God, AIDS, Africa & HOPE

Reflections / Gedanken

07/09/2010 • 3:43 pm Comments Off on PlusNews Africa: Money no protection from HIV

PlusNews Africa: Money no protection from HIV

JOHANNESBURG, 6 July 2010 (PlusNews) – A new study has challenged widely held assumptions about income level in relation to HIV, finding that neither wealth nor poverty are reliable predictors of HIV infection in Africa.
Previously, the argument that poverty drove HIV epidemics was supported by the World Bank and UNAIDS, as well as less reliable authorities like former South African President Thabo Mbeki, who told the International AIDS Conference in Durban in 2000 that the disease was a partner with “poverty, suffering, social disadvantage and inequity”.
More recent research suggests that the reality is far more complex. For example, Botswana and South Africa, described as two of the wealthiest countries on the continent, also have among the highest rates of HIV infection.
Nevertheless, the idea that poverty fuels the spread of HIV has persisted as “a very dominant narrative”, according to Justin Parkhurst of the London School of Hygiene and Tropical Medicine.
Parkhurst analyzed and compared data on HIV and wealth from demographic and health surveys in 12 sub-Saharan African countries with generalized epidemics (national prevalence rates higher than 1 percent); his findings are published in the July issue of the Bulletin of the World Health Organization.

He noted that in lower-income countries HIV prevalence tended to rise in tandem with wealth – in Uganda and Cote d’Ivoire, for example, women in the highest income bracket had the highest HIV prevalence.
In countries with a per capita gross domestic product higher than US$2,000, the link between wealth and prevalence was less clear.
Parkhurst also found that the relationship between wealth and HIV changed over time. A survey was conducted In Tanzania in 2003, and another in 2008; in the intervening five-year period, HIV prevalence declined among women in higher income brackets and rose among those in the lower income groups. Among men, prevalence stayed the same in the poorest group but was lower in all other groups, with the biggest declines in the highest income groups.
“HIV spreads through sexual behaviours, and these are social behaviours that change over time and are responsive to outside influences,” Parkhurst told IRIN/PlusNews. He compared the way HIV affected different social groups with the way tobacco use and obesity once affected mainly the rich, but were now bigger problems among the poor.

Wealthier people were often harder hit early in an HIV epidemic, probably because of their broader social and sexual networks. “Over time, the wealthy tend to be more educated [about HIV risk] and more likely to think about their future health,” said Parkhurst.
However, these trends are by no means universal and the patterns for men and women differ. In Swaziland, for example, which has the highest HIV prevalence of all the countries Parkhurst looked at, there was little evidence of a link between household wealth and individual prevalence.
Know your epidemic
Parkhurst’s findings have implications for one-size-fits-all prevention campaigns that do not take into account the complex and changing ways in which wealth, education level and gender can affect risk-taking behaviours.

“We need to educate people [about HIV] in a way that’s relevant to their context,” he said. “It’s about letting local actors to find out what’s going to work best. If we try to work out the solution from London … it’s unlikely to work.”

Parkhurst said “bottom-up” HIV prevention initiatives targeting the specific lifestyles and risk behaviours of a community were more likely to work. This approach is already catching on, with UNAIDS urging countries to “know your epidemic” and design prevention programmes accordingly.
“Health practitioners know they have to diagnose a problem before they can treat it,” he said. “I think the international community is starting to recognize the importance of addressing structural drivers of HIV, not just broadly, but to look at the specifics for specific communities.”

Source: http://www.plusnews.org/Report.aspx?ReportId=89746

Filed under: HIV and AIDS, HIV Prevention, Politics and Society, Society and living environment, , , ,

07/05/2010 • 10:52 am 2

Global Commission on Law & HIV/AIDS

Press release of UNAIDS:

Launch of the Global Commission on HIV and the Law:
“Addressing punitive laws and human rights violations blocking effective AIDS responses”

