INVITATION  AIDS ASIA e FORUM.

Hi,

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

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

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

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

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

Please review the archived messages on the following url

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

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

Dear FORUM,

Hi, protesters in Thailand are marching on Abbott’s offices, while Indian
activists are trying to hold off patent applications on key drugs that many of
us use around the world, yet except for a few scattered protests in the USA,
South Africa and in Germany, we have all been remarkably passive about what
Abbott, Novartis and the brand-name manufacturers are doing in Asia.

If Abbott succeeds in forcing Thailand’s hand around compulsory licensing, if
Novartis wins its case and if the patents on tenofovir, Kaletra and other drugs
are granted in India, the supply of ARVs could be compromised for millions of
people who depend on inexpensive, generic equivalents of these drugs.

We all know all this, but yet, we don’t hear stories of people taking any action
locally against the companies (and action can mean a letter, a meeting, a
protest, a piece in a local paper).  When did the global AIDS movement decide to
roll-over and play dead for the pharmaceutical industry?

Gregg

Gregg Gonsalves
e-mail: <gregg.gonsalves@...>

Crossposted from internationaltreatmentpreparedness@yahoogroups.com

Dear AIDS ASIA e FORUM subscribers,

The Technical glitch at yahoo groups you have experienced yesterday
is regretted.

Yahoo groups experienced a technical glitch whereby the members of
groups received multiple posts and repeated mails.

Yahoo groups has resolved the issue and apologized for the error. The
details of the technical glitch experienced by Yahoo group and the
actions they have taken is presented at the following url.

http://blog.360.yahoo.com/y_groups_team?p=5241

AIDS ASIA Moderator had disabled the posting options to prevent the
deluge of
mails to our members .Now it has been enabled once again .

Sorry for the inconvenience caused.

Best regards

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

SAARC Summit 2007 Must Act to End Cross-boarder Human Trafficking for sexual
Purpose

The human trafficking for commercial sexual exploitation and abuse of children
and women is a major matter of concern in the SAARC region (South Asia). The
SAARC countries signed and later ratified the 'SAARC Convention on Preventing
and Combating Trafficking in Women and Children for Prostitution' but little
progress has been made to translate those commitment into decisive action by the
these seven countries.

The next SAARC Summit scheduled for April 2 - 4, 2007 to be held in New Delhi
and it is high time to raise the concern and seek proactive role of all the
parties.

To discuss these issues "Indian Network for Combating Trafficking" (INCT)
organized a meeting on March 25, 2007 in New Delhi.

The INCT discussed the commitment made under the "SAARC Convention on Preventing
and Combating Trafficking in Women and Children for Prostitution".

Mr Ravi Narayan, Secretary General of Indian Committee of Youth Organizations
(ICYO) welcomed the participants and briefed them about the current status of
the "Convention" in some of the countries.

Ms Roma Debabrata, President of STOP explained the problem faced in recovery,
repatriation and integration and hoped for early establishment of mutual legal
assistance between the SAARC member countries.

Dr. (Ms) Jyotsna Chatterji, Secretary JWP-India urged the countries
participating in the SAARC Summit to put in motion the Convention in total and
called to establish a regional taskforce.

Ms Salma Ali, Executive Director of BNWLA, Bangladesh emphasized for protocol
for rescuer operation and smooth repatriation system, to put on place as
committed in the 'Convention".

The meeting finally agreed to emphasized on following points:
- According to the SAARC Convention, the task force is formulated on priority
basis.
- Protocol for rescue operation and smooth repatriation system.
- Operationalize the mutual legal assistance between the SAARC member countries.
- The bilateral and multidimensional dialogue and plan of action on standardized
care and support for the survivors of trafficking.
The INCT urged to SAARC Summit to look into the above matter and act proactively
to stop trafficking in persons and protect the human rights of the trafficked
survivors.

The others organizations those contributed to the deliberations in the meeting
include the National Youth Project, All India Seva Sangh, Mahatma Gandhi Sewa
Ashram, Delhi Mahila Samaj and  Young Women's Association (YWA) .

The INCT hosted the meeting. INCT is the national platform of organizations
working for protecting children and women from trafficking and preventing
commercial sexual exploitation of children in India.

indianyouthorgs
e-mail: <indianyouthorgs@...>

[Moderators note: WHO/UNAIDS Technical Consultation Male Circumcision
and HIV Prevention: Research Implications for Policy and Programming
Montreux, 6- 8 March 2007. Conclusions and Recommendations is
available from the following url.
http://www.who.int/hiv/mediacentre/MCrecommendations_en.pdf ]
_____________________
WHO and UNAIDS announce recommendations from expert consultation on
male circumcision for HIV prevention

PARIS/GENEVA, 28 MARCH 2007 -- In response to the urgent need to
reduce the number of new HIV infections globally, the World Health
Organization (WHO) and the UNAIDS Secretariat convened an
international expert consultation to determine whether male
circumcision should be recommended for the prevention of HIV
infection.

Based on the evidence presented, which was considered to be
compelling, experts attending the consultation recommended that male
circumcision now be recognized as an additional important
intervention to reduce the risk of heterosexually acquired HIV
infection in men. The international consultation, which was held from
6-8 March 2007 in Montreux, Switzerland, was attended by participants
representing a wide range of stakeholders, including governments,
civil society, researchers, human rights and women's health
advocates, young people, funding agencies and implementing partners.

"The recommendations represent a significant step forward in HIV
prevention", said Dr Kevin De Cock, Director, HIV/AIDS Department,
World Health Organization. "Countries with high rates of heterosexual
HIV infection and low rates of male circumcision now have an
additional intervention which can reduce the risk of HIV infection in
heterosexual men. Scaling up male circumcision in such countries will
result in immediate benefit to individuals. However, it will be a
number of years before we can expect to see an impact on the epidemic
from such investment."

There is now strong evidence from three randomized controlled trials
undertaken in Kisumu, Kenya, Rakai District, Uganda (funded by the US
National Institutes of Health) and Orange Farm, South Africa (funded
by the French National Agency for Research on AIDS) that male
circumcision reduces the risk of heterosexually acquired HIV
infection in men by approximately 60%. This evidence supports the
findings of numerous observational studies that have also suggested
that the geographical correlation long described between lower HIV
prevalence and high rates of male circumcision in some countries in
Africa, and more recently elsewhere, is, at least in part, a causal
association. Currently, an estimated 665 million men, or 30 % of men
worldwide, are estimated to be circumcised.

Male circumcision should be part of a comprehensive HIV prevention
package

Male circumcision should always be considered as part of a
comprehensive HIV prevention package, which includes the provision of
HIV testing and counselling services; treatment for sexually
transmitted infections; the promotion of safer sex practices; and the
provision of male and female condoms and promotion of their correct
and consistent use.

Counselling of men and their sexual partners is necessary to prevent
them from developing a false sense of security and engaging in high-
risk behaviours that could undermine the partial protection provided
by male circumcision. Furthermore, male circumcision service
provision was seen as a major opportunity to address the frequently
neglected sexual health needs of men.

"Being able to recommend an additional HIV prevention method is a
significant step towards getting ahead of this epidemic," said
Catherine Hankins, Associate Director, Department of Policy, Evidence
and Partnerships at UNAIDS. "However, we must be clear: male
circumcision does not provide complete protection against HIV. Men
and women who consider male circumcision as an HIV preventive method
must continue to use other forms of protection such as male and
female condoms, delaying sexual debut and reducing the number of
sexual partners."

Health services need strengthening to provide quality services safely
Health services in many developing countries are weak and there is a
shortage of skilled health professionals. There is a need, therefore,
to ensure that male circumcision services for HIV prevention do not
unduly disrupt other health care programmes, including other HIV/AIDS
interventions. In order to both maximize the opportunity afforded by
male circumcision and ensure longer-term sustainability of services,
male circumcision should, wherever possible, be integrated with other
services.

The risks involved in male circumcision are generally low, but can be
serious if circumcision is undertaken in unhygienic settings by
poorly trained providers or with inadequate instruments. Wherever
male circumcision services are offered, therefore, training and
certification of providers, as well as careful monitoring and
evaluation of programmes, will be necessary to ensure that these meet
their objectives and that quality services are provided safely in
sanitary settings, with adequate equipment and with appropriate
counselling and other services.

Male circumcision has strong cultural connotations implying the need
also to deliver services in a manner that is culturally sensitive and
that minimizes any stigma that might be associated with circumcision
status. Countries should ensure that male circumcision is provided
with full adherence to medical ethics and human rights principles,
including informed consent, confidentiality, and absence of coercion.

Maximizing the public health benefit

A significant public health impact is likely to occur most rapidly if
male circumcision services are first provided where the incidence of
heterosexually acquired HIV infection is high. It was therefore
recommended that countries with high prevalence, generalized
heterosexual HIV epidemics that currently have low rates of male
circumcision consider urgently scaling up access to male circumcision
services. A more rapid public health benefit will be achieved if age
groups at highest risk of acquiring HIV are prioritized, although
providing male circumcision services to younger age groups will also
have public health impact over the longer term. Modeling studies
suggest that male circumcision in sub-Saharan Africa could prevent
5.7 million new cases of HIV infection and 3 million deaths over 20
years.

Experts at the meeting agreed that the cost-effectiveness of male
circumcision is acceptable for an HIV prevention measure and that, in
view of the large potential public health benefit of expanding male
circumcision services, countries should also consider providing the
services free of charge or at the lowest possible cost to the client,
as for other essential services.

In countries where the HIV epidemic is concentrated in specific
population groups such as sex workers, injecting drug users or men
who have sex with men, there would be limited public health impact
from promoting male circumcision in the general population. However,
there may be an individual benefit for men at high risk of
heterosexually acquired HIV infection.

More research needed to further inform programme development

Experts at the meeting identified a number of areas where additional
research is required to inform the further development of male
circumcision programmes. These included the impact of male
circumcision on sexual transmission from HIV-infected men to women,
the impact of male circumcision on the health of women for reasons
other than HIV transmission (e.g. lessened rates of cancer of the
cervix), the risks and benefits of male circumcision for HIV-positive
men, the protective benefit of male circumcision in the case of
insertive partners engaging in homosexual or heterosexual anal
intercourse, and research into the resources needed for, and most
effective ways, to expand quality male circumcision services.

Research to determine whether there are modifications in perceptions
and HIV risk behaviour over the longer term in men who are
circumcised for HIV prevention, and in their communities, will also
be essential.
http://www.who.int/hiv/mediacentre/news68/en/index.html

Moderators note: Malaysian Code of Practice on Prevention and Management of
HIV/AIDS At The Workplace is available at the following url.
http://www.ilo.org/public/english/protection/trav/aids/laws/malaysiacop.pdf
___________
Spotlight: Code to stop stigma against HIV/AIDS
25 Mar 2007

A HIV-positive single mother was almost barred from eating at the
office canteen ... a bank officer was forced to quit his job after he
was exposed for having HIV. Statistics show HIV infection is rising
daily. TAN CHOE CHOE looks at the employment realities for the
growing number of people living with HIV.

THE results for your annual health screening are out — you are HIV
positive. You are the sole-breadwinner in the family, with three
school-going children and a spouse. Once you get over the shock of
the news, you start thinking how the illness is going to affect your
life. Among the questions that run through your head at that time
will probably be: Can I continue working? Do I need to notify my
boss? Will my company fire me if they know?

What are my rights? Many of us may think that this is a far-fetched
scenario, that we will not contract HIV/AIDS because the illness is
generally among drug users. Here's a reality check — not all HIV
positive people are drug users; 13.6 per cent of cases diagnosed are
through heterosexual transmission, which includes sex workers
infecting their clients or vice versa, boyfriends infecting
girlfriends, and husbands infecting wives. In short, everyone is a
potential victim.

Yet many employers in Malaysia do not think HIV/AIDS is a serious
issue, and most definitely not in the workplace, says Dr Faridah
Amin, an occupational health physician in the Industrial Health
Division of the Department of Safety and Health (DOSH). Aware of the
potential disastrous impact of the disease on the economy, the
Government, through DOSH's initiative, had launched a code of
practice to curb the spread of HIV/AIDS in the workplace in September
2001.

"The code seemed relevant because the workplace is deemed an integral
part of any society and plays an important role in the wider struggle
against the disease," says Dr Faridah. It also stipulates how
employers and employees can work together to stop the stigma and
discrimination against HIV-positive people in the workplace.

The actual name of the code is "Code of Practice on Prevention and
Management of HIV/AIDS At The Workplace", but there is no legal
obligation to adopt it. To date, only 33 out of some 400,000
registered employers in the country have voluntarily adopted the
code. A recent study found that once a HIV-positive person's illness
is made public, he or she would invariably be forced to resign due to
open or tacit discrimination in the workplace. The study,
commissioned by the United Nations Country Theme Group on HIV/AIDS
Malaysia, found that there have also been cases where infected
individuals have been openly asked to leave their company.

Titled "Impact of HIV on People Living with HIV, Their Families and
Community in Malaysia", the study interviewed 94 HIV-positive people
and 36 non-HIV carriers. "Many want to continue working but the
reality is nobody wants to hire a HIV-positive person, even when he
or she has responded well to treatment," says the study's head
researcher Dr Siti Norazah Zulkifli, who is also a public health
consultant.

She says many Malaysians also do not feel comfortable working with a
HIV-positive person. "Some non-HIV carriers who agree that HIV-
positive people should be allowed to continue working prefer them to
be isolated from the `healthy' community." There are no figures
available to determine the socio-economic impact of the illness on
the country, but Malaysian Aids Council programme director Joe
Selvaretnam says the consequences of laying off a HIV-positive
individual who is still productive is "huge". "Not only will it be
psychologically traumatising and damaging to that person's health,
but if he's the sole breadwinner, overnight, you'll turn his whole
family into dependents of the state," he says.

A survey of 154 companies carried out by DOSH in 2000 found that the
level of awareness among employers on HIV/AIDS and its potential
destructive impact on business and the economy was "very low". "And
going by the adoption rate of the code today, it seems the situation
is still the same," says Dr Faridah, who is in charge of promoting
the code for adoption among employers. It also means the barrage of
facts and figures about the disease disseminated by the media to jolt
them to reality have been largely ineffective.

Not the 73,429 cases of HIV infection up till June last year; not the
daily estimated infection rate of between 18 and 20 people; and not
the fact that Asia, and South-East Asia in particular, is the hottest
region for HIV/AIDS infection in the world after the sub-Saharan
countries in the African continent. Our employers, says Dr Faridah,
are still struggling with compliance of "hard issues" like noise
level control, pollution, chemical emission and heat emission. "They
have yet to reach the level of thinking of companies in developed
countries, where they pay equal attention to `soft issues' like
healthy living and the prevention of HIV/AIDS."

Some employers also erroneously believe that they need to fork out
huge amounts of money to implement HIV/AIDS awareness programmes once
they adopt the code, adds Dr Faridah. "All educational materials are
free and many government and non-governmental organisations (NGOs)
are ready to help if an employer wants to run programmes related to
HIV/AIDS awareness." Some may also think there is no real "economic
benefit" from adopting the code, when all they get is a certificate
of appreciation from DOSH.

Malaysian Employers Federation executive director Shaharudin Bardan
says about 80 per cent of MEF's registered members are employers in
the SME/SMI category. Based on that figure, he echoed Dr Faridah's
opinion about their struggle to comply with DOSH's regulations
on "hard issues" at work. "Some also find it hard to seek a balance
between the need for confidentiality in dealing with a HIV-positive
worker and at the same time, implement the policy fully in the
workplace.

"How can the code be successfully implemented if employers cannot
identify the HIV-positive workers?" He said while MEF had encouraged
its members to embrace the code since its launch, "I would not be
surprised if many of our members don't really know about the
existence of the code, much less its contents". Meanwhile, some NGOs
are calling for the code to be made compulsory.

"I feel that as long as it's a voluntary code, they won't see HIV as
a big problem in this country," says MAC's Joe. He says adopting the
code "is an investment in the right direction because you're ensuring
your workforce is informed enough to take necessary preventive
actions to avoid what is a completely preventable disease".

