30% of the estimated 17,000 new HIV cases last year were
married women, followed by the men having sex with men group (20%),
intravenous drug users (10%), with the rest being teenagers and
buyers of sex services, according to the Public Health Ministry's
latest report.

Lack of abstinence, faithfulness and condom use (ABC) was the major
cause of increase in the infection rate among married women, Dr
Sombat claimed.

The finding should be a wake-up call for authorities handling the
HIV/Aids prevention campaign.

It is now clear that the changing situation is creating new
challenges for those involved in fighting the disease. Health
authorities usually regard sex workers as the direct risk group.

They have been promoting the 100% condom use campaign to prevent
Aids and other sexually-transmitted diseases.

Dr Sombat said the ministry has also urged hospitals nationwide to
run the Partner Notification project, which encourages married
couples to have their blood regularly tested and promotes the ABC
principles.

Under the project, five million condoms would be distributed to
married couples by the end of this year in a bid to control the
transmission of HIV between husband and wife, he said.

Nimit Tien-udom, director of the Aids Access Foundation, blamed the
government's discontinuation of the campaign to promote condom use
as a reason of an increase in HIV infections.

He said the campaign had been frozen over the past seven years and
it should be revived to educate not only the high-risk groups, such
as sex workers, but also the public as a whole, he said.

Mr Nimit called on the government to show its political will to
fight Aids by stepping up sex education and the condom use campaign.
''You cannot solve this chronic problem by only providing anti-Aids
drugs to the patients,'' he said.

http://www.bangkokpost.com/090906_News/09Sep2006_news14.php

TREAT Asia is pleased to announce its second network meeting on
pediatric HIV in Asia, scheduled for Thursday to Saturday, 2 - 4
November 2006.

This meeting continues the formation of a collaborative research network focused
on pediatrics HIV and begins the creation of the TREAT Asia Pediatric HIV
Observational Database.  The meeting will take place in Thailand over the course
of a day and a half (Friday & Saturday), bringing together primary care
providers, donors, foundations, and others interested in pediatric HIV/AIDS from
throughout the region.

Thursday, 2 November 2006:

* Arrive to Thailand
* Welcome dinner

Friday, 3 November 2006:

* TREAT Asia Pediatric Network Meeting (full day)

Saturday, 4 November 2006:

* TREAT Asia Pediatric Network Meeting (half day)
* Depart from Thailand (evening)

More information and a full agenda will be available shortly.  Please
feel free to pass this information along to anyone you think might be
interesting.

If you have any questions or comments, please contact Stan Wong
(stan.wong@...).

TREAT Asia (Therapeutics Research, Education and AIDS Training in Asia)is
not-for-profit, non-governmental organization.  It is a network of clinics,
hospitals, and research sites working together with governments, the private
sector and civil society to ensure the safe and effective delivery of HIV/AIDS
treatments throughout Asia and the Pacific.

To achieve its purpose, TREAT Asia seeks to: conduct research
on appropriate treatment regimens, train healthcare workers, educate
affected communities, and build regional collaboration and policy
capacity.

"Stan Wong"
e-mail: <stan.wong@...>

China: Low awareness and inefficient monitoring retard AIDS control
and prevention

Xinhua

10/9/2006: Low awareness caused by inadequate publicity and
inefficient monitoring and testing systems have retarded control and
prevention of the disease in China, said Dai Zhicheng, president of
the Chinese Association of STD & AIDS Prevention and Control, on
Friday.

"Some local officials believe that too much publicity of the disease
will negatively impair investment and local economy, while others
underestimate the disease and neglect control and prevention," said
Dai.

As a result, the number of reported cases is far less than the
actual number, said Dai.

By the end of last year, localities in China had reported 144,089
people infected with HIV. This represents just 22.2 percent of the
officially estimated figure of 650,000 people living with HIV.

Although China has for a number of years promoted an AIDS awareness
program, many people still know very little about the disease. A
poll conducted by the State Health Ministry asked 1919 college
students from 24 universities in 19 cities about their level of AIDS
awareness. Almost 24 percent of the students don't know how AIDS was
spread and 24.4 percent don't know how to prevent the spread of AIDS.

Discrimination against people with HIV is still serious, noted Dai,
adding that people have an irrational fear of the disease.

Dai was speaking in Nanning, capital city of South China's Guangxi
Zhuang Autonomous Region, where the HIV/AIDS control and prevention
promotion team were visiting to help raise AIDS awareness.

The team, organized by the Working Committee for HIV/AIDS Prevention
and Treatment, under the State Council, will visit another eight
provinces and autonomous regions including Henan, Xinjiang,
Guangdong.

Dai hopes that by giving lectures, they will help local officials
better understand that AIDS prevention requires long-term efforts.

http://english.eastday.com/eastday/englishedition/features/userobject
1ai2310442.html

From the Co-Chairs;

"Risks & Responsibilities:" Male Sexual Health and HIV in Asia and the Pacific
International Consultation. New Delhi, India. September  23 to 26, 2006:

UNAIDS is supporting this important dialogue on a platform of
governments, communities and donors throughout Asia and the Pacific,
because male-to-male sexual transmission of HIV is real and
contributes to increasing numbers of people living with the virus in
Asia and the Pacific. This warrants nothing less than focused
attention and support to strategic well-funded programmes that are
geared towards addressing male-to-male sexual behaviours and the
vulnerabilities of these men.

UNAIDS supports the 'Three Ones' principles of strong leadership and
HIV Programme coordination of one National Strategic HIV Plan and
one comprehensive instrument to track, trace and measure programme
implementation and success. We must in this endeavor also make sure
that the most vulnerable to HIV, including sex workers, injecting
drug users and men who have sex with men are well addressed in these
programmes.

We have an obligation to support initiatives that are geared towards
getting answers to critical questions on men who have sex with men
HIV: "What do we know?" and "What do we need to know?‿ and to
facilitate country-led processes for removing obstacles that hinder
working towards universal access to prevention, treatment, care and
support, including for men who have sex with men.

UNAIDS has agreed to support this International Consultation because
it offers an excellent opportunity to renew or establish long-term
['tripartite'] dialogue and alliances between governments,
communities and key donor and technical partners for strategic work
in the area of men having sex with men and HIV.

I have great pleasure as Director of the UNAIDS Regional Support
Team for Asia and the Pacific, to co-chair this important meeting
alongside Mr. Shivananda Khan who has just earlier this year
received the Order of the British Empire for his many years of
outstanding work in the area of `MSM and HIV' in the Region, and I
am looking forward to meeting you all in New Delhi in September.

JVR Prasada Rao,
Co-chair Risks and Responsibilities Consultation on Male Sexual
Health and HIV in Asia and the Pacific
Director UNAIDS Regional Support Team for Asia and the Pacific
________________________________________

There are very few strategic interventions in Asia and The Pacific
that specifically address male-to-male sex and its related risks and
vulnerabilities to HIV. This is despite significant evidence that
such sexual activity is substantive in the Region and that much of
it is invisible within differing frameworks of masculinities,
genders, and sexualities.  Social exclusion, discrimination and
violence against males who have sex with males, lead to increased
risk and vulnerability to the virus. Because of illegality and
stigma, very few programmes currently exist that address the HIV
prevention, care and support needs of MSM, and where they do exist
this is usually against all odds.

Recent studies indicate HIV prevalence rates among MSM, of 28% in
Bangkok, 20% in Mumbai, 5% in Karachi, 4% in Katmandu, 3% in
Beijing, 14% in Phnom Penh, Ho Chi Minh City 6%; and we could go on.
What further complicates matters is that many males who have sex
with males are also married, and have sex with their female sex
partners. Knowledge and understanding of the issues is poor, social
exclusion is the norm, and risk and vulnerability to HIV is high.
As individuals, families, and countries we stand to lose whatever
gains we may have had in this struggle to reduce the levels of HIV
infection, if we ignore the fact of male-to-male sex and HIV risk
and vulnerability.

Why should we work with MSM for HIV prevention, treatment care and
support? Because it is the right thing to do on humanitarian
grounds; it is the right thing to do epidemiologically; and it is
the right thing to do from a public health perspective!