Geneva, 24 June 2010 – The United Nations Development Programme (UNDP), with the support of the UNAIDS Secretariat, launched the Global Commission on HIV and the Law today. The Commission’s aim is to increase understanding of the impact of the legal environment on national HIV responses. Its aim is to focus on how laws and law enforcement can support, rather than block, effective HIV responses.
The Global Commission on HIV and the Law brings together world-renowned public leaders from many walks of life and regions. Experts on law, public health, human rights, and HIV will support the Commissions’ work. Commissioners will gather and share evidence about the extent of the impact of law and law enforcement on the lives of people living with HIV and those most vulnerable to HIV. They will make recommendations on how the law can better support universal access to HIV prevention, treatment, care and support. Regional hearings, a key innovation, will provide a space in which those most directly affected by HIV-related laws can share their experiences with policy makers. This direct interaction is critical. It has long been recognized that the law is a critical part of any HIV response, whether it be formal or traditional law, law enforcement or access to justice. All of these can help determine whether people living with or affected by HIV can access services, protect themselves from HIV, and live fulfilling lives grounded in human dignity.
Nearly 30 years into the epidemic, however, there are many countries in which negative legal environments undermine HIV responses and punish, rather than protect, people in need. Where the law does not advance justice, it stalls progress. Laws that inappropriately criminalize HIV transmission or exposure can discourage people from getting tested for HIV or revealing their HIV positive status. Laws which criminalize men who have sex with men, transgender people, drug-users, and/or sex workers can make it difficult to provide essential HIV prevention or treatment services to people at high risk of HIV infection. In some countries, laws and law enforcement fail to protect women from rape inside and outside marriage – thus increasing women’s vulnerability to HIV.
At the same time, there are also many examples where the law has had a positive impact on the lives of people living with or vulnerable to HIV. The law has protected the right to treatment, the right to be free from HIV-related discrimination in the workplace, in schools and in military services; and has protected the rights of prisoners to have access to HIV prevention services. Where the law has guaranteed women equal inheritance and property rights, it has reduced the impact of HIV on women, children, families and communities.
With more than four million people on life-saving treatment and a seventeen per cent decrease in new infections between 2001 and 2008, there is hope that the HIV epidemic is at a turning
point. To reach country’s own universal access targets and the Millennium Development Goals (MDGs), persistent barriers like punitive laws and human rights violations will need to be overcome.
UNDP Administrator Helen Clark believes that the next generation of HIV responses must focus on improving legal, regulatory, and social environments to advance human rights and gender equality goals. “Some 106 countries still report having laws and policies present significant obstacles to effective HIV responses. We need environments which protect and promote the human rights of those who are most vulnerable to HIV infection and to the impact of HIV, and of those living with HIV/AIDS,” Helen Clark said.
Michel Sidibé, UNAIDS Executive Director has made removing punitive laws a priority area for UNAIDS. “The time has come for the HIV response to respond to the voice of the voiceless,” he said. “We must stand shoulder to shoulder with people who are living with HIV and who are most at risk. By transforming negative legal environments, we can help tomorrow’s leaders achieve an AIDS-free generation.”
The Global Commission on HIV and the Law is being supported by a broad range of partners and stakeholders, including donors such as the Ford Foundation and AusAID. Murray Proctor, Australia’s Ambassador on HIV, expressed strong support for the Commission and the work it is tasked to do. “We commend UNDP and the UNAIDS programme for courageously taking this work forward, and we welcome the opportunity to contribute and support.”
The Commission’s work will take place over an 18 month period –mobilizing communities across the globe and promoting public dialogue on how to make the law work for an effective response to HIV. The findings and recommendations of the Commission will be announced in December 2011.
For more information contact:
Adam Rogers | Geneva | Senior Strategic Communications Advisor |tel. +41 22 917 85 41| adam.rogers@undp.org
Natalie Amar| New York | Commission Secretariat |tel. +41 22 917 85 41| natalie.amar@undp.org
Saya Oka | UNAIDS | Geneva | Communications Officer |tel. +41 22 791 1697| okas@unaids.org
UNDP is the UN’s global development network, an organization advocating for change and connecting countries to knowledge, experience and resources to help people build a better life. We are on the ground in 166 countries, working with them on their own solutions to global and national development challenges. As they develop local capacity, they draw on the people of UNDP and our wide range of partners.
UNAIDS: Leveraging the AIDS response, UNAIDS works to build political action and to promote the rights all of people for better results for global health and development. Globally, it sets policy and is the source of HIV-related data. In countries, UNAIDS brings together the resources of the UNAIDS Secretariat and 10 UN system organizations for coordinated and accountable efforts to unite the world against AIDS. http://www.unaids.org

http://data.unaids.org/pub/PressRelease/2010/20100624_pr_lawcom_en.pdf

Filed under: General, HIV and AIDS, Politics and Society, , , , ,

07/03/2010 • 10:33 am Comments Off on Vienna Declaration Seeks Changes to “War on Drugs”