But Sabarudin disagrees on forcing employers to oblige by the power
of the law. "You'll scare off foreign investors, who'll think it's a
hassle to do business here with so many regulations. In the end, the
country will stand to lose."

http://www.nst.com.my/Current_News/nst/Sunday/Focus/20070324141025/Art
icle/index_html

Position/Title: Clinical Director, China

Location: Lixin Training Center (a HIV/AIDS Clinician Training Center
run in collaboration by Anhui Province, NCAIDS, Global Fund 3, USCDC
GA Clinton Foundation) Lixin County, Anhui Province, China

Essential Duties and Responsibilities include the following. Other
duties may be assigned:

1. On-site clinical care in a direct provider of care and
consultative capacity to the provincial and/or county HIV/AIDS
treatment centers.
2. Lead full-time clinical and didactic teaching in a 3-month
per session clinician training program for rural Chinese physicians
to learn HIV/AIDS clinical management.
3. Work cooperatively with Clinton Foundation and US CDC
management staff and provincial and local Health Bureau officials in
program management and evolution.
4. With local partners, set up and operate HIV medical clinics,
including primary care of HIV infected populations, ARV management
and OI treatment. Duties may also include lab support, medication
procurement and distribution, clinic monitoring and evaluation, staff
training and other logistics needed to support the provision of a
high quality of medical care.
5. Assist in community outreach to identify and retain patients
in care.
6. Work with local NGOs to identify and retain patients in care
and treatment support services.
7. Work with in-country and international HIV/AIDS/TB experts to
optimize care and services.
8. Commitment of a minimum of six months, preferably one year or
more.

The table below explains the required past history of knowledge,
skill, and/or ability:

Work Experience
Experience with HIV/AIDS and TB clinical care, including ARV therapy
and management of opportunistic infections, both inpatient and
outpatient
Three-years of post-residency clinical working experience
International / multicultural work experience, particularly in China

Experience doing academic clinical teaching
Education
University Degree
Medical Degree
Internal Medicine or Family Medicine Residency
Infectious Disease, Pulmonary or HIV Fellowship
Other skills and knowledge
English language (fluent oral and written)
Computer skills: Word, PowerPoint, Excel
Chinese (Mandarin) language (oral and written)
Experience or academic background in health systems or policy
Skills for problem solving in the context of community-level and
multi-sectoral cooperation

Job Challenges:
• Skilled at dealing with political leadership at national ,
provincial , and local levels of government in the development and
management of a clinical program in China
• Comfortable working independently in rural resource poor
setting
• Comfortable working within the confines of the Chinese
medical delivery system at the county/village levels
• Comfortable working with distant medical back up by phone and
email
• Able to problem solve in clinical setting: e.g., barriers to
care, laboratory support, pharmacy support, and transportation in
rural setting
• Able to work in cooperatively with both National and
International NGOs and bilateral organizations.

TO APPLY: Please send an email with letter of interest, resume, and
names of three references to chaijobs@... (in the
subject field of the email, please type CLINICAL DIR, CHINA ) by June
30. Please indicate where you found the advertisement

Clinton Foundation HIV/AIDS Initiative

Attn: Human Resource Department
225 Water Street
Quincy, MA 02169
U.S.A.

http://www.clintonfoundation.org/job-openings.htm
___________________

Position/Title: Monitoring and Evaluation Advisor, China

The Clinton Foundation's program mission in China is to support the
Chinese government in delivering high quality, comprehensive, and
integrated care and treatment services for patients with HIV/AIDS on
a wide scale. On April 29, 2004, the Clinton Foundation signed a
Memorandum of Understanding with the Chinese Ministry of Health,
under whose direction CHAI is collaborating with the Chinese Academy
of Medical Sciences (CAMS) and the Chinese Center for Disease Control
(CCDC). In addition, CHAI, under the auspices of these partnerships,
is working in specific provinces in China, including Yunnan, Anhui
and Xinjiang who all have patient information system needs. The
monitoring and evaluation advisor will work with Chinese partners to
help meet those needs and develop strategies for electronic patient
information systems and/or patient information systems that are
consistent and interoperable with existing related electronic
information systems in China.

Responsibilities:
• Advise and participate in technical assistance and training
to implement China's National Treatment Database Datafax system.
• Advise and participate in planning, recommendations, and
strategies for integrating multiple information systems, including
the National Datafax system, the China's web-based disease reporting
system, and existing or developing provincial or local patient
information systems.
• Advise and participate in ongoing design and adjustment of
Clinton Foundation monitoring and evaluation and other information
systems to optimize interoperability and coordination with other
information systems in China.
• Provide technical assistance for planning and associated M&E,
assist in the preparation and review of M&E sections of proposals.
• Support capacity building of staff and partners in the use of
planning and monitoring & evaluation strategies and methods.
• Support staff and partners to ensure smooth operation of
programs, through the use of monitoring procedures.
• Support implementation of standardized reporting policies and
procedures.
• Facilitate assessment of current activities; participate in
periodic project evaluations as required.
• Support data collection and analysis, synthesis of analysis
results.
• Support maintenance of project databases.

Skills Required:
• Experience in program design, particularly M&E components and
instrumentation.
• Familiarity with electronic medical records, patient
information systems, and public health databases.
• Quantitative and analytical skills; ability to assimilate,
process, and disseminate information.
• Appropriate interpersonal skills to communicate and negotiate
effectively with a diverse range of people, representing government
and non-government stakeholders.
• Experience working with international non-government
organizations.

Education/Experience:
• University degree in public health, social science, medical
science, or related field.

Other Attributes:
• Fluency in English and Mandarin Chinese.
• Strong computer skills for word processing, database,
spreadsheets.
• HIV/AIDS program or clinical experience.
• Monitoring and evaluation work background of at least 3 years.

TO APPLY: Please e-mail letter of interest, resume, and names of
three references to: chaijobs@....

Please include: M&E Advisor—CHINA in the subject of the email.

Clinton Foundation HIV/AIDS Initiative

Attn: Human Resource Department
225 Water Street
Quincy, MA 02169
U.S.A.

50th SESSION OF COMMISION ON NARCOTIC DRUGS CLOSES

The 50th session of the Commission on Narcotic Drugs concluded on
Friday, March 16.  Among the most important developments were a
decision to defer the high-level meeting that marked ten years since
the UN Special Session on drugs until 2009, and the establishment of
a process for NGO feedback in advance of that meeting.  See below for
brief excerpts of issues related to harm reduction.

HIGH LEVEL MEETING TO MARK TEN YEARS AFTER UNGASS ON DRUGS DEFERRED
UNTIL 2009; NGO INCLUSION ENDORSED

As the ten year anniversary of the UN General Assembly Special
Session on drugs approaches, the CND adopted a resolution to delay
review of progress and the subsequent high-level meeting to 2009.
The resolution was meant to allow for more time to conduct "an
objective, scientific and balanced" assessment.

NGO FORUM DRAWS REPRESENTATIVES OF MORE THAN 80 NGOS AND COUNTRY
DELEGATES; PLANS MADE FOR REGIONAL CONSULTATIONS


On Tuesday, March 13, the Vienna NGO Committee on Narcotic Drugs held
a forum where non-governmental organizations from Africa, Asia,
Eastern Europe, and the Middle East and North Africa presented
findings on drug trends and available services. Presentations
included those from the Central and East European Harm Reduction
Network and Asian Harm Reduction Network, as well as European Cities
Against Drugs, International Medical Corps, Mentor Arabia, Ugandan
Youth Development Link, and Shelter Don Bosco, Caritas Egypt, South
African National Council on Alcoholism and Drug Dependence, Dhaka
Ahsania Mission, the International Federation of Non-Governmental
Organizations for the Prevention of Drug and Substance Abuse, Yayasan
Cinta Anak Bangsa, Centros de Integracion Juvenil, Intercambios, and
RISE Life Management Services. Regional consultations, with many of
these organizations acting as regional focal points, will be held
this year, and a modified version of UNODC's country questionnaire to
measure progress in drug demand reduction will be developed so that
data can be collected from NGOs.  This process will be an important
opportunity to provide information from the ground to the UN, and
more information will be forthcoming from the regional focal points.

For more information, please see the website of the Vienna NGO
Committee on Narcotic Drugs' website, www.vngoc.org.

2006 INCB Report Offers Little on Harm Reduction; Governments and
NGOs Challenge Findings President of the International Narcotics
Control Board Philip Emafo presented the INCB's annual report for
2006 on the first day of the CND.  As in the previous two years, the
2006 report (available at
http://www.incb.org/incb/en/annual_report.html) noted the connections
between drug use and HIV in more than a dozen countries (including
Afghanistan, Armenia, Azerbaijan, Bangladesh, China, Estonia, India,
Kazakhstan, Latvia, Lithuania, Malaysia, Russia, Thailand, and
Uzbekistan) but contained no mention of the sterile needle and
syringe programs shown to reduce transmission through injection.

The Board also did not mention the connection of substitution
treatment to HIV prevention.  The INCB report was strongly critical
of supervised injection facilities/drug consumption rooms in
Australia , Canada , Germany , Netherlands , Norway , Spain , and
Switzerland , referring to them as "rooms for drug abuse" and
reiterating the INCB view that such facilities violated the
international conventions and should be "brought to a halt."

Several member states emphasized that the 1961 convention emphasizing
this view was written before HIV, and that injection-driven HIV
epidemics and the convention's mandate to provide treatment,
rehabilitation, aftercare, and health protections justified a range
of measures including harm reduction.  Dr. Emafo, in his responses,
offered no further comment on either harm reduction or supervised
injection facilities/drug consumption rooms.


COUNTRIES DIVIDED ON HARM REDUCTION: Europe, Brazil , China and Iran
among those in support, US and Japan against

Country delegations offered positions both for and against harm
reduction generally and needle exchange particularly during the
session.

• Brazil cited the success of harm reduction initiatives undertaken
in partnership with UNODC and UNAIDS, and noted that it had achieved
a 70% reduction in HIV cases among drug users since implementation
these efforts.

• China noted that it had launched a "people's war on drugs" but also
increased access to methadone, with as many as 320 community-based
clinics reaching as many as 25,000 people in 22 provinces.

• Iran noted that it had increased its harm reduction and demand
reduction budget more than threefold and supporting triangle clinics
in the prisons.

• The US expressed concern that some countries were relying on
distribution of needles, rather than a comprehensive approach to drug
demand reduction, and described the work of the International
Narcotics Control Board as "outstanding."

• Japan expressed strong opposition to promotion of needle exchange,
and noted its drug prevention campaign called "No, Absolutely no!" in
which youth and civil society groups participated.

The divergence between views on harm reduction was captured most
clearly by the differences between the statements of the United
Kingdom and United States .

• The UK noted that it had two decades of positive experience with
harm reduction and that it supported the comprehensive package of
interventions endorsed by the UNAIDS program coordinating board,
which include provision of sterile injection equipment, substitution
treatment, peer outreach, voluntary counseling, confidential HIV
testing, prevention of sexual transmission of HIV among drug users
(including condoms and the prevention and treatment of sexually
transmitted infections), and access to primary healthcare and
antiretroviral therapy.

• The United States noted that drug abuse prevention was HIV
prevention, and that the US government opposed harm reduction
practices such as needle exchanges, decriminalization of
drugs, "government provision of illegal drugs, needles and drug
injection rooms," and other forms of assisting people in using or
abusing drugs.  The US called instead for expanded access to
substance abuse treatment, including medication assisted therapy
(e.g., methadone or buprenorphine).

A more comprehensive review of CND proceedings will be forthcoming
from the International Drug Policy Consortium, http://www.idpc.info/

You can also get in touch with Daniel Wolfe, OSI,
e-mail: dwolfe@...


Kasia Malinowska-Sempruch
Director, IHRD
Open Society Institute
e-mail: <kmalinowska@...>

6th Training Institute on HIV/AIDS Counselling and Psycho -Social Interventions.
Cell for AIDS Research Action and Training (CARAT) August 06 – October 13, 2007

ABOUT CARAT

The Cell for AIDS Research Action and Training (CARAT) of Tata
Institute of Social Sciences has been active in training and capacity building
for HIV/AIDS since 1993:

· Training as Western Regional Center for the National AIDS Counselling Training
Programme.
· Training and capacity-building for countries in South Asia.
· Chairing the NACO Technical Resource Group on Counselling.
· Training for paraprofessionals, health educators, students and
researchers in counselling and HIV research.

WHY A TRAINING INSTITUTE?

As the HIV pandemic has progressed, so too the need for personnel who are
equipped to respond to HIV& AIDS in an appropriate and effective manner. CARAT
has received repeated requests for long term training programmes. The Training
Institute is our way of ensuring a flexible program that offers a qualitative
input.

It is an intensive 10- week residential programme that encompasses various
HIV/AIDS interventions for professionals who are seeking to upgrade their
knowledge and skills. It includes field work, and action based research with
experienced faculty from the Tata Institute of Social Sciences as well as from
major NGOs working in the field of HIV/AIDS.

Professionals who have obtained post-graduate degrees in social work,
psychology, medicine, counselling, nursing or human development are
eligible. We prefer people with commitment to and experience in the field of
HIV/AIDS.

People living with HIV/AIDS are especially encouraged to apply.


CURRENT DATES:

August 06 – October 13, 2007.


CRITERIA FOR APPLICATION:

Fluency in English is a must.
Previous work experience/currently working in the field of HIV/AIDS/
Reproductive Health/ Sexual Health and other allied fields.

COURSE CONTENT:

252 hours of theory
120 hours of field work

COURSE EVALAUATION:

The seven courses will be taught in a modular fashion. This will enable
individuals to opt for selected inputs (within reasonable limits). Evaluation
will be undertaken through assignments, class presentations and class
participation.

Certificates will be awarded only on completion of all course requirements.

COURSES INCLUDE:

Course 1:  Clinical Aspects of HIV/AIDS
Course 2: Sexuality and Gender
Course 3: HIV& AIDS related Counselling
Course 4: HIV and Development
Course 5: Developing Micro- and Macro- Interventions
Course 6: Management of Prevention and Care Programmes
Plus one of two optional courses
Course 7: Introduction to HIV/AIDS Research
or Introduction to Training Methodology

At the end of the training institute, we expect that the participants
will:

Be able to analyze psycho-social, ethical, legal and human rights
aspect of HIV and AIDS from the health and development perspectives.
Develop skills in HIV-related counselling and interventions for
prevention and care at all levels.
Develop skills in research, advocacy, programme management and
training at various levels.

COST OF THE PROGRAMME:

Tuition fees (including course material) : Rs. 30,000/-

Lodging & Boarding :                            Rs. 50,000/-
                                                                    ___________
Total cost:                                     Rs. 80,000/-


Non- residential participants:                   Rs. 40,000/-
(Inclusive of lunch & tea only)

Per Module cost:
Residential Participants :                        Rs. 13,000/-
(Including course fee, lodging &boarding)
  Non Residential Participants:                    Rs. 8,500/-
(Inclusive of lunch & tea only)

(Above rates applicable for participants from India and other SAARC Countries.
Else where)

Tuition fees (including course material):          $1,000
Lodging & Boarding:                                 $ 1,500
                                                                      ______
Total                                               $ 2,500

Per Module cost:

Residential Participants:                          $ 450

(Including course fee, lodging &boarding)
  Non Residential Participants:                       $ 300
(Inclusive of lunch & tea only)

The above cost does not include travel in Mumbai during fieldwork.
Participants have to make their own arrangements for travel to attend the
programme.


APPLICATION DEADLINE: May 31, 2007.

OUR CONTACT:

Cell for AIDS Research Action and Training (CARAT)
Centre for Health & Mental Health,
School of Social Work,
Tata Institute of Social Sciences,
Sion-Trombay Road, Deonar, Mumbai- 400088,
INDIA
Tel: 91-22-65901233/25563290 Ext. 494
E-mail: carat@...
Website: www.tiss.edu

TB--what the papers aren't saying

For World TB Day 2007, Panos Global AIDS Programme launches findings from a 
global media analysis of print media coverage of TB. The paper highlights
findings from a content analysis of print media in 12 countries undertaken in
2006. It also draws upon recent reports and initiatives around health
journalism. Although 7 of the 12 countries included in the analysis are ranked
among the highest TB burden countries in the world, the research found little
coverage of TB in local or national print media.