Males who have sex with males, whether their self-identity is linked
to their same sex behaviour or not, have the right to be free from
violence and harassment; the right to be treated with dignity and
respect; the right to be treated as full citizens in their country;
and the right to be free from HIV and AIDS. And those who are
already infected with HIV have the right to access appropriate care
and treatment equally with everyone; regardless if how the virus was
transmitted to them. This Consultation gives us a great opportunity
to develop a Regional response with political will and donor will,
in full participation with communities.

I wish to express my warmest thanks to all who are making this
important meeting possible. A special thanks to the Government of
India, co-host of this Consultation, and all the sponsors. A special
thanks for the technical and moral support from the Joint United
Nations Programme on HIV and AIDS (UNAIDS) and all the others who
have come together to recognise the critical situation we find
ourselves in regarding `MSM and HIV,' so we can together increase
investment and expand coverage throughout Asia and the Pacific.

As one of the two co-chairs of this of this meeting, let me welcome
you to New Delhi in September 2006. Let us work together,
governments, policy makers, donors, MSM community-based agencies,
non-governmental organisations, international NGOs, and individuals,
not only to make this Consultation a success, but also to ensure
that its outcomes will be a more effective and enlarged response to
the needs of `MSM and HIV,' increased investment for programming,
and a more tolerant and accepting environment for these programmes
to succeed.

Shivananda Khan,
Co-chair Risks and Responsibilities Consultation on Male Sexual
Health and HIV in Asia and the Pacific
Chief Executive of the Naz Foundation International
_________________________________
http://www.risksandresponsibilities.org/
e-mail: secretariat@...

Dear FORUM,

The following is the text of the press note that has just come out
in relation to the XDR TB issue. Very relevant 7th action point is
universalizing ARV access.

Dr. Bobby John
e-mail: <bj@...>
_______________________________
Seven point emergency action plan to combat XDR-TB
issued by global health agencies

Johannesburg 7 September 2006 – Leading health experts today called
for dramatic improvements in TB control to contain and combat the
spread of a deadly new form of the disease, XDR-TB (extensive or
extreme drug resistant TB).  The measures were outlined in an
emergency consultation called by the South African Medical Research
Council (SAMRC), World Health Organization (WHO) and the US Centers
for Disease Control and Prevention (CDC).

Among the actions required are urgent and rapid surveys in high risk
countries to assess the full extent of XDR-TB globally, matched by
increased laboratory capability to carry out vital culture and drug
resistance testing especially in countries where such facilities do
not exist.

Representatives from 11 Southern African countries joined
international experts in the call for increasing the capacity of
clinical and public health managers and their teams to provide
appropriate treatment programmes and train staff to identify,
investigate and combat future XDR-TB outbreaks.

A global survey reported earlier this year that XDR-TB is present in
every region of the world.  However, a recent outbreak in the
KwaZulu Natal province in South Africa highlighted the risk of XDR-
TB for HIV-infected people.  In this outbreak, all but one of 53
patients died within an average 25 days from the point when
resistant TB was first suspected.  This extremely high mortality is
in part explained by the fact that 44 patients tested were all HIV
infected; 15 of these were receiving ARVs.  Nevertheless all died
with XDR-TB.

"HIV has the potential to fast track XDR-TB into an uncontrollable
epidemic," warned Dr Karin Weyer, TB Research Director from the
SAMRC.  "Infection control precautions are needed now, and must be
scaled up without delay in settings where HIV patients are brought
together."

New anti-TB drugs are desperately required to treat XDR-TB
patients.  Research into these new agents has only recently been
revitalized and despite promising drugs in the pipeline, these will
not be available for at least five years.  Further investment in new
drug research and development will be necessary to ensure an
adequate number of effective drugs.

"Crucial to fighting drug resistant TB will be rapid diagnostic
tests – with results available in days rather than months.  Sadly,
many HIV infected patients have died from XDR-TB while waiting for
TB test results," said Dr Ken Castro, Director, CDC's Division of
Tuberculosis Elimination, U.S. Department of Health and Human
Services.

Similar calls for priority action were made by Dr Ernesto Jaramillo,
Manager of the WHO's Anti-TB Drug Resistance team:  "Countries are
requesting technical support and we must be ready to provide the
expertise and skills.  WHO will therefore convene a global task
force to develop detailed recommendations for countries to respond
to XDR-TB effectively."

TB kills 1.7 million people a year.  Just over a year ago, African
Health Ministers declared TB an emergency, and unanimously called
for "urgent and extraordinary" measures to be put in place to
strengthen TB control.  Combating XDR-TB must now be added to
national TB emergency plans, together with promotion of universal
access to ARVs under joint TB/HIV activities.

XDR-TB is defined as resistance to the two most potent anti-TB
drugs, isoniazid and rifampin, together with resistance to at least
three of six classes of reserve second-line drugs.

7 Point XDR TB Action Plan

1.Conduct rapid surveys of XDR-TB
2. Enhance laboratory capacity
3. Improve technical capacity of clinical and public health managers
to effectively respond to XDR-TB outbreaks
4. Implement infection control precautions
5. Increase research support for anti-TB drug development
6. Increase research support for rapid diagnostic test development
7. Promote universal access to ARVs under joint TB/HIV activities

Call for Participation in the Global Fund Contact Group
for Developed Country NGOs ("Contact Group")

NGO members from the Developed Countries are invited to participate in the
Contact Group to work in the following areas:

Global Fund governance
Civil society involvement in program implementation, technical
support, and/or monitoring and evaluation
Increasing the effectiveness and impact of the Global Fund
Increasing the effectiveness of civil society at all levels of the
Global Fund
Resource mobilization for the Global Fund

Purpose of the Contact Group:

Formulate the Developed Country NGO Delegation’s position and
strategy regarding issues that are identified as priorities by the
constituency;

Coordinate activities and share information regarding national,
regional and international advocacy efforts in support of the Global Fund;

Provide candidates for positions of Board Member, Alternate Board
Member, and Communications Focal Point (CFP);
Participate in the GF Board meetings as part  of the Delegation,
if selected by the Board member, Alternate and CFP;
Provide support to the Delegation on specific issues of the Board
Committees:
Policy and Strategy Committee (PSC)
Finance and Audit Committee (FAC)
Portfolio Committee (PC)
Ethics Committee (EC)

Qualifications for Contact Group Members:

Interest in the Global Fund issues;
Strategic ability to work in liaison with other Contact Group
members through email, teleconferences and in-person meetings as required.

Expectations from the Contact Group members:

Invest time and effort in review of the GF documents and other
related information to provide input on specific issues and decision
points;
Willingness to contribute in policy analysis and advocacy for the
Global Fund from the civil society perspective at national, regional and
international levels.

How to join the Contact Group:

Please submit your request to join the Contact Group to Natalia Ciausova at
nataliac@... along with a brief description of your expertise and your
areas of interest regarding the Global Fund. Requests should be submitted before
Friday September 15, 2006.

Gala Vrabiye
Administrative Coordinator
International Council of AIDS Service Organizations (ICASO)
65 Wellesley St. E., Suite 403
Toronto, ON M4Y 1G7, CANADA
Tel: + 1-416-921-0018 ext. 10
Fax: + 1-416-921-9979
E-mail: icaso@...
Web site: www.icaso.org

Chinese rights activist detained

Mr Hu had been under police watch since July

Chinese police have detained a prominent human rights activist and
Aids campaigner who has fought several high-profile cases.
More than 20 plain clothed policemen took Hu Jia from his home in
Beijing, according to his wife, Zeng Jinyan.

Mr Hu, 33, was said to be collecting data on the detention of
activists and has been under house arrest since July. Ms Zeng said
she believed the arrest was part of a wider crackdown on rights
campaigners.

Last month, Chen Guangcheng, who had campaigned against forced
sterilisation and abortion, was jailed for public order offences.
His lawyers were detained ahead of his trial.

Gao Zhisheng, a well-known lawyer who represented members of the
banned Falun Gong group and villagers who accused local officials of
stealing their land, was also detained last month.

"In the past month, I keep hearing about people missing, arrested, I
believe it's part of a campaign," Ms Zeng said.