Vienna Declaration Seeks Changes to “War on Drugs”

Please read and sign the Vienna Declaration on: http://www.viennadeclaration.com/the-declaration.html

———————————–

The Vienna Declaration

The criminalisation of illicit drug users is fuelling the HIV epidemic and has resulted in
overwhelmingly negative health and social consequences. A full policy reorientation is needed.

In response to the health and social harms of illegal drugs, a large international drug prohibition regime has been developed under the umbrella of the United Nations.1 Decades of research provide a comprehensive assessment of the impacts of the global “War on Drugs” and, as thousands of individuals gather in Vienna at the XVIII International AIDS Conference, the international scientific community calls for an acknowledgement of the limits and harms of drug prohibition, and for drug policy reform to remove barriers to effective HIV prevention, treatment and care.

The evidence that law enforcement has failed to prevent the availability of illegal drugs, in communities where there is demand, is now unambiguous.2, 3Over the last several decades, national and international drug surveillance systems have demonstrated a general pattern of falling drug prices and increasing drug purity—despite massive investments in drug law enforcement.3,4

Furthermore, there is no evidence that increasing the ferocity of law enforcement meaningfully reduces the prevalence of drug use.5 The data also clearly demonstrate that the number of countries in which people inject illegal drugs is growing, with women and children becoming increasingly affected.6 Outside of sub-Saharan Africa, injection drug use accounts for approximately one in three new cases of HIV.7, 8 In some areas where HIV is spreading most rapidly, such as Eastern Europe and Central Asia, HIV prevalence can be as high as 70% among people who inject drugs, and in some areas more than 80% of all HIV cases are among this group.8

In the context of overwhelming evidence that drug law enforcement has failed to achieve its stated objectives, it is important that its harmful consequences be acknowledged and addressed. These consequences include but are not limited to:

  • HIV epidemics fuelled by the criminalisation of people who use illicit drugs and by prohibitions on the provision of sterile needles and opioid substitution treatment.9, 10
  • HIV outbreaks among incarcerated and institutionalised drug users as a result of punitive laws and policies and a lack of HIV prevention services in these settings.11-13
  • The undermining of public health systems when law enforcement drives drug users away from prevention and care services and into environments where the risk of infectious disease transmission (e.g., HIV, hepatitis C & B, and tuberculosis) and other harms is increased.14-16
  • A crisis in criminal justice systems as a result of record incarceration rates in a number of nations.17, 18 This has negatively affected the social functioning of entire communities. While racial disparities in incarceration rates for drug offences are evident in countries all over the world, the impact has been particularly severe in the US, where approximately one in nine African-American males in the age group 20 to 34 is incarcerated on any given day, primarily as a result of drug law enforcement.19
  • Stigma towards people who use illicit drugs, which reinforces the political popularity of criminalising drug users and undermines HIV prevention and other health promotion efforts.20, 21
  • Severe human rights violations, including torture, forced labour, inhuman and degrading treatment, and execution of drug offenders in a number of countries.22, 23
  • A massive illicit market worth an estimated annual value of US$320 billion.4 These profits remain entirely outside the control of government. They fuel crime, violence and corruption in countless urban communities and have destabilised entire countries, such as Colombia, Mexico and Afghanistan.4
  • Billions of tax dollars wasted on a “War on Drugs” approach to drug control that does not achieve its stated objectives and, instead, directly or indirectly contributes to the above harms.24

Unfortunately, evidence of the failure of drug prohibition to achieve its stated goals, as well as the severe negative consequences of these policies, is often denied by those with vested interests in maintaining the status quo.25This has created confusion among the public and has cost countless lives. Governments and international organisations have ethical and legal obligations to respond to this crisis and must seek to enact alternative evidence-based strategies that can effectively reduce the harms of drugs without creating harms of their own. We, the undersigned, call on governments and international organisations, including the United Nations, to:

  • Undertake a transparent review of the effectiveness of current drug policies.
  • Implement and evaluate a science-based public health approach to address the individual and community harms stemming from illicit drug use.
  • Decriminalise drug users, scale up evidence-based drug dependence treatment options and abolish ineffective compulsory drug treatment centres that violate the Universal Declaration of Human Rights.26
  • Unequivocally endorse and scale up funding for the implementation of the comprehensive package of HIV interventions spelled out in the WHO, UNODC and UNAIDS Target Setting Guide.27
  • Meaningfully involve members of the affected community in developing, monitoring and implementing services and policies that affect their lives.