The paper is a briefing for health practitioners, TB programmers,
policymakers, media professionals and people affected by TB. Based on an
analysis of media coverage of TB, it argues that health professionals and TB
specialists should be supported to engage more effectively with the media so
that the media can, in turn, play a more critical role in national and
international responses to public health concerns. The briefing aims to raise
awareness of TB and to raise its media profile, while at the same time
highlighting key obstacles to effective reporting on TB and other health
issues. It concludes with practical suggestions as to how the relationship
between the health and media sectors can be strengthened to enhance the media’s
contribution to global efforts to control TB.

Health epidemics like TB are not simply medical issues. They reflect wider
social inequalities linked to living conditions, poverty, immigration and access
to healthcare. As such, stories about TB do not deserve to be confined to the
health pages of the news. There is a need for collaborative interventions on HIV
and TB communication. In short, more needs to be done to improve media coverage,
to promote greater accountability and ultimately better health service delivery
around TB, HIV and other global health priorities."

Click http://www.panosaids.org/world_tb.htm or paste address on browser window
to download paper.

Anushree Mishra
E-MAIL: <anushreemishra@...>

Intensive Course on Health, Development and Human Rights, 16-20 July 2007,
University of New South Wales, Sydney, Australia

The UNSW Initiative for Health and Human Rights, a multi-disciplinary initiatve
comprised of members from the Faculties of Medicine, Arts and Social Sciences
and Law, is pleased to announce its inaugural Intensive Course on Health,
Development and Human Rights. The course will be delivered by pre-eminant
scholars from UNSW and other international experts.

The course will establish the key concepts and frameworks of the three domains
of health, development and human rights, before exploring the reciprocal links
between the three fields. The final sessions of the course will explore the
applications of these
concepts and methods to particular areas of interest to the participants. It
will be relevant to industrialised and developing country situations alike and
will take an added focus on the Asia-Pacific region.  Both UNSW students and
professional participants are welcome to apply and enrol in the course.

If you are interested in expanding your understanding and skills in Rights-based
Approaches to such areas as mental health, HIV/AIDS, sexual and reproductive
health, child health, public health emergencies, indigenous development, and
more generally the
interace between health, human development and human rights, please consult our
website. www.ihhr.unsw.edu.au

Or phone: +61 2 93851071
Fax: +61 2 9385 1036
Email: ihhr@...

Jacqui Davison
UNSW Initiative for Health and Human Rights
Samuels Bldg, Level 2
University of New South Wales, Kensington Campus, Sydney, Australia
ihhr@...
www.ihhr.unsw.edu.au
e-mail: s3206762@...

Postexposure Prophylaxis for HIV in Children and Adolescents After
Sexual Assault: A Prospective Observational Study in an Urban Medical
Center.

Article

Sexually Transmitted Diseases. 34(2):65-68, February 2007.
Neu, Natalie MD *; Heffernan-Vacca, Susan CPNP +; Millery, Mari PhD
++; Stimell, Mindy MD *; Brown, Jocelyn MD *

Abstract:
Background: We sought to evaluate the tolerability and feasibility of
establishing an HIV postexposure prophylaxis (PEP) program at our
hospital using the guidelines for children and adolescents after
sexual assault.

Methods: This study was a prospective, nonrandomized observational
study conducted from March 1999 until September 2002. Subjects (age
<19 years) who presented to a pediatric emergency room within 72
hours of a sexual assault were eligible for enrollment. A 28-day PEP
regimen of zidovudine and lamivudine was given.

Results: In all, 70 adolescents were evaluated and 33 (31 females and
2 males) were enrolled. The mean age of enrolled subjects was 15
years, 61% were Hispanic, 30% black, and 79% presented to the
emergency room within 24 hours of assault. Vaginal exposure was the
most common site of penetration (64% [21 of 33]), but 18% (6 of 33)
reported anal penetration. Only 9 subjects (27%) took >=90% of all
the medications. All subjects who returned for follow up tested HIV-
negative. Adverse events occurred in 48% (16 of 33) of subjects; the
most common events were abdominal pain, nausea, or vomiting.

Conclusion: Poor adherence to medications and visits is a significant
problem in PEP programs for sexually assaulted children and
adolescents.

Vietnam ranks 6th for HIV carriers in Asia

VietNamNet Bridge – The information was released at a conference on the
implementation of the national HIV/AIDS prevention programme on
information, education and behavior changing organized by the Ministry
of Health Tuesday.

Vietnam currently has 114,000 HIV carriers. Of these, nearly 19,700
have developed into AIDS and 11,500 have died.

According to the conference, 95% of HIV carriers in Vietnam are between
15-49, 55% at the age of 20-29, and 8.3% at the age of 10-19.  Males
make up 85.19% of all cases.

At the conference, many attendants agreed that responsible agencies
must take the initiative to propagandize to increase people's knowledge
of HIV prevention.

http://english.vietnamnet.vn/social/2007/03/675926/

UNAIDS and AusAID are looking for a Senior HIV Adviser to be based in Beijing,
China.

The deadline for submission of applications is 4 April 2007. Only on-line
applications are accepted and no late applications will be considered. To review
the job description and to apply, please go to:
http://www.unaids.org/en/Careers/Professionalvacancies/default.asp

Due to the large number of applications expected, it will not be possible to
respond to individual enquiries regarding the post. Shortlisted candidates will
be contacted at the time of reference checks and interviews, which are
tentatively scheduled for early/mid-May.

A mutually acceptable starting date will be agreed upon with the candidate
selected for the post with a target starting date between July 1 and September
1, 2007.

Additional information about UNAIDS in China can be found at:
http://www.unaids.org.cn/

Joel Rehnstrom, Country Coordinator, UNAIDS China
e-mail: unaids@...

HIV-positive man 'organised gay orgies'

An HIV-positive Melbourne man organised orgies to deliberately infect
other men with the virus, a court has been told.

Michael John Neal, 48, of suburban Coburg, faces 122 charges relating
to sex with 16 men when he was knowingly infected with the HIV virus
between 2000 and 2006.

He is accused of infecting two people with HIV over this period.

He appeared at the Melbourne Magistrates' Court for a committal
hearing on Tuesday.

Prosecutor Mark Rochford told the court that Neal's reasons for
infecting other men with HIV was to increase the number of men he
could have unprotected sex with.

"In conversations and other material Mr Neal has demonstrated an
intention to infect people with HIV," Mr Rochford said.

"He indicated his reasons for doing that is for more people (to be)
introduced to a particular group of HIV-infected persons actively
participating in unprotected ... sex."

Mr Rochford told the court Neal organised sex parties and orgies,
which were called "conversion parties", to thus facilitate the
infection of people with HIV.

He said some people attending the parties were aware of this and
others were not.

When interviewed by police, Neal denied deliberately infecting people
with HIV and said that he had a document from a doctor saying the
chances of him infecting others was very low.

The committal hearing before magistrate Peter Reardon continues.

http://au.news.yahoo.com/070319/2/12su2.html

Health as an instrument of foreign policy

The Lancet 2007; 369:806-807

DOI:10.1016/S0140-6736(07)60378-X
Richard Horton a

What has been the greatest achievement from 10 years of Labour
government in Britain? Economic stability? Stronger public services?

Winning the race to host the 2012 Olympics? In place of these, one
might rank the unprecedented cross-government awareness and
commitment to global health and human development as history's
ultimate judgment on three terms of New Labour. At the terminus of
Tony Blair's leadership, the paper published this week by Liam
Donaldson, the UK's Chief Medical Officer, and Nick Banatvala is a
watershed statement of the UK government's transformational vision of
international health.1

The Donaldson report2 reasserts the primacy of health for human
development. Traditionally in the UK, the Department for
International Development (DFID) has led government policy on the
development applications of international health. First, under Clare
Short and now under Hilary Benn, the past decade has seen DFID's role
upgraded and extended. Adopting the mantle of a campaigning non-
governmental organisation within the heart of government has changed
Whitehall radically.

DFID is typically progressive and well ahead of most other
departments in its policymaking. It offers a critique of orthodox
government strategy with the zeal of any self-respecting activist
group. Ministers at DFID seem encouraged to let their idealism
flourish. This substantial strategic shift allowed the government to
align itself with the Make Poverty History campaign in 2005, and gave
it a global leadership role in debates about how the international
community should meet the Millennium Development Goals.

For those of us in the medicine sector, DFID was the tantalising hope
for applying public-health knowledge to alleviating poverty. The
Department of Health, our natural home, was silent and seemed
indifferent. All this has now changed. Donaldson and Banatvala
advance a mission for health that is both subversive and
extraordinary.

Health can improve global security. Health can enhance development
and trade. Health can promote human rights. Health creates knowledge
that is of global value. In sum, health is a catalyst for the
rearrangement of powerful interests within government. It sets a new
standard against which foreign policy can be measured. Health moves
foreign policy away from a debate about national interests to one
about global altruism. This is a revolutionary agenda that deserves
cross-party support. It demands strenuous efforts by all those
concerned with global health to nurture the nascent ideas set out by
Donaldson and Banatvala into a strong programme of work.

Donaldson and Banatvala's argument is also a significant staging post
for a movement that has been building for some time. In addition to a
revitalised DFID, the Commission for Africa3 set a new benchmark for
international commitment to poverty reduction. The Commission linked
the UK's colonial legacy to emerging African democracies, development
to culture, fragile governance to political aspiration, and peace to
people. Meanwhile, a new dialogue began with a series of seminars
between the Department of Health and the Foreign and Commonwealth
Office to discuss how health had foreign-policy implications and vice
versa.

The Treasury also adopted a pivotal role. Gordon Brown's
International Finance Facility and the Stern Review on the
consequences of climate change both put health and well-being at the
forefront of the Chancellor's international policy objectives. And
Nigel Crisp's recent analysis of the UK contribution to health in
developing countries4 concluded that: an inter-ministerial group
should give greater guidance on health and development; a framework
for international development should be devised within the National
Health Service; and the government should expand its support of links
between the UK and low-income nations, such as those created by the
UK's Tropical Health and Education Trust.

These domestic signs of a political step-change might signify a much
wider revision of expectations about the purpose of foreign policy.5
One former senior UK diplomat, Christopher Meyer, has called the UK
Foreign Office "smug, timid, and stiflingly conformist".6 He has
argued that "it is no longer possible to draw a clear boundary
between what is foreign policy and what is domestic". Lessons from
health policy in one setting often have important global
consequences.7 The status quo in foreign policy no longer seems an
option either for politicians or career diplomats. George Bush is now
said to be making dramatic foreign-policy reversals, given his
continuing problems in Iraq.8,9 Traditional notions of diplomacy are
changing.

WHO has now joined this intellectual tumult.10 Norway will soon
deliver a report on how foreign ministers should address health
issues.11 And the UK is re-evaluating its view of public diplomacy.
Gone is the idea that foreign policy exists solely to promote
Britain's interests. Instead, the UK is now more concerned about
creating partnerships not rivalries, alliances not enmities. Health
provides one very useful bridge to greater international
understanding.

The Donaldson report2 indicates that a steering group within
government has been created to move this work forward. It has already
met twice. A 3-month consultation is to follow on the priorities for
a UK government global-health strategy. This consultation will result
in the creation of small expert groups to work on specific issues,
such as trade, climate change, and human resources for health. These
deliberations will be fed back to a larger stakeholder meeting,
ultimately to be translated into policy. The key is collaboration,
nationally and globally. A formally convened UK alliance for global
health and human development would be a constructive next step.

References
1. Donaldson L, Banatvala N. Health is global: proposals for a UK
Government-wide strategy. Lancet 2007;
published online March 7. DOI:10.1016/S0140-6736(07)603...
.

2. Donaldson L. Health is global: proposals for a UK Government-wide
strategy. London: Department of Health, 2007:.

3. Our Common Interest. Report of the Commission for Africa. March,
2005:
http://www.commissionforafrica.org/english/report/intro...
(accessed March 5, 2007)..

4. Crisp N. Global health partnerships: the UK contribution to health
in developing countries. February, 2007:
http://www.dh.gov.uk/assetRoot/04/14/31/75/04143175.pdf
(accessed March 5, 2007)..

5. Horton R. Iraq: time to signal a new era for health in foreign
policy. Lancet 2006; 368: 1395-1397. Full Text | Full-Text PDF (47
KB) | CrossRef

6. Meyer C. The FO: smug, timid, conformist. Sunday Times Culture
March 4 2007; 46-47.

7. Lozano R, Soliz P, Gakidou E, et al. Benchmarking of performance
of Mexican states with effective coverage. Lancet 2006; 368: 1729-
1741. Abstract | Full Text | Full-Text PDF (454 KB) | CrossRef

8. Anonymous. Turn and turn again. Economist March 3 2007; 48.

9. Goldenberg S. The Bush conversion: how the president saw the light
and changed foreign policy. Guardian March 2 2007; 25.

10. Drager N, Fidler DP. Foreign policy, trade and health: at the
cutting edge of global health diplomacy. Bull World Health Organ
2007; 85: 162.

11. Střre JG. Health is a foreign policy concern. Bull World Health
Organ 2007; 85: 167-168.

Back to top

Letters

Characteristics of Australian women who test positive for HIV:
implications for giving test results

Carol A Hopkins, Rosey A Cummings, Tim R H Read and Christopher K
Fairley. MJA 2007; 186 (6): 327

To the Editor: Improving clinical efficiency helps sexual health
services deal with the demands of increasing rates of sexually
transmitted infections.1,2 Many Australian sexual health centres
require all clients to return in person to obtain their HIV test
results; legislation only requires those who test positive to return
in person.3 Giving HIV test results by phone to low-risk clients may
improve efficiency.

We determined the proportion of women testing positive for HIV
infection at Melbourne Sexual Health Centre (MSHC) between 1 January
1996 and 1 January 2006, and reviewed the files of those who tested
positive to determine their risk factors for HIV acquisition.

In this period, 16 655 women were tested for HIV and 48 (0.29%)
tested positive. For 11 of these 48 women (0.07%; 95% CI, 0.027%–
0.10%), this was their first positive test. Six had been born in a
high-prevalence country4 and had had sexual contact in those
countries (two in South Africa, one in Ethiopia, one in Zimbabwe, one
in Kenya, and one in Thailand); two had a sexual partner with HIV;
one had had sex with a resident of a high-prevalence country
(Thailand); one had had sexual contact in Australia with a man from a
high-prevalence country (South Africa); and one had had sex with a
bisexual man. All these risk factors were recorded in the patient's
history at the time of initial testing.

Of the 37 women who tested positive and whose initial HIV test was
performed elsewhere, risk factors were documented for 34. Thirty-one
women (91%) had similar risk factors to the 11 who had first tested
positive at MSHC. All three women without identified risk factors at
the time of testing subsequently discovered their male partners were
known to have HIV.

We found that fewer than one in 1000 women attending MSHC tested
positive for the first time, and all who did had clear risk factors.

The upper 95% CI for testing positive among those without risk
factors (ie, none in 16 655) was also extremely low and in the order
of 1 in 1000.

In the light of these findings, it is difficult to justify providing
all results in person. MSHC now provides HIV test results by
telephone to women without risk factors. Women with unexpected,
indeterminate or positive results are recalled. This requires
sensitive management to minimise stress and anxiety.