Surveillance

She said the men banged on the door at 0830 (0030 GMT) and told Mr
Hu to go with them to a local police station.

"We can only wait and see if this will be just an interrogation or
something longer," she said.

The couple had been under constant police surveillance by police
since July, Ms Zeng said.

Mr Hu, 33, had worked to protect the rights of Aids sufferers and
had also protested against the detention of other activists.

He had reportedly been trying to arrange a lawyer for Gao Zhisheng.
On the night before his arrest, he received a telephone call from Mr
Gao's wife, Geng He, after which telephone and internet access were
cut, his wife said.

http://news.bbc.co.uk/1/hi/world/asia-pacific/5323238.stm

Dear Forum Members,

This is an Open Letter addressed to Australia's Federal Health
Minister.

Mr Tony Abbott, M.P.,
Federal Minister for Health and Ageing,
Parliament House,
Canberra, ACT.

Dear Mr Abbott,

I write on behalf of The Australian AIDS Fund Inc., an HIV/AIDS care
agency of some 20 years standing, to support the recommendation by
the Royal Australian and New Zealand College of Obstetricians and
Gynaecologists that all pregnant women in Australia be offered HIV
testing as part of their antenatal care. Given the counselling
services and the ARV's that are so readily available in this
country, we cannot see why this change in national policy shouldn't
be introduced as soon as possible, and we urge you to introduce such
a change.

We are showcasing the detailed Evidence for a change in antenatal
HIV screening policy in Australia (Michelle L.Giles, Margaret E
Hellard, Sharon R.Lewin and Ann M Mijch) on our www.aids.net.au.
website which records some one and a half million visits each year
by those seeking global HIV/AIDS resources.

Those who reach out to us for support, especially from the
impoverished and piteously HIV/AIDS stricken areas of PNG and Malawi
would especially wonder why Australia isn't presently offering such
a service given its wealth of resources and pacesetter leadership in
this critical health area.Let's show them we haven't dropped the
ball.

Yours sincerely,

Brian Haill

President,
The Australian AIDS Fund Inc.,
PO Box 1347,
Frankston, VIC, 3199
Australia
Email: bhaill@...
Website: www.aids.net.au.

CALL FOR NOMINATIONS

Civil Society Representatives to the International Drug Purchase
Facility (IDPF) Board

This is to inform you that there are 2 seats available for civil
society representatives at IDPF Board:  1 seat for communities
living with HIV/AIDS, TB and malaria, and 1 seat for NGOs fighting
the diseases.

We therefore are soliciting nominations for the following positions:
1 Board member and 1 Alternate from communities living with HIV/AIDS;
1 Board member and 1 Alternate from NGOs fighting the diseases;

The selection committee will ensure that the developing and
developed countries are equally represented.

Draft Terms of Reference (ToR):

A Civil Society member of the International Drug Purchase Facility
(IDPF) Board represents the viewpoint and needs of Civil Society
concerning the IDPF (see background information about IDPF).

In particular, Civil Society IDPF Board members actively promote
that IDPF decisions would:

1. respond to the needs of people living with the diseases, NGOs
fighting the diseases, and programs to provide care to people living
with the diseases;

2.lead to responsible and efficient use of the resources channeled
through IDPF;

3. have a positive impact on resources available to pre-existing
essential institutions fighting the three diseases, such as the
Global Fund;

4.Advance the global fight against the three diseases, through
facilitating the use of compulsory licensing to ensure generic
competition of medicines; financing IDPF through wholly additional
funding; and supporting evidence-based, comprehensive HIV prevention
programs for all;

5. increase the accountability of the IDPF to people living with the
diseases, to NGOs fighting the diseases, and to programs providing
care to people living with the diseases.

The role of an IDPF Board member is that of a volunteer - there is
no payment for participating. Travel and per diem costs to attend
Board meetings are expected to be covered by the IDPF. The Board
shall meet on average 4 times a year. Candidates should expect the
position to demand 25% of their working time.

(A) IDPF Board Member functions:

1. Discuss, amend and approve proposed Constitution and Business
Plan (mainly at first Board meeting, September 2006);
2. Determine, modify and approve IDPF's objectives, scope and
workplan; monitor and evaluate its progress;
3. Oversee and solicit the contributions of partners;
4. Review the annual financial statement prepared by the
Secretariat  and approve the budget;
5. Appoint the Executive Secretary (and other Secretariat members
where appropriate);
6. Discuss and approve IDPF support to treatment provision programs
in developing countries; monitor reports about these programs and
their use of IDPF support;
7. Discuss and approve IDPF contracting and partnership policies, as
well as any other Board-approved policies;

(B) Mandate and working methods for the IDPF Board member position:

Participate fully in all meetings of the IDPF Board (study all
relevant documents in advance in order to provide relevant input in
the decision-making process);

Participate in teleconferences and other virtual means of
communications among Board members, among civil society Board
members, and among constituency members (communities living with the
diseases, NGOs fighting the diseases);

Advocate for the participation of civil society representatives in
the design, implementation and evaluation of all policies and
programs at all levels of the IDPF;

Provide input into equitable and appropriate allocation of resources;

Maintain a focus on issues of importance to the community and civil
society movements;

Represent the views of various civil society constituencies;

Seek input from communities living with the diseases and/or NGOs
fighting the diseases on key issues related to IDPF Board decisions;

Consult with and report to the broader constituency of communities
living with the diseases and/or NGOs fighting the diseases, both
before and after working group meetings;

Consult with advisor-status members of the civil society delegations
to the IDPF Board.

(C) Qualifications and criteria for selection

Based on the IDPF Board functions, including representing the
various constituencies (communities, NGOs), the selection committee
for the Board members should look for the following qualities in
candidates:

IDPF-specific requirements:

Understanding of global treatment access scale-up blockages, and of
the role of commodity prices in these blockages;

Understanding of HIV, TB and malaria commodity procurement and
supply issues;

Understanding of global drug accessibility determinants, especially
market-based determinants, including the role of intellectual
property rules;

In-depth knowledge of the needs of people living with the diseases,
especially from a gender and vulnerability perspective and of issues
facing NGOs fighting the diseases;

Understanding of political environment of global health initiatives
including IDPF, Global Fund and of issues related to financing for
development.

Requirements common to Boards of all global fight initiative:

Has time and ability to carry out the tasks derived from his/her
role as a Board member;
Has minimum 3 years experience in front-line civil society work in 1
or more of the 3 disease areas;

Is able to communicate and network effectively and broadly (must
have functioning communications linkages such as telephone, fax,
computer and email);

Is able and willing to recognize gaps in own abilities when new work
requirements arise, and to seek out and enlist outside help in order
to fill these gaps;

Is able to act within a team setting;

Has proven record of sound advocacy and media relations;

Is gender sensitive; has good skills in gender and age analysis, as
well as understanding of the needs of vulnerable groups;

Has diplomatic and strategic thinking skills, ability to prioritize;

Fluent in written and spoken English (additional languages are
preferred)*;

Has linkage to an organization that can facilitate communication and
liaison as well as provide consultation and support;

Possess assurance from employer regarding availability of up to 25%
of working time for Board related duties, until September 2007.

IDPF Board documentation will generally be provided in English
(large volume), and group discussions will be in English.

(D) Length of term

The Board members are selected for 1 year from September 2006 to
September 2007. Alternates are selected for 2 years from September
2006 to September 2008 to serve 1 year as an Alternate followed by 1
year as a Board member.

It means that in the future only Alternates will be selected with
the expectation that they progress to the Board member position in
the 2nd year of their 2-year Board mandate.

The length of terms and criteria of selection will be reviewed after
one year.

(E) Cessation of Appointment

A civil society appointee to the IDPF Board will cease to be Board
member if:

He/she resigns
He/she no longer has an employer who is supportive of the time
commitment required, or he/she no longer has links to the
organizations that secured his/her nomination and/or selection to
the IDPF Board;

He/she is unable to perform the agreed upon tasks;
He/she is unable to work with the other civil society delegates to
the IDPF Board as part of a team; and,
If a conflict of interest is declared.