We further call upon the UN Secretary-General, Ban Ki-moon, to urgently implement measures to ensure that the United Nations system—including the International Narcotics Control Board—speaks with one voice to support the decriminalisation of drug users and the implementation of evidence-based approaches to drug control.28

Basing drug policies on scientific evidence will not eliminate drug use or the problems stemming from drug injecting. However, reorienting drug policies towards evidence-based approaches that respect, protect and fulfil human rights has the potential to reduce harms deriving from current policies and would allow for the redirection of the vast financial resources towards where they are needed most: implementing and evaluating evidence-based prevention, regulatory, treatment and harm reduction interventions.

EFERENCES
1. William B McAllister. Drug diplomacy in the twentieth century: an international history. Routledge, New York, 2000.
2. Reuter P. Ten years after the United Nations General Assembly Special Session (UNGASS): assessing drug problems, policies and reform proposals. Addiction 2009;104:510-7.
3. United States Office of National Drug Control Policy. The Price and Purity of Illicit Drugs: 1981 through the Second Quarter of 2003. Executive Office of the President; Washington, DC, 2004.
4. World Drug Report 2005. Vienna: United Nations Office on Drugs and Crime; 2005.
5. Degenhardt L, Chiu W-T, Sampson N, et al. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: Findings from the WHO World Mental Health Surveys. PLOS Medicine 2008;5:1053-67.
6. Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: A systematic review. Lancet 2008;372:1733-45.
7. Wolfe D, Malinowska-Sempruch K. Illicit drug policies and the global HIV epidemic: Effects of UN and national government approaches. New York: Open Society Institute; 2004.
8. 2008 Report on the global AIDS epidemic. The Joint United Nations Programme on HIV/AIDS; Geneva, 2008.
9. Lurie P, Drucker E. An opportunity lost: HIV infections associated with lack of a national needle-exchange programme in the USA. Lancet 1997;349:604.
10. Rhodes T, Lowndes C, Judd A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia. AIDS 2002;16:F25.
11. Taylor A, Goldberg D, Emslie J, et al. Outbreak of HIV infection in a Scottish prison. British Medical Journal 1995;310:289.
12. Sarang A, Rhodes T, Platt L, et al. Drug injecting and syringe use in the HIV risk environment of Russian penitentiary institutions: qualitative study. Addiction 2006;101:1787.
13. Jurgens R, Ball A, Verster A. Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infectious Disease 2009;9:57-66.
14. Davis C, Burris S, Metzger D, Becher J, Lynch K. Effects of an intensive street-level police intervention on syringe exchange program utilization: Philadelphia, Pennsylvania. American Journal of Public Health 2005;95:233.
15. Bluthenthal RN, Kral AH, Lorvick J, Watters JK. Impact of law enforcement on syringe exchange programs: A look at Oakland and San Francisco. Medical Anthropology 1997;18:61.
16. Rhodes T, Mikhailova L, Sarang A, et al. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Social Science & Medicine 2003;57:39.
17. Fellner J, Vinck P. Targeting blacks: Drug law enforcement and race in the United States. New York: Human Rights Watch; 2008.
18. Drucker E. Population impact under New York’s Rockefeller drug laws: An analysis of life years lost. Journal of Urban Health 2002;79:434-44.
19. Warren J, Gelb A, Horowitz J, Riordan J. One in 100: Behind bars in America 2008. The Pew Center on the States Washington, DC: The Pew Charitable Trusts 2008.
20. Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Social Science & Medicine 2005;61:1026.
21. Ahern J, Stuber J, Galea S. Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence 2007;88:188.
22. Elliott R, Csete J, Palepu A, Kerr T. Reason and rights in global drug control policy. Canadian Medical Association Journal 2005;172:655-6.
23. Edwards G, Babor T, Darke S, et al. Drug trafficking: time to abolish the death penalty. Addiction 2009;104:3.
24. The National Centre on Addiction and Substance Abuse at Columbia University (2001).  Shoveling up: The impact of substance abuse on State budgets.
25. Wood E, Montaner JS, Kerr T. Illicit drug addiction, infectious disease spread, and the need for an evidence-based response. Lancet Infectious Diseases 2008;8:142-3.
26. Klag S, O’Callaghan F, Creed P. The use of legal coercion in the treatment of substance abusers: An overview and critical analysis of thirty years of research. Substance Use & Misuse 2005;40:1777.
27. WHO, UNODC, UNAIDS 2009. Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injection drug users.
28. Wood E, Kerr T. Could a United Nations organisation lead to a worsening of drug-related harms? Drug and Alcohol Review 2010;29:99-100.