Carol A Hopkins, Sexual Health Nurse1 and Research Nurse2
Rosey A Cummings, Nursing Services Manager1

Tim R H Read, Sexual Health Physician1
Christopher K Fairley, Director1 and Professor of Sexual Health2
1 Melbourne Sexual Health Centre, The Alfred Hospital, Melbourne, VIC.
2 Sexual Health Unit, School of Population Health, The University of
Melbourne, Melbourne, VIC. chopkinsATmshc.org.au

Rogstadt KE, Copas AJ. The impact of pump-priming funding on
genitourinary medicine and modernization of services. Int J STD AIDS
2004; 15: 653-657. <PubMed>

Wright SJ, Kell PD, Tobin R, Breen E. A review of policy change
regarding how patients access their HIV test results at two
genitourinary medicine services in Central London. Int J STD AIDS
2006; 17: 753-754. <PubMed>

Government of Victoria. Health Act 1958. Section 127.
http://www.austlii.edu.au/au/legis/vic/consol_act/ha195869/s127.html
(accessed Oct 2006).

Joint United Nations Programme on HIV/AIDS (UN/AIDS). 2006 report on
the global AIDS epidemic. Annex 2: HIV and AIDS estimates and data,
2005 and 2003.

http://data.unaids.org/pub/GlobalReport/2006/2006_GR_ANN2_en.pdf
(accessed Oct 2006).
(Received 25 Oct 2006, accepted 2 Jan 2007)

Afghanistan's silent plague of AIDS

By Carlotta Gall
Published: March 18, 2007

KABUL: Sitting and eating quietly on his father's lap, the 18-month-
old boy was oblivious to the infection running through his veins.
But his father, a burly farmer, now a widower and father of four,
knew only too well. It was the same one that killed his wife, the
boy's mother, four months ago. The man started to cry.

"When my wife died, I thought, well, it is from God, but at least I
have him," he said. "Then I learned he is sick too. I asked if there
is medicine and the doctors said no. They said, 'Just trust in God.'"
Long cloistered by two decades of war and then the strict Islamic
rule of the Taliban, Afghanistan was for many years shielded from the
worst ravages of the AIDS pandemic. Not anymore.

HIV and AIDS have quietly arrived in this land of a thousand
calamities. Still, little is known of the disease in Afghanistan. It
remains almost completely underground, shrouded in ignorance and
stigma as the government struggles with the help of U.S. and NATO
forces to rebuild the country amid a new offensive by Taliban
insurgents.

The father of the boy, Afghanistan's youngest known HIV sufferer,
agreed to speak to a reporter only on condition their names and other
details be omitted. He has not even told his family what disease his
son has.

He believes that his wife contracted it through a blood transfusion
she received during surgery in Pakistan years ago. The few surveys
that exist suggest that Afghanistan has a low prevalence of HIV —
there are only 69 recorded cases of people contracting the virus,
three of whom have died. Yet health officials are warning that the
true incidence of HIV and AIDS is much higher.

"That figure is absolutely unreliable, even dangerous," said Nilufar
Egamberdi, a World Bank consultant on HIV/AIDS. The World Health
Organization has estimated that 1,000 to 2,000 Afghans are infected,
but Egamberdi said that even those numbers were "not even close to
reality."

Saifur Rehman, director of the national AIDS control program in the
Ministry of Health, agreed. Afghanistan, a deeply religious and
conservative country with strict social mores — sex outside marriage
is against the law — may still be less at risk to the spread of the
disease than other places, some argue.

But international and Afghan health experts warn that the country has
a unique set of vulnerabilities — poor education and government
services, the mass movement of people, and the sudden influx of aid,
commerce and outsiders since the U.S. invasion in October 2001.
Afghanistan borders countries with the fastest-growing incidence of
AIDS in the world — Russia, China and India. Its other neighbors,
Pakistan and Iran, have high levels of drug addiction and growing HIV
populations, as does Central Asia to the north, experts said.

Experience in other countries has shown that AIDS can easily cross
borders, carried by migrants or returning refugees who picked up drug
habits or had sex with infected people in those countries. And rates
of drug addiction are rising in Afghanistan itself, along with its
booming opium crop and the growing availability of heroin.

But even though the Afghan government and senior religious leaders
have won praise for making the problem of HIV a national priority,
they are struggling to manage many problems.

"In Afghanistan, all the traditional risk factors for rapid spread of
HIV exist concurrently," said Fred Hartman of Management Sciences for
Health, a nongovernmental organization in Boston that is working in
Afghanistan. He has worked as technical director of Reach, an
American-financed program to expand health care to Afghanistan's
rural communities, and advises the government on HIV/AIDS.

The return home of more than two million refugees has played a part
in the spread of the disease, said Renu Chahil- Graf, regional
coordinator for Unaids, the United Nations program, who was visiting
Pul-I-Charkhi prison in Kabul, where a testing clinic has opened.
Some of those returning to Afghanistan from working abroad have drug
habits, and they spread AIDS by contact with spouses, prostitutes and
street children, Rehman said.

Afghanistan, the biggest opium- and heroin-producing country in the
world, has nearly one million drug users, according to UN estimates.
Most users still smoke the drug rather than inject it.

But five years ago, injectable heroin hit the streets of Kabul, and
intravenous drug use is increasing, with an estimated 19,000
intravenous drug users here, according to the World Bank. Addicts are
not difficult to find, living in bombed-out buildings in the old part
of the city and in Kota-e-Sangi, a neighborhood on the south side.

They are homeless or returned refugees fallen on hard times, mostly
young men, said Miodrag Atanasijevic, a coordinator for Doctors of
the World, a French aid group that runs a clean needles program in
Kabul.

"It will become a huge thing," he said. "In this country you have a
lot of drugs."

Even after five years of international assistance to the health
sector, only 30 percent of blood used in transfusions in
Afghanistan's hospitals is screened for HIV, says a World Bank report.
Eighty percent of government hospitals now screen blood, Rehman said,
but he acknowledged that many institutions do not. Health workers
remain ill-informed about HIV and careless, often reusing needles
even when they know the practice can spread the disease, he said.

While several organizations are working to provide needle exchanges
and to increase awareness of HIV, a far wider program is needed, said
the World Bank, which is providing $10 million to fight HIV/AIDS in
Afghanistan.

A recent study of 461 intravenous drug users in Kabul showed that 3
percent were HIV-positive, Rehman said. He, like many officials,
cited the situation in neighboring Pakistan as a warning.

There, drug users identified as HIV- positive in Larkana, near the
port city of Karachi, were stoned and chased from the area when the
local people learned of their infections. They then drifted into the
vast city of 16 million, and went underground. Within just two years
the HIV rate among drug users skyrocketed from 2 percent to 26
percent, Rehman said, citing a survey on the episode.

The stigma of HIV/AIDS is perhaps the largest obstacle Afghanistan
faces. The Taliban government, with its stoning and execution of
adulterers and homosexuals, may be gone, but sex outside marriage and
homosexual sex are still socially unacceptable.

Doctors and health workers here warn that AIDS sufferers will face
ostracism, even death, if their communities learn they have the
disease. The Ministry of Health is closely guarding the identity of
the few people who have tested HIV-positive.

Muhammad Farid Bazger, HIV/AIDS coordinator of the German
nongovernmental organization ORA International, has seen firsthand
the cruelty communities are capable of in neighboring Pakistan and
his native Afghanistan.

During his work in villages and refugee camps in Pakistan, he came
across an unmarried man who had returned from the Arabian peninsula
infected with HIV. The man told his father, who, not understanding
the consequences, told others, and soon the whole village knew.

The villagers told the father he should kill his son. He was swiftly
ostracized and then locked up in a brick cell in the family yard,
with only a small opening where food was thrown in.

Bazger and his colleagues eventually rescued him and made a film of
his story, which has been shown on an Afghan television channel.
Scores of foreign prostitutes have arrived in Kabul in recent years,
capitalizing on the influx of foreigners. Afghans are using their
services as well, particularly the well-paid young men employed by
foreign organizations, health officials warn. Sex between men is a
serious crime here, but health officials say this has not eradicated
homosexuality. Gay men, many unaware of the risks, often have
unprotected sex, putting them at high risk of contracting HIV.

Afghanistan's efforts to combat AIDS have been stymied by a lack of
money and a lack of urgency among donors who regard Afghanistan as a
country with low prevalence of HIV, Hartman and others said.
Afghanistan's application to the Global Fund for AIDS programs failed
last year. Even United Nations agencies have been slow to develop
HIV/AIDS education, saying that they need to see figures documenting
more AIDS cases, Egamberdi said.

Until this year, the members of the government AIDS team worked out
of a shipping container on the grounds of the Health Ministry. Now
they have graduated to a drafty, unheated hall inside the main
building. While the World Bank has granted Afghanistan money to
gather data and work with high-risk groups, Rehman hopes for an AIDS
treatment ward in Kabul, testing around the country and
antiretroviral drugs for AIDS patients remain unfulfilled.

His ministry has even enlisted the Ministry of Hajj and Religious
Affairs to educate mullahs, often the most influential people in
Afghan villages, about HIV and AIDS to help promote basic health
education and mitigate the stigma.

The man interviewed for this article has not shown positive for HIV
in nearly a year of tests, despite the death of his wife from an AIDS-
related illness.

http://www.iht.com/articles/2007/03/18/news/afghan.php?page=2

EXPLORING DISPARITIES BETWEEN GLOBAL HIV/AIDS FUNDING AND RECENT
TSUNAMI RELIEF EFFORTS: AN ETHICAL ANALYSIS

TIMOTHY CHRISTIE, GETNET A. ASRAT, BASHIR JIWANI, THOMAS MADDIX,
JULIO S.G. MONTANER (2007) EXPLORING DISPARITIES BETWEEN GLOBAL
HIV/AIDS FUNDING AND RECENT TSUNAMI RELIEF EFFORTS: AN ETHICAL
ANALYSIS. Developing World Bioethics 7 (1), 1–7.
doi:10.1111/j.1471-8847.2006.00150.x

Objective: To contrast relief efforts for the 26 December 2004
tsunami with current global HIV/AIDS relief efforts and analyse
possible reasons for the disparity.

Methods: Literature review and ethical analysis.

Results: Just over 273,000 people died in the tsunami, resulting in
relief efforts of more than US$10 bn, which is sufficient to achieve
the United Nation's long-term recovery plan for South East Asia. In
contrast, 14 times more people died from HIV/AIDS in 2004, with
UNAIDS predicting a US$8 bn funding gap for HIV/AIDS in developing
nations between now and 2007. This disparity raises two important
ethical questions. First, what is it that motivates a more empathic
response to the victims of the tsunami than to those affected by
HIV/AIDS? Second, is there a morally relevant difference between the
two tragedies that justifies the difference in the international
response?

The principle of justice requires that two cases similarly situated
be treated similarly. For the difference in the international
response to the tsunami and HIV/AIDS to be justified, the tragedies
have to be shown to be dissimilar in some relevant respect. Are the
tragedies of the tsunami disaster and the HIV/AIDS pandemic
sufficiently different, in relevant respects, to justify the
difference in scope of the response by the international community?

Conclusion: We detected no morally relevant distinction between the
tsunami and the HIV/AIDS pandemic that justifies the disparity.
Therefore, we must conclude that the international response to
HIV/AIDS violates the fundamental principles of justice and fairness.

INTRODUCTION

The flow of humanitarian support for victims of the 26 December 2004
tsunami in South East Asia is appropriate and encouraging. It is
reported that, in the aftermath of this natural disaster,
international donors pledged over US$10 bn to tsunami relief
efforts.1 Of this US$10 bn, US$2.8 bn of funding was dispersed within
the first six months after the disaster, and there is a concerted
effort to ensure that donor countries live up to their funding
promises.2 The projection is that US$10 bn over the next five to ten
years will be sufficient funding to complete the United Nations' long-
term recovery plan for South East Asia.3 Public generosity for
tsunami relief has been so overwhelming that Médecins Sans Frontiéres
has been compelled to decline further donations for this cause;4 in
addition, World Vision, Care USA, Oxfam America, and the American Red
Cross also have stopped actively collecting for this cause.5

The magnitude and immediacy of the international response to the
tsunami disaster compels us to ask why, paradoxically, other
problems, most notably the HIV/AIDS pandemic, have failed to strike
the same chord with the international community. In comparison to the
ample amount of US$10 bn pledged to tsunami relief efforts and the
US$2.8 bn actually dispersed so far, HIV funding pledged for 2005 is
less than half of the US$12 bn required, and it is estimated that by
2007 the pledged HIV funding will be only a quarter of the US$20 bn
that will be necessary at that time.6 Between now and 2007 the Joint
United Nations Programme on HIV/AIDS (UNAIDS) predicts a funding gap
of US$18 bn for HIV/AIDS.7

In referring to the `international community,' we realise that there
is no universally recognised group of stakeholders that make up this
association. However, in response to the tsunami, a coordinated
international effort developed that is so extraordinary it almost
defies description. For instance the United Nations have administered
billions of dollars of pledges from more than 60 donor nations. The
following is a quotation, which describes the extent of the
international response for one city of the 12 tsunami-affected
countries:

The international community response has been extraordinary,
involving 12 governments, 100 local governments, more than 150 NGOs
and partner organizations with 5,000 international staff in Banda
Aceh alone.8

The tsunami disaster demonstrates that stakeholders, such as
governments, non-governmental organisations, religious organisations,
individual members of the public, etc., have collaborated to
orchestrate the world's largest humanitarian relief operation in
history.9 Therefore, it is fair to ponder why such collaboration has
occurred in response to a natural disaster like the tsunami, but not
the much larger HIV/AIDS pandemic.

Although it makes many of us uncomfortable to compare disasters, the
fact remains that the tsunami death toll in 2004 of approximately
273,000 people is far less than the global death toll from HIV/AIDS
in 2004, which was approximately 3.1 million people. In fact, some
commentators have stated that the mortality rate from HIV/AIDS is
equivalent to one tsunami a month.10

The intention of this paper is to compare the international response
to the tsunami disaster with the international response to HIV/AIDS.
We will explain some specifics about the disparity and offer an
ethical analysis, which critically examines some of the fundamental
differences between the two events. We will conclude that although
there are differences between the tsunami and the HIV/AIDS pandemic,
these differences do not justify the colossal difference in the
response of the international community to these tragedies.

The Asian tsunami killed approximately 273,000 people in one
afternoon, it affected 12 countries, resulted in more than 150,000
casualties, 24,000 missing persons reports, and more than one million
displaced persons.11 In response to this disaster, the international
community pledged an incredible US$10 bn, of which US$2.8 bn has
already been dispersed. It is expected that this funding will be
sufficient to achieve the United Nations' long-term recovery plan for
South East Asia. On the other hand, the annual death toll from
tuberculosis is 2–3 times higher than the death toll from the
tsunami,12 and every month diarrhoea kills more than 140,000 people
worldwide, while malaria and AIDS each kill an additional 250,000
people per month.13 The tsunami orphaned approximately 100,000
children, whereas AIDS has orphaned more than 11 million children in
Africa alone.14

The latest HIV/AIDS statistics report that the global prevalence of
HIV is more than 39.4 million people and the incidence rate in 2004
was 4.9 million new infections. The death rate from HIV/AIDS related
causes in 2004 was 3.1 million people. Sub-Saharan Africa, by itself,
has over 60% (n = 25.4 million) of the world's population of people
living with HIV/AIDS.15 In 2002, the UNAIDS programme estimated that,
without proper prevention efforts, there would be approximately 45
million new cases of HIV in Africa by 2010. They further argued that
more than 64% (or 29 million) of these infections are avoidable via
proper prevention efforts.16 Regarding treatment of HIV, the `3 by 5
initiative' is a plan to provide three million people in low- and
middle-income countries, with antiretroviral treatment by the end of
2005. The cost will be as little as US$17 per month/per patient, or
US$0.56 per day/per patient, but will reach less than 50% of the
people who need Highly Active Antiretroviral Therapy (HAART).17

A telling example of political inconsistency in response to these
disasters is Canada's response. Within the first two weeks after the
tsunami, Canada pledged over C$5 million without knowing exactly what
was needed or what the strategic direction for relief efforts would
be. On 10 January 2005, the Prime Minister announced that Canada
would contribute C$425 million over the next five years for a
comprehensive disaster relief package.18 In fact, Canada has been
applauded as one of the most generous countries in the world for its
tsunami relief efforts.19 In contrast, funding for the Canadian
Strategy on HIV/AIDS will gradually increase from C$42.2 million to
C$84.4 million over the next five years, which is still significantly
below the C$106 million currently necessary to get ahead of the
epidemic in Canada.20 Furthermore, Canada's pledge of C$70 million
for the Global Fund remains far below that deemed adequate by the
Equitable Contribution Framework.21

Unlike the international response to HIV/AIDS, the response to the
tsunami disaster has demonstrated that rapid and massive resource
mobilisation is possible if the international community is suitably
motivated. In fact, resources allocated for the tsunami exceed what
is required to deal with 100% of the demand; whereas the projected
resource allocation for HIV/AIDS is expected to be deficient by US$18
bn between now and 2007. This comparison raises two ethically germane
questions, which, furthermore, are importantly linked. First, what is
it that motivates a more empathic response to the tsunami than to
HIV/AIDS? Why is it that the international community has made such an
extraordinary effort to address this need so completely? Second, is
there a morally relevant difference between the two tragedies that
justifies the difference in the international response?