(F) Alternate member functions:

1. Provide support to the Board members between and during the Board
meetings, including review of IDPF documents, advising on specific
issues, preparing background information, drafting motions and
position statements and support the Board member in other functions
as above;

2. Liaise with the communities living with the diseases and/or NGOs
fighting the diseases to coordinate the civil society position and
seek input on important matters that are debated and discussed at
IDPF Board;

3. Assist in preparation of briefs and updates for the communities
living with the diseases and/or NGOs fighting the diseases on key
issues discussed and decided on at the IDPF Board meeting.

(G) Application Process - Read carefully

Nominated individuals to sit in the IDPF Board need to prepare and
submit a 4 page application (only the first 4 pages in the
application will be considered) that covers the following:

1.Name, contact information, age, organizational affiliation,
communities served, position applied for;
2. Short Curriculum Vitae (CV) outlining experience; (maximum 2
pages);
3. Short Narrative outlining your understanding of the IDPF and of
the challenges and opportunities it represents the global fight
against HIV/AIDS, TB and malaria; your civil society and community
linkages in terms of relevant experience (particularly experience in
southern and developing countries) ; and the most significant
capabilities and strengths you would bring to the civil society
delegations to the IDPF Board that address the specific criteria
mentioned in these ToR (maximum 2 pages).

Also attached to the 4-page application will be:

* 2 letters of reference from relevant organizations other than your
own (1 page per reference only);
* 1 letter of reference from your own organization, or closest
affiliated organization, agreeing to the additional travel and
workload (1 page only).

The CLOSING DATE for nominations is Friday, September 15, 2006. The
International Council of AIDS Service Organizations (ICASO) will
serve as a mailbox for applications. Please send applications with
all required documents to:

Natalia Ciausova
c/o ICASO Secretariat
E-mail: nataliac@...
Fax: (1-416) 921-9979; tel: (1-416) 921-0018 ext.24
(email messages preferred)

We thank all applicants for their participation but only those
selected  will be contacted. The results of selection process will
be announced on Friday September 22 through the listserves:

AF-AIDS
SEA-AIDS
Gender AIDS
INTAIDS
Community Research
ProCAARE
Healthgap
PWHA-Net
Stigma AIDS
Partners GF
AIDS INDIA
AIDS ASIA
Indian Network
ITPC
_________________________

Background Information on IDPF

IDPF stands for the International Drug Purchase Facility. It is a
new initiative meant to purchase pharmaceutical and diagnostic
products needed for the treatment of HIV/AIDS, tuberculosis and
malaria in developing countries. IDPF also exists under the brand
name UNITAID. Both names are interchangeable and refer to the same
initiative.

In order to have added value compared to other initiatives which
purchase medicines and diagnostics against the three diseases (such
as Global Fund or PEPFAR), IDPF will focus on products which are
currently inaccessible in most developing countries due to very high
prices, such as pediatric or latest-generation HIV drugs,  and
artemisin-combination therapies against malaria.

The governments which are spearheading this new international tool
in the fight against the three diseases are France, Chile, Brazil,
Norway and the UK.

These 5 countries are expected to contribute to IDPF between 300 and
400 million USD in 2007. Several other international organizations
have been enlisted as partners of the IDPF, most notably the Global
Fund and the World Health Organization. The Global Fund will help
match IDPF drug and diagnostic offer with the demand from fast-
growth treatment access programs in developing countries. The WHO
will help IDPF make sure that the products whose purchase it funds
are of high quality. IDPF has also enlisted the services of the Bill
Clinton Foundation to negotiate price reductions from manufacturers
especially generic manufacturers.

The first meeting of the IDPF Board is currently planned for late
September 2006, probably September 28. This first Board meeting will
discuss, amend and approve proposals for a Business Plan, as well as
a Constitution, for the IDPF. A consultation will be organized in
Paris on September 8 to allow civil society to comment and request
changes to these proposals. The proposals will be circulated to
civil society by the 5 governments on September 1st.


Gala Vrabiye
Administrative Coordinator
International Council of AIDS Service Organizations (ICASO)
65 Wellesley St. E., Suite 403
Toronto, ON M4Y 1G7
CANADA
Tel: + 1-416-921-0018 ext. 10
Fax: + 1-416-921-9979
E-mail: icaso@...
Web site: www.icaso.org

WHO guidelines for the use of ART in children

Antiretroviral therapy of HIV infection in infants and children in
resource-limited settings: towards universal access: Recommendations
for a public health approach

The most efficient and cost-effective way to tackle paediatric HIV
globally is to reduce mother-to-child transmission (MTCT). However,
every day there are nearly 1500 new infections in children under 15
years of age, more than 90% of them occurring in the developing
world and most being associated with MTCT (1). HIV-infected infants
frequently present with clinical symptoms in the first year of life,
and by one year of age an estimated one-third of infected infants
will have died, and about half by 2 years of age (2, 3). There is
thus a critical need to provide antiretroviral therapy (ART) for
infants and children who become infected despite the efforts being
made to prevent such infections.

In countries where it has been successfully introduced, ART has
substantially changed the face of HIV infection. HIV-infected
infants and children now survive to adolescence and adulthood. The
challenges of providing HIV care have therefore evolved to become
those of chronic as well as acute care. In resource-limited
settings, many of which are countries hardest hit by the epidemic,
unprecedented efforts made since the introduction of the `3 by 5'
targets and global commitments to rapidly scale up access to ART
have led to remarkable progress. However, this urgency and intensity
of effort have met with less success in extending the provision of
ART to HIV-infected children. Significant obstacles to scaling up
paediatric care remain, including limited screening for HIV, a lack
of affordable simple diagnostic testing technologies, a lack of
human capacity, insufficient advocacy and understanding that ART is
efficacious in children, limited experience with simplified
standardized treatment guidelines, and a lack of affordable
practicable paediatric antiretroviral (ARV) formulations.
Consequently, far too few children have been started on ART in
resource-limited settings. Moreover, the need to treat an increasing
number of HIV-infected children highlights the primary importance of
preventing the transmission of the virus from mother to child in the
first place.

WHO guidelines for the use of ART in children were considered within
the guidelines for adults published in 2004 (4). Revised, stand-
alone comprehensive guidelines based on a public health approach
have been developed in order to support and facilitate the
management and scale-up of ART in infants and children.

The present guidelines are part of WHO's commitment to achieve
universal access to ART by 2010. Related publications include the
revised treatment guidelines for adults (i.e. the 2006 revision),
revised guidelines on ARV drugs for treating pregnant women and
preventing HIV infection in infants, guidelines on the use of co-
trimoxazole preventive therapy (CPT),(i) and revised WHO clinical
staging for adults and children (5). (i) These three documents are
currently in preparation and are expected to be published by WHO in
2006.

Download file in English [pdf 1.54Mb]
http://www.who.int/hiv/pub/guidelines/WHOpaediatric.pdf

INVITATION  AIDS_ASIA e FORUM.

Hi,

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

[AIDS ASIA eFORUM] is an 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/

WB and IMF are coming to Asia: But where is AIDS Agenda?

Joe Thomas (1)

In two weeks International Monitory Fund (IMF) and World Bank (WB)
official will be in Singapore at it's annual meetings.

According to World Bank, right now Asia is certainly the most
dynamic region in the world and a region that has grown in
importance every year. Asia now accounts for nearly a quarter of the
global GDP. Its share of world exports is over 27 percent and it has
a third of global capital inflows. Asian growth prospects continue
to remain bright with growth forecast at 7Ľ  percent in 2006 and 7
percent next year.

It is clear that what happens in Asia is affecting not only the more
than two and a half billion people that live in Asia but also the
whole of the world economy.  HIV/AIDS has been firmly established in
many countries in Asia Pacific region, and wrecking havoc in social.
Political and economic domains of this region.

However, it appears that IMF and WB are not willing to address the
challenges of HIV/AIDS in their annual meeting.

In press a conference given  by the IMF Managing Director Mr.
Rodrigo de Rato at Washington, D.C on August 31, 2006, to brief the
press on the Agenda of the Annual conference, there is was no
mentioning about how the IMF and WB are going to approach HIV/AIDS
issues in Asia Pacific region.

Even though, the IMF claims that "The HIV/AIDS epidemic poses an
unprecedented threat to global health, development, and security.
The IMF collaborates with other organizations in the fight against
this disease, most notably by supporting national poverty-reduction
strategies that allocate additional spending to HIV/AIDS and other
poverty-reducing programs" How ever, the annual meeting largely down
playing the issue of HIV/AIDS and the role of IMF/WB.. It even
appears that Mr. Rodrigo de Rato and his senior staff are completely
unaware of the global challenges of HIV/AIDS.

Currently, some 40 million people worldwide are living with
HIV/AIDS. Over the past year, about 5 million were newly infected
and more than 3 million died. The disease is spreading quickly in
other regions of the world—especially in the former Soviet states,
the Caribbean, and parts of East and South Asia. The Joint United
Nations Program on HIV/AIDS (UNAIDS) estimates that an additional 45
million people in 126 low- and middle-income countries will become
infected by 2010.

HIV/AIDS is a major development crisis. Since the pandemic began, it
has killed millions of adults in the prime of their lives, separated
families, and destroyed and impoverished communities. More than 14
million children have been orphaned because of AIDS. In some
countries, life expectancy has fallen by more than 20 years. The
scale of the epidemic is causing informal social safety nets to
collapse. Overall health care is declining as health services
struggle with mounting demand. Workforces are being decimated and
labor costs are rising, with severe consequences for investment,
production, and per capita income.

In many countries, the WB and IMF are critical stake holders in
financing prevention, care and mitigating the impact of HIV/AIDS, in
some countries these institutions hold direct influence on the
health care of the people through it's structural adjustment program
and it's sector wide approaches.

It appears that, many of the ActionAid International's criticism of
IMF "Blocking Progress: How the Fight Against HIV/AIDS is Being
Undermined by the World Bank and International Monetary Fund (2004)"
still remain valid.

In such a context, it is unfortunate to see that, the IMF and the WB
official are coming to Singapore at it's annual meetings without a
strong agenda on HIV/AIDS. As part of the emerging global
partnership, and within its mandate, the IMF was expected to a
present a clear statement elaborating on its share to help fight
this disease, its devastating effect on human and economic
development and ensuring universal access to care, treatment and
prevention.
____________________
Dr. Joe Thomas is a leading commentator on HIV/AIDS related issues
in Asia Pacific region. Views expressed in this article do not have
any institutional affiliation.

Editorial: AIDS patients have rights too

Tuesday, Aug 29, 2006,Page 8

It is difficult for Taiwan to expect to be lauded as a nation that
respects human rights when people like Lin Ting, the deputy director-
general of the Center for Disease Control (CDC), make comments like
those he uttered last week.

On Friday, Lin urged women diagnosed as HIV-positive to avoid
getting pregnant. He then said that those who find themselves
pregnant can seek help from the authorities in getting an abortion.
He also urged doctors to encourage HIV-positive women to consider
this option.

The background for his statement was that most women who have
contracted AIDS in Taiwan are intravenous drug users, a large
percentage of whom reside in prison, where the disease is identified
via routine screening.

But what is Lin really trying to say, and what message do his words
send to the rest of the world?

During his oration Lin admitted that, if treated early, a mother can
be prevented from passing the disease on to her newborn child. Was
Lin therefore making the announcement on behalf of the cash-strapped
national insurance program to combat the cost of the expensive drugs
these women would require, or was he suggesting that women who
contract HIV forfeit the right to reproduce, and that drug addicts
are not entitled to the same treatment as other people?

It is doubtful Lin would relay the same message to a businessman's
wife who had contracted HIV from her husband after he had been
philandering in China.

Whatever the reasons for Lin's announcement, this is not the kind of
message that showers the authorities with glory, especially those
who prattle on about Taiwan being a nation that respects human
rights. These comments are the sort of thing we expect from across
the Taiwan Strait, where discussion of AIDS is largely taboo,
figures showing the true extent of the disease are fudged and
activists who try to expose the truth are harassed and arrested.

What people with HIV/AIDS need more than anything is help:

counseling so they can understand the reality of their predicament
and ways that they can deal with it. They do not need a government
official saying that they are inferior and telling them they must
exterminate their unborn children.

Taiwan is one of the most forward-thinking nations in Asia in regard
to equal opportunity, with women taking a strong role in many areas
of society such as politics, business and commerce. But time and
again the government has claimed to champion the cause of human
rights while making little progress on important issues like human
trafficking, abolishing the death penalty or improving the
circumstances of disadvantaged groups like teenage mothers, HIV/AIDS
sufferers and drug addicts.

With the pending abolition of the minimum wage for foreign workers,
the government continues to allow foreign laborers to be treated
like slaves, even after last year's Kaohsiung riots exposed the
corruption, nepotism and cruelty endemic among labor brokers.

Politicians and government officials can talk about Taiwan being a
human rights paradise until they are blue in the face, but until the
government starts taking a more humane and committed approach to
problems like HIV/AIDS and brings people like the CDC deputy
director-general into line for making irresponsible comments,
independent observers here and abroad will conclude that human
rights in this country is a slogan as much as a reality.

http://www.taipeitimes.com/News/editorials/archives/2006/08/29/200332
5372

Sex worker registration - privacy and ethical concerns

HIV Australia. Vol. 5 No. 2. Published by the Australian Federation of AIDS Organisations

Sex industry laws in Australia, while written and legislated by state governments, are implemented and regulated by a range of parties including government, statutory bodies, police, the judiciary and local councils.  Beyond the written law, these statutory bodies have a variety of responses to implementing the laws and the impact of their different attitudes brings about further complexity. ^[1]

While a certain activity may be deemed illegal on paper, if it is not prosecuted by the local police, and if other systems regulating sexual behaviour do not deem it to be unwanted, then it may become best practice in a given city or region.  By comparison, some activities deemed legal can actually be heavily policed due to political pressure and police protocol resulting in high rates of prosecution. Given this, if sex workers in Australia worked within the boundaries of the written law they could be working in unsafe conditions, which may impact on their safe sex practices and place them at risk of contracting sexually transmitted infections including HIV. . As a result workers pick and choose when to comply with the law.

Some of the factors impacting on the working behaviour and real life application of the law include the balance of the written law, police behaviour and corruption, acceptability of vigilante `resident' behaviour, client knowledge of the law and the resulting client behaviour.

The Queensland review of the Prostitution Act 1999 (Queensland) by the Crime Misconduct Commission (CMC) provides an interesting case study of the complexities surrounding sex workers and the law. ^[2] 

Many sex workers, sex worker groups and advocates including Scarlet Alliance and its Queensland member organisation, SSPAN, (Sexual Service Provider Advocacy Network) have participated in the CMC's work providing submissions and participating in surveys, giving verbal evidence at the inquiry, and lobbying on specific issues.

In January this year, Scarlet Alliance and SSPAN lodged submissions in response to a question raised in an interim paper released by the CMC - "Should legal outcall prostitution services in Queensland be extended to licensed brothels and/or escort agencies?"

The most controversial proposal in the CMC interim paper was not related to legal outcall sex work, but the individual registration of private sex workers. ^[3]Private sex workers in Queensland have operated 'legally' through a loophole in the Prostitution Law Amendment Act 1992 which left single sex workers unregulated yet not criminalised. The majority of laws relating to private sex work are contained in the Queensland Criminal Code, so while the act of private sex work itself is not criminal, certain activities surrounding it are, such as having another person aware of the work that you are doing, doing 'doubles,' working in pairs, phoning a friend or colleague to inform them of your whereabouts while on escort or hiring a driver or receptionist.

The Prostitution Act 1999 empowered the Prostitution Licensing Authority to regulate certain areas of the licensed brothel sex industry including advertising. This particular regulatory power also includes private sex workers. Performing a sexual service for money without a condom is illegal under section 77A of the Prostitution Act 1999 (as amended in December 2003) and sections 229E(5)and 229D of the Criminal Code. The advertising regulations, laws against working in pairs, and laws against offering or performing any sex (including giving or receiving oral sex) are the main grounds by which the Prostitution Enforcement Taskforce charges an estimated 50 private workers a year in Queensland.^[4]  At this stage, the proposal for registration of private workers is a concept only and there has been no discussion on criminal penalties for non-compliance.