The first of these questions is a matter of moral psychology, on
which we will only speculate. The tsunami was a one-time event,
whereas HIV/AIDS is an ongoing crisis. It is probably true that a
sudden disaster generates a different visceral response than a slow
ongoing horror such as the HIV/AIDS pandemic. Furthermore, the shock
value of this event was definitely influenced by the media response
and, quite possibly, the resultant empathy for victims of the tsunami
was a `knee jerk' response.

It is also possible that tsunami relief efforts are, in a
sense, `easier' and more concrete than what is needed to fight
HIV/AIDS. Many health system constraints, in developing countries,
create bottlenecks that prevent aid from being used efficiently where
it is most needed.22 Tsunami relief efforts largely went to tasks for
which infrastructure and skills were readily available for use of
resources, for example, providing food, shelter, rebuilding and re-
equipping schools and clinics, rebuilding boats, desalinating rice
paddies, etc.; whereas what is needed to confront HIV/AIDS is:
education, changing attitudes, changing intimate behaviour, changing
unequal gender relations and attitudes toward women, etc. These are
much more involved projects that may be harder for people to
conceptualise and difficult to achieve without adequate
infrastructure support.

It is one thing to speculate whether the difference between a one-
time event and an on-going crisis, or whether the lack of
infrastructure supports, is actually the cause of the difference in
the international response to the two events. However, it is quite
another question to ask whether this difference is justified. In the
first question we are simply trying to understand the phenomenon of
the international community's reaction to the two events. But with
the second question we are exploring whether any difference in
response, whatever its actual cause, is justified. The principle of
justice suggests that any two cases that are situated similarly ought
to be treated in a similar fashion. For any difference in the
international response to the tsunami and HIV/AIDS to be justified,
the two tragedies have to be shown to be dissimilar in some relevant
respect – in some way that is material to the purpose of the
comparison. The general question from this ethical principle is; are
the tragedies of the tsunami disaster and the HIV/AIDS pandemic
sufficiently different, in relevant respects, to justify the
difference in scope of the response by the international community?

One of the biggest differences between the tsunami and HIV/AIDS is
the apparent morally neutral nature of the tsunami disaster. The
tsunami was a natural disaster that did not involve human agency.
HIV/AIDS, on the other hand, is a disease that is spread via human
conduct, primarily through sex and/or injection drug use.23 This, at
a superficial level, may make it is easier to blame the victims, or
at least to be less empathic. The following quotation from Stephanie
Nolen's Globe and Mail piece describes the difference:

It's not [for] people fighting each other all the time – and there is
a moral judgment that people still make about HIV and AIDS, but there
is no moral judgment about being hit by a wave. I feel a slight
undercurrent – AIDS is connected with sex and sex is bad. But this is
just a wave.24

The general point is that a major difference between the two
tragedies is the role of human agency. That is, the victims of the
tsunami did nothing to precipitate the event (the underwater
earthquake) that led to the harms they ended up experiencing, but
those affected by HIV/AIDS have had a causal role to play in the
events that led to their being affected by the disease. This line of
argument reasons that human agency justifies the difference in the
way that the global community has responded to the two events.

The major problem with this argument is that it grossly overstates
the roles of a great many individuals, particularly in developing
countries, who end up with HIV/AIDS because they occupy relatively
weak positions in the power relationships that govern the social
order. For instance Dr Mark Wainberg explained the weakness in this
argument as follows:

It is incredible to hear some people still arguing that the victims
of HIV are largely deserving of their fate because of injection drug
use, promiscuity, prostitution or failure to use condoms – as though
abject poverty, poor education and a too common sense of despair in
AIDS-endemic countries had nothing to do with it. Not to mention that
millions of women are the victims of sexual assault in any given year
and are often not empowered to insist on condom use under the best of
circumstances.25

Regardless of what one thinks about sex, injection drug use,
prostitution, promiscuity, and/or any other HIV risk behaviour,
evidence clearly indicates that the negative consequence of
contracting HIV/AIDS and/or having untreated HIV are largely
preventable and unnecessary. For example, the proper administration
of HAART can significantly reduce the morbidity and mortality
associated with HIV/AIDS and can extend, significantly, the lives of
those infected with the HIV virus.26 There is even evidence that
providing effective HAART can reduce the heterosexual transmission of
HIV by as much as 80%.27 The correct use of condoms can reduce the
risk of sexual transmission by more than 80%;28 harm reduction
strategies can significantly reduce the spread of HIV via injection
drug use by more than one third;29 and mother-to-infant transmission
can be virtually eliminated with proper interventions.30

One consequence of the disparity that results from the human agency
argument, is that if people behave in a way that precipitates holding
individuals or groups responsible for their disease, it is then
appropriate for that person (or group of people) to suffer the
consequent harms, no matter how severe or preventable. The principles
of respect for human life and human dignity, however, suggest that
the lives of those suffering preventable morbidity and/or mortality
(e.g. HIV/AIDS) are not any less deserving than those who suffer
morbidity and/or mortality from a natural disaster. Thus, we argue
that focusing on the human agency argument misses the point. The
question should not be whether or not we condone the risk behaviors
that could lead to HIV, but whether we should tolerate avoidable
negative consequences, simply because some may disapprove of certain
human behaviors.

Because the negative consequences of HIV/AIDS are largely
preventable, by employing the same type of supports and international
collaboration as were provided to the tsunami victims, it is
irrelevant whether or not we hold the victims of the HIV/AIDS
pandemic responsible for their tragic fates. Yet, the way we have
responded to the tsunami disaster, compared to the way we have
responded to the HIV/AIDS pandemic, implies precisely this. Blameless
victims have received unprecedented international support, whereas
victims who are blamed for their own situations have received much
less support. As Ian Culbert, Director of the Canadian HIV/AIDS
Information Centre with the Canadian Public Health Association
wrote: `the global HIV/AIDS crisis is really two epidemics that fuel
each other: an epidemic of disease ravaging countries and continents
and an epidemic of stigma and discrimination.'31

As for the argument that the infrastructure for supporting those
affected by the tsunami is in place, whereas it is missing in the
cases of HIV/AIDS victims and the victims of other conditions; while
the argument may have some explanatory merit, it lacks justificatory
force. A recent example of how investing properly in health system
infrastructure could help the more efficient use of resources is
South Africa's programme for the prevention of mother to child
transmission of HIV. This treatment regimen is relatively simple, a
single dose of Nevirapine given to the mother during delivery and to
the newborn. Prior to investing in infrastructure support, less than
10% of eligible women received this intervention, however, after
improving the service delivery infrastructure, coverage increased to
over 78% in South Africa.32 The lack of infrastructure support in
developing countries certainly is a barrier that would have to be
addressed. If the international community collaborated to fight HIV
in the way it came together in response to the tsunami, the lack of
infrastructure in developing countries would be rectified. For
instance, the tremendous efforts of the United Nations in
coordinating tsunami relief required developing new infrastructure
and this was done without delay.33 This is not an insurmountable
obstacle and, based on the above reasoning, there is an ethical
imperative that it must be addressed.

Critics may reject our argument for why there is a disparity between
tsunami relief efforts and HIV/AIDS relief efforts. Perhaps, stigma,
discrimination, and/or blaming the victims are not the only reasons
for the disparity. However, this does not mean that one is justified
in accepting this disparity uncritically. We argue that there is no
morally relevant difference between the two events that could lead to
an ethically just distinction in response by the international
community. Therefore, we must pose tough questions to the
international community, and to ourselves, about how such injustice
could occur and how it can be rectified.

What happened in South East Asia was basically unpreventable. Of
course, an early warning system could have saved many lives, but the
event itself could never have been prevented. Meanwhile, HIV/AIDS is
an appalling example of a largely preventable disease with proven
effective interventions. Responses to HIV/AIDS and the tsunami are
examples of our inconsistency in responding to large-scale human
tragedies. Regarding HIV/AIDS, we shrink behind rationalisations and
fallacious reasoning, whereas in the case of the tsunami we simply
did what needed to be done out of genuine empathy.

We can find no morally relevant distinction between the tsunami
disaster and the HIV/AIDS pandemic that withstand critical
examination. Therefore, we must conclude that the international
response to HIV/AIDS (not the response to the tsunami) violates the
fundamental principles of justice and fairness. Although it is very
difficult to pinpoint exactly what is meant by the `international
response', the disparity between tsunami relief efforts and HIV/AIDS
relief efforts is so grotesque that one cannot help but be morally
outraged. If the tsunami disaster has taught us anything, it is that
the public does have an enormous capacity for generosity in the face
of human tragedy, and for pressuring governments to respond. In
conclusion, our argument does not suggest that we should spend less
money on tsunami relief. Rather, we should abandon fallacious
rationalisations when it comes to dealing with the HIV/AIDS pandemic
and do what needs to be done.

Acknowledgments

The authors would like to acknowledge the contribution of Fred
Koning, Director of Ethics Services for Providence Health Care and
Anne Drummond, Medical Writer, BC Centre for Excellence in HIV/AIDS,
for their comments on the penultimate version of this paper. The
authors would also like to acknowledge the peer reviewers and editors
of Developing World Bioethics. By incorporating their comments and
critical questions this manuscript has been significantly improved.
Thank you very much.

Footnotes
1  Reuters Foundation. 2005. Tsunami Pledges/Donations Top $10
Billion. Reuters Foundation: Alert Net 27 July. Available at:
http://www.alertnet.org/thefacts/countryprofiles/218357.htm [Accessed
17 May 2006].

2  B.S. Klapper. 2005. U.N.: Tsunami Relief Pledges Surpass $10B.
Associated Press 22 June. Available at:
http://www.wtopnews.com/index.php?nid=412sid=393828 [Accessed 17 May
2006]; L. Cruz. 2005. Governments must Make Good on Tsunami Relief
Pledges. Boston, MA: Oxfam America. Press Release, 7 January.
Available at:
http://www.oxfamamerica.org/newsandpublications/press_releases/press_r
elease.2005-01-11.9987149063 [Accessed 17 May 2006].

3  Klapper, op. cit. note 2.

4  M. Thieren. Asian Tsunami: Death-toll Addiction and its Downside.
Bull World Health Organ 2005; 83: 82.Medline, ISI

5  WWW Virtual Library-Sri Lanka. 2005. Tsunami charities enough
already: U.S. Tsunami Donations Alone have Topped $1 Billion in
Relief. NewsMax.com 1 March. Available at:
http://www.lankalibrary.com/news/charities.htm [Accessed 17 May
2006].

6  H.M. Coovadia & J. Hadingham. HIV/AIDS: Global Trends, Global
Funds and Delivery Bottlenecks. Global Health 2005; 1: 13:
doi:10.1186/1744-8603-1-13. Available at:
http://www.globalizationandhealth.com/content/1/1/13 [Accessed 1 June
2006].

7  C. Akukwe. 2005. HIV/AIDS: Looming Funding Crisis. Worldpress.org
27 July. Available at: http://www.worldpress.org/Africa/2123.cfm
[Accessed 1 June 2006].

8  E. Carll. United Nations Coordinated Tsunami Relief Efforts,
Including Billions in Pledges. International Society for Traumatic
Stress Studies Winter. Available at:
http://www.istss.org/publications/TS/Spring05/tsunami.htm [Accessed
17 May 2006].

9  B. Barber. 2005. Worldwide Tsunami Relief Pledges Top $6b. USAID
Frontlines May. Available at:
http://www.usaid.gov/press/frontlines/fl_may05/tsunamirelief.htm
[Accessed 17 May 2006].

10  M. Wainberg. 2005. A Tsunami a Month: Canadians are Turning their
Backs on the Global Fight against HIV/AIDS, Even though the Number of
Dead and Orphaned Keeps Rising. The Ottawa Citizen 24 February: A15.

11  Carll, op. cit. note 8.

12  I. Bastian. The Tsunami of Tuberculosis. Med J Aust 2005; 182:
263– 264.Medline, ISI

13  R. Deonandan. 2005. Why not (Cough Cough) Diarrhea? The West as a
Whole seems to Prefer the Poor of Asia to the Poor of Africa. rabble
news 19 January. Available at:
http://rabble.ca/everyones_a_critic.shtml?x=36710 [Accessed 17 May
2006].

14  Klapper, op. cit. note 2.

15  Joint United Nations Programme on HIV/AIDS (UNAIDS). 2004. 2004
Global Summary of the HIV and AIDS Epidemic in 2004. Executive
Summary. Geneva: UNAIDS. Available at:
http://www.unaids.org/bangkok2004/GAR2004_html/ExecSummary_en/ExecSumm
_00_en.htm [Accessed 3 June 2006].

16  R. Parker & P. Angleton. 2002. HIV/AIDS-related Stigma and
Discrimination: A Conceptual Framework and an Agenda for Action.
Washington, DC: The Population Council Inc. Available at:
http://www.popcouncil.org/pdfs/horizons/sdcncptlfrmwrk.pdf. [Accessed
17 May 2006].

17  D. Bangsberg. 2005. HAART-felt or HAART-less: The Benefits and
Harms of providing HAART to HIV Positive Persons in Low and Middle
Income Countries. Seminar Paper. Presented to the Canadian
Association of HIV/AIDS Research, May.

18  Canada: Office of the Prime Minister. 2005. Canada Announces
Comprehensive Tsunami Disaster Relief, Rehabilitation and
Reconstruction Assistance. Office of the Prime Minister: Ottawa, ON.
New Release, 10 January. Available at: http://www.pco-
bcp.gc.ca/default.asp?
Language=EPage=archivemartinSub=newscommuniquesDoc=news_release_200501
10_381_e.htm [Accessed 3 June 2006].

19  Wainberg, op. cit. note 10.

20  J. Boothroyd. 2004. How Ottawa has run down the Canadian Strategy
on HIV/AIDS. LIVING+ July/August: 9–11. Available at:
http://www.bcpwa.org/articles/issue_31_9-11_critical_care.pdf
[Accessed 17 May 2006].

21  KAIROS: Canadian Ecumenical Justice Initiatives. Cultivating just
Peace: KAIROS Education and Action Campaign 2004–2005. Factsheet on
HIV/AIDS. Toronto, ON: KAIROS. Available at:
http://www.kairoscanada.org/e/action/CJPFactsheeHIV.pdf [Accessed 1
June 2006].

22  Coovadia & Hadingham, op cit. note 6.

23  WWW Virtual Library-Sri Lanka, op. cit. note 5.

24  S. Nolen. 2005. While we Mourn the Losses from the Tsunami . . .
Federal Tsunami Aid hits $425 million . . . as Cash Woes Hurt African
AIDS Fight. The Globe and Mail 11 January: A1. Available at:
http://www.actupny.org/reports/tsunami.html [Accessed 17 May 2006].