The registration of private workers was suggested by brothel owners in their submission to the CMC. ^[5] It was again tabled by brothel owners at the CMC face to face inquiry in 2005 as a method of reducing 'illegal operators' by reducing the advertising options as private workers would be required to display a registration number. At that inquiry the Prostitution Licensing Authority, the Queensland Police Service representatives and all three sex worker groups (Scarlet Alliance, SSPAN and Self Health for Queensland Workers in the Sex Industry) opposed the idea, as did the individual private sex workers present. In particular, it was questioned why the brothel sector saw it as their role to raise such an issue when it clearly fell outside their scope of influence. The issue was since proposed by the CMC in a formalised interim position paper: "In relation to 'sole operators'… consider requiring sole operators to have a registration number based on photo identification and pseudonym (provided to the Prostitution Licensing Authority) for display advertisements…"^[6]

In its response to the proposal, SSPAN said:

".. SSPAN argues that a registration number simply isn't going to be a realistic option for most sex workers and places a discriminatory burden on a group which is already marginalised and stigmatised. Registration compounds stigma and 'otherness'. Furthermore the registration system adopted in Victoria, where sole operators must register as an exempt brothel or escort agency, may be the primary reason for the growth of the illegal industry there. Sex workers there who do not want a permanent record of their sex worker status are locked into either working for a licensed brothel or an illegal option. This is an undue assault on civil liberties and it imputes guilt on innocent parties. Obviously, if there were no stigma attached to prostitution there would be no problem with registration. However, while the Queensland Government maintains an approach of not condoning sex work, sex workers continue to work within a hypocritical system. There are inherent privacy issues associated with any form of registration and a record impedes a clean exit from the industry for those who desire to do so.  Most workers are happy to pay tax but they do not want evidence that they are sex workers.  Who could access this information?  How could privacy be guaranteed?  In the United States, a government imposed registration system for the pornographic film industry has proved devastating for porn actors recently when the database of names was posted on the internet."^[7]

Scarlet Alliance had already raised concerns earlier in 2005 when the CMC proposed registration for legal brothel escort workers:

Scarlet Alliance fundamentally opposes the licensing or registration of individual sex workers under any circumstances. The following points outline our concerns: 

1) Public health - Concerns about public health are often cited as a reason for laws aimed at increasing control over sex workers' lives and indeed the CMC discussion paper includes 'health and safety reasons' as possible reasons for monitoring compliance.  However, recent history has demonstrated that despite the major barriers of criminalisation and stigma, sex workers enjoy higher standards of sexual health than other members of the general community…^[8]

2) Human rights - The registration of individual sex workers is a violation of their human and civil rights.  Sex workers have the right to privacy, the right to work in an occupation of their choice, the right to live and work free from violence and harassment, the right to live free from discrimination, vilification and stigmatisation.^[9] When a government singles out individual sex workers for surveillance in excess of how other industries are treated, they endorse sex workers being treated differently and the stigma and discrimination which results. 

3) Privacy - It [registration] unnecessarily creates a barrier to individual sex workers working legally.  Many sex workers fear their identity and profession being known for fear of potential violence, extortion, coercion, family breakdown, discrimination, harassment etc.  It raises serious concerns over who has access to the information, how this information is secured, confidentiality, privacy and a range of other issues. 

3) Over-regulation - The registration of sex workers is also unnecessary and counterproductive to the aims of controlling the activities of sex workers and the sex industry.  There are a range of other ways in which the professional standards of the industry can be maintained - through codes of practise, general criminal laws if required, and other statutory laws.  The registration of individuals in the sex industry is perceived to be done for no other reason than surveillance and is in excess of the way in which other industries are regulated.  It does not improve the occupational health and safety of sex workers. 

4) Low compliance - The outcome of attempts to register individual sex workers has at best met with low compliance.  Unfortunately, even the threat of penalties do not outweigh the fear of possible discrimination due to the high level of stigma attached to working as a sex worker. Criminal penalties will not stop people working but rather add a criminal record to those who, in other states, would be considered legitimate private sex workers and who may have worked as such for many years without negative impacts to themselves, their families or the community…. 

Concerns and negative outcomes for the broader community include:

• The considerable cost associated with the adoption of a registration system on community and government resources
• The devotion of significant police resources to policing unworkable laws which make historical sex industry working practises illegal rather than focussing on significant crimes such as rape and assault
• The significant costs associated with the prosecution and incarceration of unlicensed sex workers. .
• Public health initiatives aimed at maximising sexual health among sex workers and their clients would be undermined by commercial sex being pushed further underground.^[10]

The recent moves in Queensland towards individual registration are illustrative of the deep prejudice and discrimination that surrounds sex worker regulation when it is shaped without sex worker input. It indicates that policies in regards to private sex workers are driven by notions of control and identification, rather than by health or privacy concerns. The Sex Services Premises Planning Guidelines, produced by the Sex Services Planning Advisory Panel of NSW clearly states that identifying individual private sex workers is in opposition to ensuring their health and privacy concerns. In relation to private sex workers and Development Applications (DA) requiring them to make their address public it states: "sex workers are unlikely to comply with it, as a DA or Complying Development Certificate reveals sex workers' addresses, making them vulnerable to abuse and violence from the public and coercion from operators or larger premises.  As a result, home occupations would continue to exist illegally within council areas, which is to be discouraged as it keeps them underground and isolated from sex worker peer support and health services." The Report of the Brothels Taskforce (2001) stated (p. 12): 'The identification of individual sex workers through the development application process is also contrary to the recommendations of the Legal Working Party of the Intergovernmental Committee on AIDS (Department of Health 1992).^[11] Such requirements are also counter to the UN Declaration of Commitment on HIV/AIDS 2001.'

In both the Northern Territory and the ACT recent events have cast yet more doubts over the ethics and health outcomes of registration.  In Darwin police have been enforcing registration to the detriment of individual sex workers who are unable to register due to their criminal record (certain criminal records including drug convictions exclude sex workers from being able to register, and thus those workers are 'illegal.') Anecdotal evidence suggests that the two main escort agencies have held the individual unregistered workers responsible for the fines incurred, even though it is the responsibility of management to ensure that staff are registered. One of the concerns raised by sex workers in Darwin according to SWOP NT is that the police are selectively enforcing the laws. The sex worker community as a result feels resentment towards police as the law enforcers, and is acutely aware of the unfair nature of their enforcement.  SWOP NT continues to advocate against the registration of sex workers.

In the ACT sex workers in the past have felt a level of security as their registration information is held by the Office of Fair Trading, and not by the police. However in recent interactions with the Office of Fair Trading, SWOP ACT was advised during a telephone conversation with staff that the police in the ACT have access to both the records of ACT private workers and also to information held by the Office of Fair Trading on individuals who work at brothels. This is extremely alarming for the sex workers involved as the information sharing has compromised the privacy of sex workers who register in good faith. 

Clearly the right to privacy and protection under the law is yet to be won for sex workers in Australia. Many sex workers will and do choose to remain unregistered and therefore illegal in Victoria and the ACT, in order to protect their privacy and maintain control over the disclosure of their work. For those workers who have registered there have been terrible outcomes. One former Northern Territory sex worker feels that her registration as a past sexworker led her to lose custody of her children in the Family Court last year.  In this particular case the mother had chosen not to disclose her sex work status to the court for fear of discrimination., but it was exposed when registration details were subpoenaed from the Northern Territory Police. The court determined her to be 'dishonest' due to her decision to not disclose. In Queensland where registration is being discussed for the first time, they would do well to consider all of these factors before changing the laws. 

The Queensland Crime and Misconduct Commission is likely to release their findings in April, 2006.

This article was written by members of the Scarlet Alliance Executive Committee.

^[1]Regulating Sex: the Politics of Intimacy and Identity, edited by Elizabeth Bernstein and Laurie Schaffer.

^[2]A requirement of the Prostitution Act 1999 was that the Crime and Misconduct Commission evaluate the laws within three years. 

^[3] Crime and Misconduct Commission Interim Position Paper on Escort, December 2005, pg 12 [viewed March 2006 http://www.cmc.qld.gov.au/library/CMCWEBSITE/Outcall.pdf]

^[4] Crime and Misconduct Commission Interim Position Paper on Escort, December 2005, pg 12 [viewed March 2006 http://www.cmc.qld.gov.au/library/CMCWEBSITE/Outcall.pdf]

^[5] Quote from the QABA submission (April 2005) to the CMC available at http://www.cmc.qld.gov.au/PUBLICHEARINGS.html "Further, QABA recommends that a regime should be put in place to prevent unlicensed operators from advertising. This could include penalties for those accepting advertising from an illegal operator and the inclusion of a license number on all advertising, though the latter is less effective without the licensing of sole traders since most illegal operators masquerade as sole traders currently."

And their own words from the hearing (13/9/2005) available from same link http://www.cmc.qld.gov.au/PUBLICHEARINGS.html)

MR CHRISTIE: My name is Gary Christie, secretary of QABA. It seems to me that you've put your finger on a very large issue which is the issue of illegal prostitution on Queensland, and the QABA position is that there's a relatively simple way of regulating the illegal industry and that's to do it through advertising, and I'm assuming that that was - that you had some reason for wanting to excavate what those particular possibilities might be, and the possibility that QABA favours is to have all sole operators and other service providers have a registration number and for advertising to be illegal except by using that advertising number.

^[6] `Should legal outcall prostitution services in Queensland be extended to licensed brothels and/or escort agencies?

^[7]SSPAN (Sexual Service Providers Advocacy Network) RESPONSE TO THE QUEENSLAND Crime and Misconduct Commission Interim Position Paper (December 2005) 31^st January 2006, pg 7

^[8] STD Control Branch South Australia Health Commission (Epidemiological evidence submitted to the Social Development Committee of the Parliament of South Australia Inquiry into Prostitution).

^[9]Banach and Metzenrath, Unjust and Counterproductive: The failure of Governments to Protect Sex Workers from Discrimination, Scarlet Alliance and AFAO, 1999 and Metzenrath Prostitution Law Reform: Towards a Human Rights Based Model, Prostitution Law Reform Forum in Queensland, Brisbane, 1997

^[10] Scarlet Alliance Submission to the Queensland CMC inquiry into the Queensland Prostitution Act 1999, Escort, April 2005 [viewed March 2006 http://www.scarletalliance.org.au/library/qld_sub05/file_view]

^[11] Sex Services Premises Planning Guidelines, Dec 2004, Pg 54

http://www.afao.org.au/view_articles.asp?pxa=ve&pxs=103&pxsc=127&pxsgc=139&id=582

Hong Kong: AIDS situation in the second quarter of 2006

The Centre for Health Protection (CHP) of the Department of Health
(DH) today (August 29), revealed that 90 people tested were positive
for HIV (Human Immunodeficiency Virus) antibody in the second
quarter of 2006, bringing the cumulative total of reported HIV
infections to 3,004.

Twenty-five new cases of AIDS (Acquired Immune Deficiency Syndrome)
were reported in the same quarter, bringing to 824 the total number
of confirmed AIDS cases reported since 1985. Forty-four per cent of
the new cases were related to heterosexual contact.

Reviewing the AIDS situation in Hong Kong at a press conference, the
Consultant (Special Preventive Programme) of DH, Dr Wong Ka-hing
said the predominant route of HIV transmission in this quarter
remained to be sexual contact.

'Of the 90 new HIV cases reported, 22 acquired the infection via
heterosexual contact, 26 via homosexual or bisexual contact and 13
via injection of drug.'

The routes of transmission of the remaining 29 cases were
undetermined due to insufficient data.

The 90 cases comprised 71 males and 19 females.

In this quarter, the most commonly presenting AIDS defining illness
is Pneumocystic Pneumonia (PCP), a kind of chest infection, which is
closely followed by Mycobacterium tuberculosis infection (TB).
Of the 3 004 cumulative total of HIV infections since 1984, around
76% acquired infection through sexual contact. Of them, 67% were
resulted from heterosexual transmission and 140 infections occurred
among injection drug users.

The newly diagnosed cases of this quarter were reported by four
major sources: public hospitals and clinics (45), private hospitals
and clinics (17), Social Hygiene Clinics (14) and the DH's AIDS
Counselling Service (9).

Cumulatively, the four sources have accounted for 45.1%, 21.6%,
14.6% and 12.7% of all reported infections.

Of the newly reported cases in this quarter, 66(73.3%) have received
care at the HIV specialist services of the Department of Health or
the Hospital Authority.

Seventy-six per cent of the reported cases in the year 2005 attended
these services where effective antiretroviral treatment was offered
according to clinical indication.

The DH monitors the HIV/AIDS situation through a voluntary reporting
system. The first cases of HIV and AIDS were reported in 1984 and
1985 respectively.

Dr Wong said members of the public can request free, anonymous and
confidential HIV counselling by calling AIDS Hotline (2780 2211).
HIV antibody testing may also be arranged as appropriate through
this hotline.

Information on AIDS and data on HIV/AIDS, which are released on a
quarterly basis, can be viewed on the DH's AIDS Unit web page
http://www.aids.gov.hk.

HIV is the cause of AIDS and, without treatment, half of the HIV-
infected people will progress to AIDS within 10 years.

Tuesday, August 29, 2006
http://www.info.gov.hk/aids/english/main.htm

LANCET: A prescription for AIDS 2006-2010

The Lancet 2006; 368:716-718, DOI:10.1016/S0140-6736(06)69266-0

A prescription for AIDS 2006-10

Richard Horton a

In June, 2006, UN member states at the General Assembly High Level Meeting on
AIDS ambitiously committed themselves to provide “universal access to
comprehensive prevention programmes, treatment, care, and support by 2010”.
The XVI International AIDS Conference, held last week in Toronto, provided the
first opportunity to draft a strategy to meet that goal.

What were the highlights of this meeting? Fresh science brought attention to a
new class of antiviral agent, the integrase inbibitors. An extremely
drug-resistant (XDR) strain of tuberculosis (TB) was described. A visible shift
took place in the terms of engagement with HIV—from treatment to prevention.1
Male circumcision, pre-exposure prophylaxis with antiretrovirals, microbicides,
and vaccines were all discussed vigorously. Women were centre stage.2 Routine
testing for HIV provoked furious debate, with proponents arguing that it was one
of the few practicable ways to expand treatment. Opponents said it would
undermine essential liberties. In sum, there was much to reflect on: narrowly
defined, a success.

But the opportunity to produce a roadmap to reach the 2010 target of universal
access was squandered. Rarely has there been a meeting that felt so disengaged
from a global predicament of such historic proportions. The agenda in Toronto
was unfocused, giving prime air time to celebrities, such as Bill Gates and Bill
Clinton, while largely ignoring Africa. Africa bears the greatest burden of AIDS
today—24·5 million of 38·6 million people with HIV.

Yet no African representative spoke at the opening of this meeting.
Instead, non-Africans were nominated to speak on behalf of Africa.

This surprising marginalisation sent an incredibly negative signal to the
conference's 30000 attendees. It suggested that Africa lacked leadership on
HIV-AIDS and that its peoples paid the disease far too little attention. A
leadership vacuum does exist in one country—South Africa. But in its anger
over South Africa's shameful handling of the AIDS epidemic, the International
AIDS Society inadvertently silenced the voice of a great continent.

Away from the star-studded plenaries, Africans and many others from countries
most affected by AIDS had a troubling message. Global action to defeat this
pandemic has stalled. A veneer of achievement—1·6 million people taking
antiretroviral drugs, together with the existence of powerful financing
mechanisms, such as the Global Fund, the President's Emergency Plan for AIDS
Relief (PEPFAR), and the Gates Foundation—has bred complacency. Those who lead
the AIDS community should be asking difficult questions if they wish to turn
back the tide of HIV. Here are ten questions that failed to get the answers they
deserved last week.