25  Wainberg, op. cit. note 10.

26 World Health Organization (WHO). 2003. Treating 3 Million by 2005:
Making it Happen. The WHO Strategy. Geneva: WHO. Available at:
http://www.who.int/3by5/publications/documents/en/3by5StrategyMakingIt
Happen.pdf [Accessed 17 May 2006]; E.L. Murphy et al. Highly Active
Antiretroviral Therapy Decreases Mortality and Morbidity in Patients
with Advanced HIV Disease. Ann Intern Med 2001; 135: 17– 26; Medline,
ISI, CSA J.T. King. Long-term HIV/AIDS Survival Estimation in the
Highly Active Antiretroviral Therapy Era. Med Decis Making 2003; 23:
9– 20; CrossRef, Medline, ISI C. Laurent et al. Long-term Benefits of
Highly Active Antiretroviral Therapy in Senegalese HIV-1 Infected
Adults. J Acquir Immune Defic Syndr 2005; 38: 14– 17.CrossRef,
Medline, ISI

27  J. Castilla et al. Effectiveness of Highly Active Antiretroviral
Therapy in Reducing Heterosexual Transmission of HIV. J Acquir Immune
Defic Syndr 2005; 40: 96– 101.CrossRef, Medline, ISI

28  S. Weller & K. Davis. Condom Effectiveness in Reducing
Heterosexual HIV Transmission. Cochrane Database Syst Rev 2002; 1:
CD003255.Medline

29  D. Vlahov & B. Junge. The Role of Needle Exchange Programs in HIV
Prevention. Public Health Rep 1998; 113(Suppl 1): 75– 80.Medline

30 Kwazulu Natal: Department of Health. Implementing Prevention of
Mother to Child Transmission of HIV (PMTCT) in Kwazulu Natal.
Unpublished data. October 24. Found in Coovadia & Hadingham, op. cit.
note 6; M.L. Newell & C. Thorne. Antiretroviral Therapy and Mother-to-
Child Transmission of HIV-1. Expert Rev Anti Infect Ther 2004; 2: 717–
  732.CrossRef

31  I. Culbert. 2003. The Fight Against HIV/AIDS Must Continue.
Toronto, ON. Canadian HIV/AIDS Legal Network. Press release, 28
November 2003. Available at: http://www.aidslaw.ca/Media/press-
releases/e-press-nov0703.htm. [Accessed 3 June 2006].

32  Vlahov & Junge, op. cit. note 29.

33  Carll, op. cit. note 8.

Tito Thomas

He talks to R. Madhavan Nair on the campaigns he has launched among sex workers and drug addicts.

Tito Thomas had earlier led a campaign for sex workers' rights, and has more recently, launched a campaign to wean away drug users from the deadly habit.

Organising a maligned and marginalised section like sex workers into a group was not everyone's idea of social service, though it had been done in a few places in other States and in a few foreign countries. After bringing them under a union in Kozhikode, he launched a campaign for protection of their right to live with dignity.

Such initiatives by Mr. Thomas and a few others in other places in the State brought sex workers' problems into the limelight and made it a human rights issue.

Mr. Thomas is now leading a campaign to give needles to drug addicts to dissuade them from using old needles used by other drug users. Mr. Thomas, director of the Kozhikode-based Centre for Social Research and Development (CSRD), says that his campaign among drug users is effective in preventing the spread of blood-borne infections, particularly HIV.

"We do not distribute needles to encourage drug users to go on using drugs, as some have alleged. What we are conducting is a Needle Syringe Exchange Programme (NSEP) to prevent the spread of HIV and other infections which happen when the same needle is used by many users."

"Drug users, always hard up for money, rub their old blunt needles on rock to sharpen it when it is time for them to take a shot of the drug, but finally they borrow needles that are being used by their friends. It often causes the spread of the virus. We at the CSRD exchange the old ones for new so that many would not have to use the same needle."

"Through this, we build friendship with them and counsel them to go for de-addiction. Through continuous counselling we could succeed in sending over 150 addicts in Kozhikode to de-addiction centres. This programme of the State Government is financially supported by the AIDS Control Society."

Mr. Thomas, a lawyer by training, points out that what the CSRD is doing is of considerable social value. The CSRD also works with the student community to prevent them from falling prey to drugs.

Mr. Thomas believes HIV is fast spreading among the Injection Drug Users (IDUs) in Kozhikode and that the prevalence has doubled to 5.2 per cent in just one year. "It is now under control after CSRD's intervention," he says.

It is estimated that there are nearly 8,000 Injecting Drug Users (IDUs) in Kerala and about 20 per cent of them are in Kozhikode. The CSRD is the only agency in the State providing the NSEP. Mr. Thomas believes more agencies should launch the NSEP among drug users in other parts of Kerala.

The CSRD was the first NGO in Kerala which started working with sex workers. It received a lot of brickbats for providing sex workers with condoms and giving them training in safe sex practices.

"But now, 12 years down the lane, it has become an accepted programme all over Kerala and the result is remarkable," he says. He also believes campaigns among sex workers have brought down HIV prevalence among this group.

When away from home, he works as a human rights lawyer with the United Nations in its refugee section. His first stint was with Vietnamese refugees.

http://www.hindu.com/2007/03/14/stories/2007031402560200.htm

Centre for Social Research and Development (C S R D)
Opp: Konnad Bus Stop
Near Fisheries Aquarium
Beach Road, P.O. West hill, Calicut,  673 005
Kerala, India
Tel : +91 495 2384576
email :  csrd1995@...

[Moderators note: Please visit the following url to download the
report  HIV/AIDS: The looming Asia Pacific pandemic.
http://www.lowyinstitute.org/HIVAIDSProject.asp ]

Asia-Pacific HIV/AIDS crisis looming, says analyst

An Australian study says the effort to control the spread of HIV-AIDS
in the Asia Pacific is failing, and a region-wide pandemic is looming.

Speaking on the Asia Pacific program, the study's author, Bill
Bowtell, told Radio Australia's Graeme Dobell that new HIV infections
are rising alarmingly in the Asia Pacific.

"We're looking at a very serious problem if we don't take urgent,
preventive and corrective action in the next little while," he said.

Mr Bowtell says that while Thailand, Cambodia and Papua New Guinea
have long been affected by heavy HIV/AIDS caseloads, the rates are
now also growing in India, China and from a low base, Taiwan.

Mr Bowtell describes the virus as a "slow-burning fuse", but one
with "a big bomb at the end of it".

"It's in the nature of the thing to travel slowly but it travels
inexorably," he said.

"In the last few years, as we've had a globalising world and much
more travel, tourism, trade and refugee flows, it has started to come
across central Asia and Russia and now is well established.

"Its first, really big-foot hold is now in the Asia Pacific region."

Mr Bowtell says Asian governments have been stuck on debates which
pit "practical science, prevention" against "people believing that
HIV/AIDS is some sort of ... divine punishment for sinners".

He says the senior leadership in some Asian countries have been in
denial about the existence of prostitution, drug abuse and
homosexuality in their communities.

But he says there has been some change in attitude in recent years.

"Since SARS especially, many leaders have become much more pragmatic,
sensible and willing to accept that we don't live in a perfect
world," he said.

"[They accept] these countries aren't perfect, and these social
questions are there, and you've got to tackle them honestly and
openly."

http://www.radioaustralia.net.au/news/stories/s1865903.htm

Gao Yaojie, 80, checks in to a ticket counter at the Beijing Capital airport as she prepares to leave China for the U.S. in Beijing, China, in this Monday, Feb. 26, 2007 file photo. (AP Photo)

WASHINGTON -- Gao Yaojie shakes her head, stabbing hard at the air with her forefinger, when asked if the Chinese government is helping fund her efforts to expose the country's AIDS problems.

"Not even a dime," the 79-year-old AIDS activist said Monday in an interview with The Associated Press.

This is a message some Chinese authorities were reluctant to have Gao deliver in the United States. Officials had repeatedly blocked her from going abroad until finally allowing this trip after her case received widespread media attention.

Gao says the government is beginning to understand the enormity of the AIDS problem. The retired gynecologist, speaking through an interpreter, praised Chinese President Hu Jintao for allowing her to travel to Washington to receive an award Wednesday night honoring her work. She also praised high-ranking health officials.

But despite many changes in government attitudes, she says, "Sometimes they support me; sometimes they don't." She is tenacious in her efforts, using her own money, and funds from foreign awards she has received, to pay for her work.

Officials, she said, should "face the reality and deal with the real issues -- not cover it up."

In the 1990s, Gao embarrassed the Chinese government by exposing blood-selling schemes that infected thousands with HIV, mainly in her home province of Henan. Operators often used dirty needles, and people selling plasma -- the liquid in blood -- were replenished from a pooled blood supply that was contaminated with HIV. Provincial officials initially covered things up.

The Chinese government and the United Nations say China's problem of tainted blood has improved. But surviving victims face discrimination and say they have not been adequately compensated for their suffering.

Gao has also faced difficulties because of her activism.

In 2001, she was refused a visa to go to the United States to accept an award from a United Nations' group. In 2003 she was prevented from going to the Philippines to receive a public service award.

Last month, authorities kept her under virtual house arrest for about 20 days to keep her from traveling to Beijing to arrange a visa for the United States.

Gao says she persists in her work because "everyone has the responsibility to help their own people. As a doctor, that's my job. So it's worth it."

Gao says she is 80 years old by Chinese calculations. By Western calculations, she says she is 79. (AP)

March 13, 2007

http://mdn.mainichi-msn.co.jp/international/news/20070313p2g00m0in028000c.html

AIDS Healthcare Foundation 'Horrified' as Abbott Blacklists Thailand
From New Drugs

In Response to the Thai Government's Recent Move to Issue a Compulsory
License for Abbott's Kaletra, a Move Intended to Save the Lives of Its
People, Drug Giant Refuses to Issue Any New Drugs in Country Already
Hard-Hit by AIDS Epidemic US' Largest HIV/AIDS Healthcare, Prevention
and Education Provider Says  Abbott's Cold-Hearted Move Punishes Poor
People in Need; Underscores Drug Company's Greed

LOS ANGELES, March 13 /PRNewswire/ -- AIDS Healthcare Foundation AHF),
the US' largest HIV/AIDS healthcare, prevention and education rovider,
which operates free AIDS treatment clinics in the US, Africa, Latin
America/Caribbean and Asia, today excoriated US drug giant, Abbott
Laboratories for its heartless decision to blacklist the country of
Thailand by withdrawing its new drugs' applications from that
country's government review process -- a move which in essence
deprives Thailand and its citizens of access to any new Abbott
medications. Abbott's move came as a mean-spirited retaliation
following Thailand's recent move to issue compulsory licenses on some
lifesaving drugs, including Kaletra, an anti-retroviral drug
manufactured by Abbott that is used in the treatment of HIV/AIDS.

World Trade Organization (WTO) regulations include flexibilities and
provisions that allow governments to issue compulsory licenses
without consulting the foreign patent owner if the country deems
it necessary and appropriate to protect the health of its citizens.

"This is a new low, and I am horrified that Abbott would deprive poor
people in need of lifesaving medications, particularly for those
living with HIV/AIDS, in a country as hard-hit by the epidemic as
Thailand," said Michael Weinstein, AIDS Healthcare Foundation's
President. "The Wall Street Journal recently ran a blistering expose
on Abbott on the front page which revealed just how down and dirty
this company gets to keep its market share and drive business to its
overpriced drugs and products. In Washington, a congressional
oversight committee is moving toward an investigation of Abbott's
price gouging and policies. At the same time, Abbott has the hubris
to blacklist a courageous country like Thailand simply trying to do
the right thing for its people. Astounding."

After Thailand issued the compulsory license for Kaletra earlier this
year, Abbott began negotiating price reductions with Thai officials.
Thailand appeared to be willing to engage in negotiations, but Abbott
would only take $200US off the $2,200US price (per patient yearly).

It is estimated that with Thailand's compulsory license, a generic
version of Kaletra can be produced for around $1,000 per patient
yearly.

The initial impact of Abbott's move to block its new drugs from being
approved for use in Thailand could be devastating. The urgent issue
for HIV/AIDS patients revolves around the heat-stable form of
Abbott's drug, Kaletra, (called Aluvia), which is currently in the
process of being approved for use in Thailand. With today's decision,
Abbott is likely to revoke the application for governmental approval
for that drug in Thailand.

"Without Aluvia in the arsenal of drugs to fight HIV/AIDS, Thailand
will now have to maintain expensive cold storage for the drug, and
poorer infected populations, who often cannot afford refrigeration,
will continue to go without access to any form of Kaletra," said
Homayoon Khanlou, MD, AIDS Healthcare Foundation's Associate Director
of Medicine. "With drug resistance a major concern for those living
with HIV, consistent access to such lifesaving medications is
crucial."

"It is our understanding that in issuing the compulsory license, the
Government of Thailand acted in accordance with all international
regulations, including paying a royalty to Abbott for all sales of
generic Kaletra," said Terri Ford, AIDS Healthcare Foundation's
Director of Global Advocacy. "AIDS Healthcare Foundation treats
people all over the world in our free clinics, and we know how
desperately these drugs are needed. I am saddened by this heartless
move by Abbott, and urge the company to consider keeping their
lifesaving drugs available to those whose lives are actually
in need of saving in Thailand and elsewhere."

In the Asia-Pacific region, AIDS Healthcare Foundation currently
provides free anti-retroviral treatment through its clinics in India,
China and Cambodia, and is opening a center in Vietnam.

SOURCE AIDS Healthcare Foundation (AHF)
http://www.prnewswire.com/cgi-bin/stories.pl?
ACCT=104&STORY=/www/story/03-13-2007/0004545637&EDATE=

Dead Man Walking

Richard Rockefeller

Chances are you have never heard of the drug, imatinib mesylate, let
alone Section 3 (d) of India's Patent Amendment Act of 2005.

But a court case in India this month involving both could determine
whether people throughout the world have access to life-saving
medicines for diseases like HIV/AIDS for decades to come.

I am intimately familiar with the drug, marketed by the Swiss-based
multinational Novartis as Gleevec, because my life depends on it.

In October 2000 doctors diagnosed me with chronic myelogenous
leukaemia (CML), a rare and deadly form of cancer. Six months later,
the Federal Drug Administration approved Gleevec.

Years of taxpayer and privately funded research went into the drug's
development, and it has all but eliminated my cancer.

Novartis has filed suit against India's government because an Indian
court rejected its patent application for a new form of the original
compound. The company is challenging both the patent office decision
and a key public health safeguard within India's Patents Act that
aims to reserve patents for real innovations only.

If Novartis succeeds, a surge of additional patents is likely,
resulting in further restrictions on the production of generic drugs
in India and inordinately high prices for newer medicines. India's
generic medicine industry is often called "the pharmacy to the
developing world" because it produces quality drugs at dramatically
more affordable prices.

Generic competition is what brought prices down for antiretroviral
(ARV) medicines for people living with HIV/AIDS from a staggering
$10,000 to $136 a year.

Most AIDS treatment programmes throughout the world rely on generic
ARVs made in India, including more than 80 per cent of the 80,000
patients treated by Doctors Without Borders in more than 30
countries.

And 70 per cent of the ARVs purchased by UNICEF, the International
Dispensary Association, the UN Global Fund, and the Clinton
Foundation to treat patients in 87 developing countries come from
generic Indian sources as well.

In Malawi, the importance of generic ARVs was brought home to me a
few years after i was diagnosed with leukaemia. I saw first-hand how
hope had replaced despair for thousands of people throughout the
impoverished country when, just a short time earlier, AIDS devastated
whole communities.

Like me, without treatment, many of the people i met most likely
would have been dead. And without a generic source of ARVs, only
dozens would have been treated, not thousands.

Even as millions around the world still have no access to treatment,
these fortunate few are put at risk by Novartis's legal attack in
India.

A constant flow of affordable newer medicines will be particularly
important for AIDS treatment, as patients inevitably become resistant
to first-line therapies and need newer drug combinations.

This lawsuit threatens the supply of these medicines because of the
precedent it could set for future patenting decisions.

Novartis says that concern with its lawsuit is misplaced because the
company gives Gleevec for free to patients in India.

Of course, those receiving it do not represent the total number of
leukaemia sufferers, and in any event, a drug delivery system based
solely on donations is vulnerable to shifting political winds and the
drugs can be withdrawn for any reason.

The company also claims on their website that their court case is
actually about increasing access to medicines because strict
intellectual property (IP) protection lays "the foundation for the
massive investments made by the pharmaceutical industry in R&D that
are vital to medical progress".