1. Why do we refuse to admit that there is still no genuine global commitment to
scale up our response to AIDS? There remains a massive funding gap in the effort
to control HIV. 2005 saw the world's AIDS budget reach US$8·3 billion. But $30
billion will be needed by 2010 to achieve the goal of universal access. The
Global Fund is already several billion dollars short of what it needs for
2006–07. And G8 countries continue to renege on their past financial pledges.

2. Why are the wider health, economic, social, and cultural contexts of AIDS
still being ignored? There are catastrophic weaknesses in health systems and
human resources for health. But AIDS is a human crisis, as well as a health
crisis. In particular, AIDS is a crisis for women, driven as it is by vast
gender inequalities that stubbornly persist in the world today. Somehow, the
international commitments made in Cairo in 1994 to the rights of women to
reproductive health services have been forgotten. Reproductive health has become
divorced from the response to AIDS, a mistake of impossibly large proportions.

3.  Why does our definition of science still seem to include only the laboratory
experiment and the clinical trial? Social and ethnographic approaches to HIV
treatment and prevention research are yielding important warnings about current
AIDS strategies. HIV programmes can foster conflict and resentment,3 they often
ignore sensitive cultural dynamics,4 and they can marginalise the influence of
violence, crime, and alcohol on the way public health messages are transmitted
and received.5 Unless we broaden the meaning of HIV science, AIDS campaigns will
fail.

4. Why do we see biology, medicine, epidemiology, social science, and policy
making as parallel, mutually exclusive “tracks” at the International AIDS
Conference? Why do we reinforce these disciplinary divisions, instead of
creating new alliances between them? The International AIDS Society would likely
plead that rigid separation of communities is the only way to handle the huge
number of submitted abstracts. But if the Society truly wants to foster science
and social change, it should not buckle in the face of scholarly boundaries. It
has to devise and promote different ways of working.

5.After 25 years of AIDS, why are children still largely ignored? 2·3 million
children under 15—2 million in sub-Saharan Africa alone—live with HIV. Yet
fewer than 5% of these children receive the treatment they need. The worst
shortfalls are in paediatric care, prevention of mother-to-child-transmission,
primary prevention, and the protection and support of children affected by AIDS,
notably the 12 million children in Africa who have lost one or both parents to
AIDS.6 HIV is an exquisitely acute child killer, yet children are barely
mentioned in our strategies to defeat this disease.

6. Why do health agencies and programmes still base their prevention messages on
the outdated and scientifically corrupt idea of abstinence? As studies in Africa
show all too clearly, abstinence programmes do not and will not work. Abstinence
alone is simply incompatible with most African cultures. Sex is bound up with
traditions and practices that cannot be terminated by the moralistic injunction
of one donor government. As the AIDS activist, Beatrice Were, argued in Toronto,
abstinence is not only not protecting women, it is also hastening stigma and
fuelling the African epidemic by making it harder to talk about sex, rape, and
intimate partner violence.

7.Why are civil society and NGOs still not being given the credit they deserve
as vital levers in the global AIDS response? Why do we still not see the
community as a means for societal change? The focus of action on AIDS ranges
from international instruments (eg, the Global Fund) to individual risk
interventions. Intermediate-level mechanisms to mobilise and engage communities
are rarely discussed. Yet it is these community-based responses that will have
the greatest impact on the epidemic, as evidenced from work in other fields,
such as maternal and child health.7

8.  Why is stigma—of gay men and women, indigenous peoples, migrants,
refugees, internally displaced persons, drug users, sex workers, and
prisoners—still not the concerted focus of the AIDS response? The greatest
impediment to AIDS prevention today is the invisibilisation of large social
groupings by mainstream society.

Communities are erased, phobias are fermented, and human vulnerabilities are
criminalised. AIDS exposes the profoundest prejudices in our society, and we do
too little to reverse their pernicious effect.

9. Why do so many of those committed to defeating AIDS prefer to lecture one
another about what each is doing wrong, instead of working harder to find
meeting points of dialogue and partnership?

Part of the answer is that there are few places where such constructive
collaborations can be formed and nurtured. This is perhaps the chief challenge
facing the global AIDS architecture.

10.  All of which leads, finally, to the most damning question of all: why is
the world's response to AIDS failing?

[Unable to display image]

The grip of AIDS will only be broken by effective programmes at country level.
The difficulty is that agencies and funders—WHO and UNAIDS; PEPFAR, the Global
Fund, and World Bank—operate quasi-independently of one another. They each
have their own separate missions, governance structures, staff, and comparative
advantages. What never happens is an event or process to develop integrated
country strategies that focus only on the country—not on the interests of the
agency, funder, or constituency (academic, policy, or activist).

This exclusive country focus should be the purpose of the International AIDS
Society's conference—a global accountability mechanism to monitor country
progress, to hold all parties responsible for the part they play in defeating
AIDS, and to set specific, measurable objectives for the succeeding 2 years.

  A partnership between scientists and people living with AIDS could develop a
set of indicators to track HIV prevention, treatment, and care, much as has been
done for child survival.8 The International AIDS Conference should identify
priority countries and devote specific sessions to each country—South Africa,
Botswana, China, Russia, and so on—inviting ministers, policymakers,
scientists, and civil society to join together in mapping, evaluating, and
planning that country's response to AIDS. This biennial gathering would then
provide the necessary accountability instrument, a tool to chart success and to
identify catalysts of change or obstacles underlying failure.

In Toronto, Julio Montaner, president-elect of the International AIDS Society,
blamed political leaders for permitting the “genocide” that is the AIDS
pandemic.9 This rhetoric attracts headlines and gives welcome publicity to a
still neglected disease.

But such extreme language fails to point out the responsibility of the AIDS
community itself, and specifically the International AIDS Society, for providing
a neutral forum for scientists, policymakers, and others to work collectively
against AIDS. The International AIDS Conference is a unique event in medicine.
Its remarkable and inspiring diversity provides the foundation for a step change
in its purpose. The power to cause a necessary schism between future and past
responses to HIV lies not in the hands of political leaders, but within the AIDS
community.

The Russian writer, Aleksander Herzen, once wrote that “Man and science are
two concave mirrors continually reflecting each other.” In Mexico in 2008, the
international AIDS community will reconvene to take stock of this unprecedented
pandemic and to review progress towards the 2010 goal of universal access. The
litmus test for Mexico's success will be the degree to which the conference can
be transformed from a scientific meeting and global beacon for AIDS, to a
coordinating mechanism to drive advances in prevention, treatment, and care at
country level. Talking is easy. Doing will demand a revolution. Historically and
programmatically, Mexico is a perfect place to begin.

References[Unable to display image]   1. Picard A. Gathering opens with focus on
AIDS prevention. The Globe and Mail August 14 2001; A1.
2. Editorial To empower women in the war on AIDS. The Globe and Mail August 17
2006; A14.
3. Gruber J, Caffrey M. HIV/AIDS and community conflict in Nigeria: implications
and challenges. Soc Sci Med 2005; 60: 1209-1218.
4. Morrow OI, Sweat MD, Morrow RH. The Matalisi: pathway to early sexual
initiation among the youth of Mpigi, Uganda. AIDS Behav 2004; 8: 365-378.
MEDLINE | CrossRef
5. Muturi NW. Communication for HIV/AIDS prevention in Kenya: social-cultural
considerations. J Health Commun 2005; 10: 77-98. MEDLINE | CrossRef
6. UNICEF, UNAIDS, PEPFAR. Africa's orphaned and vulnerable generations. New
York: UNICEF, 2006:.
7. Manandhar DS, Osrin D, Shrestha BP, et al. Effect of a participatory
intervention with women's groups on birth outcomes in Nepal: cluster-randomised
controlled trial. Lancet 2004; 364: 970-979. Abstract | Full Text | PDF (465 KB)
| CrossRef
8. Horton R. The coming decade for global action on child heath. Lancet 2006;
367: 3-5. Full Text | PDF (45 KB) | CrossRef
9. Picard A. Political leaders accused of AIDS genocide. The Globe and Mail
August 18 2006; A7.

a) Lancet, London, NW1 7BY, UK

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