While this may sound good in a press release, it is just not true for
most people in the world. A growing body of evidence - most recently
the WHO's Commission on Innovation, Intellectual Property and Public
Health - indicates that increased patent protection has done little
or nothing to increase innovation in treatments for the afflictions
of the developing world.

Of the 1,556 new chemical entities marketed worldwide between 1975
and 2004, only 20 were for diseases that affect 90 per cent of the
world's population.

To many people, Novartis' lawsuit is a case of deja vu. Novartis was
one of 39 drug companies that sued South Africa in 1997 to block
legislation aimed at improving that country's access to essential
medicines.

At the time, the companies trotted out the same arguments, predicting
the sky would fall - on them and us - if South Africa were allowed to
shop around for the lowest-priced medicines.

Since that unsuccessful court case, though, Novartis has posted
billions of dollars in profits, including $6.1 billion in 2005 alone.

I am grateful everyday that a treatment was found to prolong my life.
But one can't be as cheerful about this as one would like, knowing
that AIDS kills more people each year - nearly three million - than
the number of people in my home state of Maine.

Or when one thinks of the people in Malawi and around the world who
would be most affected if Novartis gets its way today in India. Quite
simply, the company should drop its case. The writer is chairman of
Doctors Without Borders.

http://timesofindia.indiatimes.com/Dead_Man_Walking/articleshow/1738298.cms

BEIJING (Reuters) - A Chinese province has taken the unusual step of fining
hotels and bars more than $600 if they do not provide condoms, part of efforts
to fight the spread of AIDS, a newspaper said on Friday.

The booming eastern province of Zhejiang, with 1,859 recorded infections by the
end of last year, started enforcing the rules on Thursday, the Beijing News
said.

"Condoms or condom-vending machines must be placed in hotels, bars and
designated public places, or the managers will be fined 5,000 yuan ($650)," the
report said.

The Chinese government originally stigmatized AIDS as a disease of the
decadent, capitalist West -- a problem of gays, sex workers and drug users.
Traditionally, none of these officially existed in communist China.

It has belatedly woken up to the problem, and health experts have warned the
virus is now moving into the general population.

But a lack of sex education and unwillingness to talk about sex still
hampers the fight, health experts say. ($1=7.743 Yuan)

<http://uk.reuters.com/article/oddlyEnoughNews/idUKPEK33108420070302>
http://uk.reuters.com/article/oddlyEnoughNews/idUKPEK33108420070302
______________________
Jagdish Harsh
HIV ATLAS Inc.
www.hivatlas.org
E-MAIL: <media.hivatlas@...>

AIDS ASIA eFORUM Subscriber Survey (02/07) Reminder (1)

AIDS ASIA e FORUM subscriber survey: Questionnaire (02/07)
http://health.groups.yahoo.com/group/AIDS_ASIA/

With more than 7, 500 subscribers AIDS ASIA e FORUM is one of the
largest e FORUM for information and communication on HIV and AIDS in
ASIA Pacific region

Few days ago you must have received an announcement about this survey
on the AIDS-ASIA e FOURUM. This survey is an evaluation of the
effectiveness of a peer to peer, HIV/AIDS related electronic
discussion group. We are interested in finding out how to make this
FOURM more useful to you and your work. We would appreciate, greatly
if you could help us by taking a few minutes to answer this short
survey. Your valuable feedback will assist us to meet your needs
better and to improve this service in support of AIDS prevention and
care initiatives in Asia Pacific region.

This is a voluntary survey, and confidentiality of your identity will
be respected. The results of this study will be posted on the FORUM.

There are twenty one questions in this questionnaire. Please answer
to all questions and reply by e-mail before March 30th, 2007 to
joe_thomas123@...

Please contact me if you have any further questions about this survey.

Thank you for your attention

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

INSTRUCTIONS

First hit "Reply" to this email message. Then simply type an 'X'
where appropriate. When you have answered all the questions,
press "send" to send the email message.


Q. 1 what is your profession? (Type an X between the brackets
preceding your choice. Select only one choice)

[ ] Student
[ ] Government/ Civil Service
[ ] Researcher/ Academic
[ ] Social Worker/ Counsellor
[ ] Staff of AIDS Service agency
[ ] PLWHA/ PLWHA activist
[ ] Other (please explain) [ ]



Q. 2 Affiliation/Institution: (Type an X between the brackets
preceding your choice. Select only one choice)

[ ] AIDS service agency (International)
[ ] AIDS service agency (National)
[ ] University/ research institution
[ ] PLWHA organization
[ ] Bilateral agency (Eg. AusAID, Dfid, USAID)
[ ] Multi lateral agency (UN/ World Bank)
[ ] Hospital/ clinic (Health care worker)
[ ] Government employee
[ ] Human rights/ Development agency
[ ] Funding/ Donor agency
[ ] Other (Please specify) [ ]

Q. 3 (Type your answer between the brackets. Don't worry about extra
spaces at the end of your response).

1) Country [ ]
2) State [ ]
2) District (City) [ ]
3) PIN/ZIP/POST CODE [ ]

Q. 4 Gender (Type an X between the brackets of your choice. Select
only one choice)

[ ] Female
[ ] Male
[ ] Transgender

Q. 5 what age bracket do you belong to? (Type an X between the
brackets of your choice. Select only one choice.)

[ ] Less than 20
[ ] 20- 29
[ ] 30- 39
[ ] 40- 49
[ ] 50- 59
[ ] 60 +


Q. 6 How would you rate the overall value of AIDS ASIA e FORUM as a
regular source of AIDS related information? (Type an X between the
brackets of your choice. Select only one choice.)

[ ] Excellent
[ ] Good
[ ] Adequate
[ ] Poor


Q. 7 How many of the AIDS ASIA e forum messages do you read
weekly?. (Type an X between the brackets of your choice. Select
only one choice).

[ ] All or almost all (75-100%)
[ ] Many (50-75%)
[ ] Some (25-50%)
[ ] A few (10-25%)
[ ] Very little (less than 10%)


Q. 8 How frequently do you participate in discussion on AIDS ASIA e
FORUM? (Type an X between the brackets of your choice. Select only
one choice.)

[ ] Weekly
[ ] Fortnightly
[ ] Once a month
[ ] Once in three months
[ ] Once in six months
[ ] Never


Q. 9 What are your reasons for not participating in discussions on
the FORUM? (Type an X between the brackets of your choice you wish
to select. Choose All that is Applicable).

[ ] Too much information
[ ] Prohibitive cost and expenses of the internet
[ ] My agency prohibits posting messages on the e FORUMS
[ ] Do not have regular access to internet connection
[ ] No time/too busy
[ ] Am happy just to read the discussions
[ ] Not confident in English
[ ] Don't know how to submit messages
[ ] Reluctant to give opinions in public
[ ] Other, specify [ ]


Q. 10 what type of messages do you find most useful? (Type an X
between the brackets of your choice you wish to select. Choose all
that is Applicable).

[ ] Discussion of specific topics by other subscribers
[ ] Announcements of conferences, scholarships, web sites, job
vacancies, etc.
[ ] Journal articles, book references
[ ] Conference coverage
[ ] Project reports, lessons learned, best practices
[ ] Links to resources on the Internet
[ ] Cross postings from other lists
[ ] Requests for information (RFI)
[ ] Other, please specify [ ]


Q. 11 In which ways do you use the information from the AIDS ASIA e
FORUM in your work? (Type an X between the brackets preceding each
choice you wish to select. Choose All That Apply).

[ ] To increase current knowledge and awareness about HIV/AIDS
[ ] Program development/ Policy development
[ ] Clinical management
[ ] Teaching, research
[ ] Share information with my colleagues
[ ] Networking
[ ] Print messages and keep these in the resource centre
[ ] Other, specify [ ]


Q. 12 Can you give an example of how the AIDS ASIA e FORUM has been
helpful to you in your work? (Please type your answer between the
brackets, using as much space as necessary. Do not worry about extra
spaces at the end of your response.)

[ ]


Q. 13 In the last one month have you done any of the following after
having seen/read on the AIDS ASIA e FORUM. (Type an X between the
brackets of your choice you wish to select. Choose all that is
Applicable).

[ ] Not Applicable
[ ] Visited a website of a project
[ ] Down loaded a publication or online resource
[ ] Requested for more information
[ ] Registered for an event (training, workshop, meeting)
[ ] Contacted other people/organization whom I have never contacted
before
[ ] Responded to an advocacy call for action
[ ] Other (Please specify)


Q. 14 How many other HIV/AIDS related discussion groups do you
subscribe to? (Type an X between the brackets of your choice. Select
only one choice).

[ ] Member of only this FORUM
[ ] 1-5 Forums
[ ] 6-10 Forums
[ ] More than 11 FORUMS

Q. 15. What is the most important benefit you had by being on this
FORUM? (Type an X between the brackets of your choice you wish to
select. Choose all that is Applicable)

[ ] Got my current job
[ ] Attended a conference
[ ] Received a scholarship
[ ] Beneficial information about grants/funds
[ ] More aware of the HIV/AIDS policies
[ ] Extended my friendship/contact net work
[ ] Other benefits (please list)


Q. 16 where do you usually access your e-mails from? (Type an X
between the brackets preceding your choice. Select only one choice.)

[ ] From my office/ Work Place
[ ] From my home
[ ] Internet Café
[ ] From my home and office


Q. 17. How frequently do you check your e-mails? (Type an X between
the brackets of your choice. Select only one choice).

[ ] Daily
[ ] 2-3 times in a week
[ ] Once in a week
[ ] Few times in a month


Q. 18. How would you assess the quantity/Number of the messages
posted on the FORUM? (Type an X between the brackets preceding your
choice. Select only one choice.)

[ ] Too many messages are posted daily
[ ] 4 - 5 messages posted daily is fine with me
[ ] Post more the 5 messages in a day
[ ] Reduce the postings to 2-3 messages


Q. 19. What type of network access do you have? (Type an X between
the brackets of your choice. Select only one choice).

[ ] Direct dial up net work (Slow connection)
[ ] Direct broad band connection (ADSL, Cable, ISDN) (Faster
connection)
[ ] Part of a LAN. (My computer is linked to an office computer
network)
[ ] Don't know


Q. 20 please share your suggestions to improve the contents of AIDS
ASIA e FORUM. (Type your answer between the brackets, using as much
space as necessary. Don't worry about extra spaces at the end of
your response.)

[ ]

Q. 21 Any other comments about the Forum?

[ ]

Thank you for your feedback.

Please e-mail the filled questionnaire to <joe_thomas123@...>

President's Emergency Plan for AIDS Relief (PREPFAR)

CALL FOR ABSTRACTS FOR ORAL AND POSTER PRESENTATIONS FOR 2007 HIV
IMPLEMENTERS' MEETING: "SCALING UP THROUGH PARTNERSHIPS"

The HIV Implementers' Meeting Steering Committee invites program
implementers to submit abstracts that illustrate key programmatic
steps, tools, successes, and challenges, including any results from recent
public health evaluations and studies. Selected "how to" abstracts will be
scheduled as either oral or poster presentations, and will be compiled and
published in  the program book. It is the author's responsibility to submit an
abstract that has been approved by all coauthors and their organizations.
Abstract submission will begin on January 2, 2007 and the final deadline for
abstract submissions is March 15, 2007.

We are seeking presentations that provide information for action—
lessons arising from realworld implementation that will support scalingup HIV
services to reach unprecedented levels of scope, quality, and access. The
reviewers will prioritize abstracts clearly demonstrating one or more of the
following  implementation
experiences:

• Critical steps, tools, approaches used to achieve specific
programmatic successes
• Good ideas that just didn't work
• Flexibility and response to unforeseen challenges
• Local leadership and expertise from the country and/or region of
program
• People living with HIV/AIDS (PLWHA) as providers and implementation
experts
• Using partnerships to achieve results that would not be possible
alone
• Challenges to and investments made in building strategic
partnerships
• Supports for achieving and maintaining a consistent quality of
services
• Expanding reach—including using innovative provider cadres,
accessing Hardtoreach populations, and delivering to hardtoreach areas
• Crossing boundaries and bridging gaps—between urban and rural,
facility and community, policy and implementation; among private sector,
public sector and civil society, among prevention, care and treatment services
• Supporting disclosure and decreasing stigma for increased uptake &
effectiveness of services
• New issues, unanswered questions, or unintended consequences arising
from experience
• Critical new answers or approaches arising from studies,
evaluations, and
pilot implementation
• Integration or collaboration with other development or humanitarian
assistance programs
• Challenges to and successes in coordination at multiple levels
(e.g., donors, sectors, communities)

ELIGIBILITY
Persons and organizations actively engaged in HIV program implementation,
evaluation, and policy development are eligible to submit abstracts for
consideration. Presenters of accepted abstracts will be guaranteed the
opportunity to register during a defined registration period (one guaranteed
registration slot per accepted abstract). Abstracts will be subject to a peer
review process carried out by a panel of international experts.

Abstract reviewers
will determine whether an abstract is approved for oral or poster
presentation and notification of presenters will be on or before April 1, 2007.

REQUIRED ABSTRACT FORMAT

Note: For abstract submission purposes, the author who will be
responsible for all communications on the abstract up until the time
of acceptance should be labeled the "presenting author". At the time of
notification of abstract acceptance, the presenting author details
should be reviewed and can be changed such that the person who will be 
registering for/presenting at the conference receives all future communications.

Email and telephone contact details must be provided for the presenting author.

1. Category: For review and scheduling purposes, abstracts will be
divided into subject categories. It is mandatory that one and only one of the
subject categories listed be chosen. Read all of the categories before selecting
the most appropriate one for your abstract.

2. Title: Use a concise title that indicates the content of the
abstract. Capitalize the first letter of each word except prepositions,
articles, and species names.

3. Authors: Authors' names should be typed in upper and lowercase
letters (please do not use all capital letters). Use first name and
last name. The author presenting the paper must be designated, but may be
changed at the time of abstract acceptance. There is a limit of 10 authors per
abstract.

4. Affiliations: Each author should be listed by institution, city,
and country. Do not include department, division, laboratory, etc.

5. Location of Project/Program: Denote the primary country or primary
region (for multicountry projects) of the project or program being
implemented.

6. Key Words: To aid in the appropriate scheduling of abstracts into
sessions and in the compilation of the program's subject index,
please list

3 key words of suggested session titles for each abstract (highest
priority first).
7. Abstract Text: Abstract text is limited to 2500 characters. All
abstracts must be submitted in English. There are two options for abstract body
format—you will be asked to choose one option (see below). You will be prompted
to add your abstract text in the four component areas of either option 1 or
option 2 in your submission. Please read descriptions of the components
carefully.

Abstract Text—Option 1
This option is suited for reporting on policy and program
implementation. This includes identification of issues in service delivery and
presentation of evidence based or promising practices that programs have
adopted.

Context:
Identify specific issue and describe the intervention or program or
policy by which the issue is addressed.
Describe target population(s), geographic sites/location, key
stakeholders, and type of service.

Approach:
Detail key components of program design and implementation. Highlight
originality, innovativeness or timeliness of the topic. Identify
course of action for implementation with emphasis on critical steps, tools,
stages, and partnership building processes. Describe the methods, procedures and
techniques used to collect and analyze information that informed your
conclusions.

Outcomes and Challenges:

Describe the outcome or results of the project and applications to
other programs/the benefits it will offer. Describe what worked and
what didn't work. Highlight any unique contributions that would not
have been possible without a specific collaboration/partnership.

Key Recommendations:

State recommendations for replication in other programs and for
further study.

Abstract Text—Option 2

This option is suited for reporting on public health evaluation or
study
results.
Background: State study objectives, study question or a description of
the problem.

Design/Methods:

State the methods, procedures and techniques used to collect and
analyze information. Include description of participants, procedures,
measures, and appropriate statistical analyses.

Results: Present specific findings to date.

Conclusions: Describe the main outcomes that are supported by your
results.

SUBMISSION GUIDELINES

• Abstract submission will open online at HIVimplementers.com on
January 2,
2007 and close at 5pm GMT March 15, 2007.

• To start the abstract submission process, authors submit their
email address
as an identifier and then create and a password on the website. This
will
allow authors to manage their abstracts online until the closing
date/time.
After the deadline, no changes will be allowed.

• All abstracts must be submitted electronically. Abstracts submitted
by any
other means (e.g., fax, post or Email) will not be considered.
• Authors are strongly recommended to review the abstract prior to
the final
deadline, as no changes can be made after the closing date.
• All abstracts must be submitted in English.
• The abstract text can not exceed 2500 characters.
• It is the author's responsibility to submit an abstract without any
errors.
Abstracts will be reproduced as provided by the author.
• If accepted, your abstract will appear in its full form in the
program book.

Presentations may be recorded during delivery and final oral
presentations
and abstracts may appear on the post meeting Web site.
• Abstract related correspondence such as confirmation of submission,
notification of acceptance or rejection, and instructions for
presentation will
only be sent to the presenting author. It is the author's
responsibility to share
this information with any coauthors.

CATEGORIES

Categories are distributed among four tracks: crosscutting and policy
(Track A);
prevention of HIV transmission (Track B); care of those living with
HIV/AIDS,
including TB, orphans and vulnerable children and HIV counseling and
testing
(Track C); and antiretroviral treatment for persons infected with HIV
(Track D).
Please choose the one category that best describes the content of
your abstract.
Track A: Crosscutting
and policy
This track will encompass key crosscutting issues such as country and
donor
coordination, the role of community based and faith based
organizations, gender, human capacity, training, sustainability,
quality, integration of prevention, treatment, and care, and
strategic information. In addition, topics related to policy
development and implementation, both at national and local levels
will be included. Crosscutting or policy topics that relate to
specific prevention, care, or treatment topics alternatively may be
included under Tracks B, C, or D. Also, programs that address
the `wraparound' of other development and humanitarian services (
such as reproductive, child health or other infectious diseases,
income generation, governance, food and nutrition, and education)
with specific prevention, care, and treatment topics may
alternatively be included under Tracks B, C, or D.

Crosscutting
A1. Implementation of quality management systems and quality
improvement methods into
prevention, care and/or treatment services
A2. Approaches to ensuring optimal procurement and supply chain for
commodities, drugs,
etc.
A3. Program improvement, identification of shifting targets/epidemic
drivers, and
modification of interventions resulting from routine surveillance,
national or routine
program monitoring and evaluation, periodic or special surveys
A4. Health information systems and routine reporting systems to
support national monitoring
and evaluation, to measure program effectiveness in prevention, care
and/or treatment
services, and/or to maintain client records
A5. Implementation of newer, cheaper, easiertouse
laboratory technology
A6. `Rightsized
packaging' of services to match delivery settings: how to determine
appropriate packages for different levels of care and stages of
risk/infection
A7. Approaches to knowledge management—systems for sharing best
practices and the tools
and resources used for best practices, methods to facilitate
networking of organizations
and individuals.
A8. "Three Ones" in action– implementation of one national monitoring
and evaluation
system, one national coordinating agency, and one national plan
Policy
A9. Strategies to enhance human capacity in prevention, care and/or
treatment services (e.g.
training, task shifting, retention strategies, PLWHA as expert
providers, HIV programs
for providers, other)
A10. Approaches to ensuring gender equity in prevention, care and/or
treatment programs
A11. Management strategies to promote achievement of the Three Ones
(e.g. annual reviews,
common implementation channels, common fiduciary assessments, and
integrating
national coordination bodies)
A12. Coordination of mechanisms among multiple partners (e.g.
joint/national procurements or
joint program reviews)
A13. Innovative partnerships, (e.g. government, private sector, and
civil society) and
strengthening the capacity of new partner organizations from
grassroots to national levels
A14. Cost analysis and evaluation of cost effectiveness and public
health impact of program services in prevention, care, and/or
treatment
A15. Mainstreaming AIDS in non health sectors
A16. Public private
partnerships in prevention, care and/or treatment, including
innovative
workplace programs
A17. Developing effective National AIDS Strategies & Action Plans—
making them
evidencebased,
prioritized, costed and capable of improved implementation
A18. Universal Access, GTT and the Three Ones: experience with the
nationallevel
target
setting process and its outcomes
A19. Efforts to sustain longterm
financing: incorporation of HIV/AIDS into Poverty
Reduction Strategies and Medium Term Expenditure Frameworks;
mechanisms for
sustainable financing
A20. Integration of HIV prevention, care, or treatment services with
other development and
humanitarian assistance programs
A21. Investing in public health leadership: training, practical
experiences, skills development,
and networking that lead to results
A22. Building on influence: engendering policymakers,
healthcare workers, faithbased
leaders, community leaders, traditional healers, and other
influential persons to become
champions in the response to HIV
Track B: Prevention of HIV transmission
This track will encompass all areas of prevention, including work
with the general
population and youth, risk associated with alcohol and injection drug
use, work with other at risk populations, discordant couples,
prevention of mother to child transmission (PMTCT) including PMTCT as
a "gateway" to other essential services, prevention of medical
transmission of HIV, prevention for people living with HIV/AIDS,
prevention integrated into care and treatment programs (cross
referenced with Tracks C and D), and
preparation for introduction of new prevention technologies (e.g.
safe male
circumcision). Attention will focus on datadriven
programs, quality of programs, theorybased
approaches, lessons learned, and innovations associated with behavior
change.

B1. Successes and challenges in PMTCT programs, and integration of
such programs with
other services (e.g. child health, infant feeding decisions,
nutritional supplementation,
family planning, ARV treatment, traditional birth attendants)
B2. Experience with preparation for implementation of new prevention
technologies (male
circumcision, microbicides, HIV vaccine)
B3. Prevention for youth (including crossgenerational
sexual risk, interventions with parents
and caregivers)
B4. Prevention for persons living with HIV and AIDS, including design
and delivery of
prevention interventions for care and treatment settings
B5. Prevention for couples, including discordant couples
B6. Prevention for those practicing behavior that puts them at higher
risk of sexual HIV
transmission than the general population
B7. Prevention addressing drug and/or alcohol use, (including
reducing risks of HIV
transmission through the use of contaminated injecting equipment and
unprotected sex,
provision of drug dependence treatment, substitution therapy,
counseling and providing
treatment and care for drug users living with HIV)
B8. Prevention for those in the general population
B9. Prevention of transmission through blood products and/or in
health care setting, including
prevention interventions for health care workers
B10. NonHIV
specific programs that promote HIV prevention (e.g. microcredit)
B11. Identifying, addressing, and preventing violence and its
possible sequelae, including programs for postexposure prophylaxis
Track C: Care of those living with HIV/AIDS, including orphans and
vulnerable
children, and HIV counseling and testing
This track will focus on topics associated with care; including
community support
programs, linkages between services, nutrition, basic palliative care
components
including the prevention and management of HIVrelated conditions and
symptoms (e.g., Tuberculosis) and supportive and end of life care.
This track will also focus on programs for orphans and vulnerable
children, addressing sustainability and scale of local systems and
structures and referrals to education, care, medical and social
services and quality oversight. Additionally, this track will include
topics related to counseling and testing,
including innovative approaches to integrating HIV testing of
clients, bringing partners
and families into routine clinical care, building client record
systems, and also
community outreach and home based care programs.

C1. Integration of HIV and TB services, including TB case
identification among HIVinfected persons, HIV testing among TB
patients, diagnosis among children and persons with advanced
immunosuppression, prevention of TB transmission and disease
C2. Integration of HIV and other health care services, including a
comprehensive preventive
care package of services, nutrition, pregnancy planning, malaria
C3. Integration of comprehensive HIV care services with HIV treatment
services, including
cotrimoxazole,
diagnosis and treatment of opportunistic infections, prevention
counseling
C4. Successes in optimizing cotrimoxazole
prophylaxis for children and adults: lessons in
supply chain, delivery mechanism, training, monitoring, client
outcomes
C5. Effective program implementation to serve the needs of orphans
and vulnerable children,
including improved measures of impact, support to caregivers
C6. Integration of prevention interventions into care programs:
training and support for
volunteer and professional caregivers, integration of counselors and
new cadres into care
settings
C7. Methods of expanding the reach of HIV counseling and testing, and
integration of HIV
counseling and testing into service delivery (including rapid HIV
testing and testing in
nontraditional
settings)
C8. Infection control, specifically for TB control, in the care and
treatment setting, including
settings with significant TB drug resistance
C9. Successful methods for rural and/or homebased
care delivery, including new approaches
to training, quality supports, and levels of volunteer and
nonvolunteer
cadres
C10. Endoflife
care and supportive care, including planning, communications,
spiritual
support, access to opiod analgesics and other methods
C11. Management of common coinfections
and comorbidities,
including hepatitis B and C,
mental health disorders
Track D: Antiretroviral Treatment for Persons Infected with HIV
This track will focus on topics associated with treatment; including
successful models for scale up of services, integration of prevention
and treatment, ART literacy, pediatric ART, approaches to ensuring
adherence to ART, community based programs, program monitoring and
review, patient monitoring, ensuring quality services, supervision,
building laboratory networks and external quality assurance, and
successful linkages with other services and programs (E.g.,
Tuberculosis, nutrition programs, orphans and vulnerable children).
Topics including quality management and quality improvement
systems, medical record and health information systems, new
laboratory technologies,
procurement and commodity supply chain, `right sizing' of services to
delivery settings,
and strategies for enhancing human capacity to provide services may
alternatively be
included under Track A.

D1. Methods of identifying, recruiting and treating people with HIV
earlier in the course of
their infection
D2. Integration of prevention interventions into treatment programs:
training and support of
treatment providers, integration of counselors and new cadres into
healthcare settings,
logistics and clinic flows
D3. Pediatric diagnosis and treatment
D4. Models of increasing human resource capacity for the delivery of
care and treatment (e.g.
task shifting, development of new cadres, incorporation of PLWHA as
treatment experts)
D5. Integration of communitybased
programs/follow up with public (or private) care and
treatment programs
D6. Methods of monitoring and promoting adherence and retention in
treatment programs
D7. Models of familycentered
care and treatment
D8. Provision of care services and a comprehensive preventive care
package to persons in
treatment programs, including cotrimoxazole,
malaria prevention, nutritional support as
indicated
D9. Antiretroviral switching and interruptions: assessment and
intervention at client, site, and
national levels (eg, response to toxicities and failure; responses to
supplychain
failures;
regimen planning based on resistance and procurement options;
modification of national
treatment regimens and second line regimens)
D10. Toxicity and other clinical complications/observations from ARV
drugs
D11: Maximizing `longer term' outcomes and impact of ARV Treatment—
function, quality of
life, prevention, survival, and economics after the first 24 months
D12: Maximizing the impact of laboratory testing: judicious use,
cliniclab
communications,
proficiency testing and accuracy of results, interpretation and
application of findings
D13: Monitoring for HIV drug resistance

HIV/AIDS—call for papers

The Lancet 2007; 369:628. DOI:10.1016/S0140-6736(07)60294-3

Astrid James a,   Pam Das a,   Ros Osmond a   and   Pia Pini a

In July this year, the 4th International AIDS Society (IAS)
Conference will take place in Sydney, Australia, with the aim of
examining how scientific advances can inform the global response to
HIV/AIDS. The IAS and the Australasian Society for HIV Medicine are
co-hosting the Sydney meeting on July 22–25, 2007, which will feature
the latest research on HIV pathogenesis, treatment, and prevention.

To support the aims of IAS 2007, The Lancet is planning a special
issue to co-incide with the conference. We therefore issue a call for
research papers on all aspects of HIV pathogenesis, treatment, and
prevention. We are particularly interested in publishing the results
of trials that will be presented at IAS 2007, but will also consider
other original HIV/AIDS research for our special issue. If your
submission describes a study that has been accepted for presentation
at IAS 2007, please tell us the date and time, as well as the type,
of presentation so that we can plan publication, possibly online, in
The Lancet to comply with IAS's embargo policies.

Papers should be submitted online by our deadline of May 4, 2007, and
it would help if you mention that your submission is in response to
this call for papers.

Affiliations

a. The Lancet, London NW1 7BY, UK

Dear subscribers of AIDS ASIA e FORUM,

The Global Fund today issued its Call for Proposals for countries wishing to
apply for Round 7 grants. The proposal form and various support documents are
available in six languages at

www.theglobalfund.org/en/apply/call7. Applications must be submitted by 4 July
2007.

The major changes to the Proposal Form compared to the form that was used for
Round 6 are as follows:

Where the proposal being submitted is similar to a previous proposal that was
not approved, applicants are explicitly asked to address the comments that the
Technical Review Panel (TRP) made regarding the previous proposal.

Where the proposal being submitted has some key services in common with an
earlier grant, and significant portions of that earlier grant have not yet been
disbursed, applicants are asked to explain why the Round 7 proposal covers these
same services.
Where the proposal being submitted specifies a Principal Recipient (PR) that has
had some "performance bottlenecks" with an existing grant, applicants are asked
to explain how these bottlenecks are addressed in the proposal.

On the Proposal Form itself, applicants are being asked to submit less complex
information on their budgets.

Although the Proposal Form for Round 7 contains the same five sections used in
the Round 6 form, some of the information requested has been moved from one
section to another.

Aidspan, publisher of GFO, will produce a guidance document to help potential
applicants with the applications process. "The Aidspan Guide to Round 7
Applications to the Global Fund" will be posted at www.aidspan.org/guides on
Monday or Tuesday March 5 or 6. This document will also be available in French
and Spanish versions; these versions should be posted on the Aidspan website by
19 March 2007.

All proposals submitted by the closing date will be reviewed by the Global Fund
Secretariat to ensure that they meet the Fund's eligibility criteria. Eligible
proposals will then be forwarded to the TRP for consideration. The TRP will make
recommendations to the Global Fund Board, which will make its decisions at its
board meeting scheduled for 14-16 November 2007. (In the past, all proposals
recommended by the TRP for approval have indeed been approved by the Board.)

When the TRP members review the proposals, they will do so in their personal
capacities - they must not share the information with or accept any instructions
from their employers or their national governments. Once the TRP has assessed
each proposal, it will assign it a rating in one of the following categories:

Recommended (Category 1): Proposal is recommended for approval.

Recommended (Category 2): Proposal is recommended for approval, provided that
the applicant responds promptly to a number of requests by the TRP for
clarification or adjustment. (This might be divided into Categories 2A and 2B.)

Not Recommended (Category 3): Proposal is not recommended in its present form,
but applicant is encouraged to submit a proposal in a future round following
major revision.

Not Recommended (Category 4): Proposal is rejected

In allocating each proposal to one of the above categories, the TRP will take
into consideration only technical factors, such as whether the project described
in the proposal is technically sound, whether it is one that the specified
organization(s) are capable of implementing, and whether it represents good use
of the money. The TRP is required to ignore the question of whether it believes
the Global Fund has enough money to pay for all of the proposals that it is
recommending. If the TRP recommends more proposals than the Fund has money to
finance, it will be for the Board to deal with the problem. (See next article
for information on the funding available for Round 7).

Once a proposal is approved by the Board, the Secretariat will enter into a
lengthy and complex process of: (a) ensuring that the applicant answers, to the
satisfaction of the TRP, any questions that the TRP asked regarding the
proposal; (b) assessing the ability of the proposed Principal Recipient (PR) to
perform the role that the proposal assigns to it; and (c) negotiating grant
agreement(s) with the PR. It is only after this multi-month process that the
first cash disbursement will be sent. Thus, although proposals have to be
submitted by 4 July 2007, it is unlikely that the first funding will be sent for
successful proposals before the middle of 2008.

_________________________
Dr.Ashok Rau
Executive Trustee/CEO
Freedom Foundation-India, Nigeria, and Botswana
(Centers of Excellence- Substance Abuse & HIV/AIDS)
180, Hennur Cross, Bangalore - 560043, India
Phone (O) +91 80 25440134, 25449766
e-mail: <ashokrau@...>