Filed under: General, HIV and AIDS, HIV Prevention, Medical and Research, Politics and Society, Uncategorized, , , ,

06/22/2010 • 7:48 pm 1

POZ Magazine: New workplace protection for HIV positive workers worldwide

A new set of principles to protect the rights of HIV-positive workers around the world was adopted at this year’s annual conference of the International Labour Organization (ILO), an agency of the United Nations, according to an ILO statement. The core principles include: no discrimination or stigmatihttp://www.ilo.org/global/About_the_ILO/Media_and_public_information/Press_releases/lang–en/WCMS_141928/index.htmzation in the workplace; protection of HIV-positive workers; no mandates to take an HIV test or reveal status; and availability of HIV prevention, treatment, care and support.

Source: http://www.poz.com/rssredir/articles/ILO_HIV_Work_1_18589.shtml

The offical statement of the ILO you can find under:

http://www.ilo.org/global/About_the_ILO/Media_and_public_information/Press_releases/lang–en/WCMS_141928/index.htm

Filed under: HIV and AIDS, Politics and Society, , , , ,

06/18/2010 • 2:27 pm 1

HIV @ the work place – 17.06.2010

Talk at the economic forum “Bavaria meets Western Cape” in Cape Town – outline of the talk  – as usual “check against delivery”

HIV/AIDS in the workplace – I am sure when you saw the topic some of you were considering a second coffee break – what new can come from this topic – even presented by a priest who has no dealing with business affairs.. And you are right… I do not have any hard core dealings… and when I present this, I have in mind on one surely your business interest – a dying worker is not a very productive worker… – and even with all our turn around in the month before the world cup – thousands are dying still every week as a result of HIV and AIDS – round about 800 per day to be more precise – and on the other hand – you should be aware and taking on the duty to realise, that you offer your employers much more than just a money earning scheme – you offer them meaning in life. Without getting to philosophical – with your workplace you offer your employers also meaning and purpose in life and you owe them a deeper understanding and commitment than only the salary sleep at the end of the week or month.

So let’s see this 20 minutes rather as a time of reflection – which fits a priest much more I guess…

Not only since the World Economic Forums in Switzerland we know and you are aware, that HIV/AIDS is impacting on economic benefits and social progress around the world. The CIA calls it in one of their reports one of the major threats to stability on our planet – and when you want to do business – there must be stability and people who produce and people who buy… That is the easy circle to have revenue and success with your business. Besides all costs for an individual company, HIV is known to delay human resource development, it undermines certainly the skills base and for South Africa it means that investors have to look twice before investing in a country with almost 6 million infected people.

Companies are obviously also direct affected ranging from lower productivity, greater absenteeism till less reliable supply chains and distribution channels – another consideration is surely the question of medical coverage, funeral covers and pension funds. I guess that most small and medium companies never made the effort to calculate the costs of this pandemic for there business – the bigger companies are running since years programs to tackle the pandemic – Daimler Chrysler, BMW, Volkswagen, De Beers, Anglo American and many more. They – and as big companies they are able – to use the direct access to the most affected, the productive members of our society, to tackle the pandemic by education, training and treatment. And in doing so they also prevent more erosion of our society – breadwinner of the family, who die away means that others in the family have to stand in, abandoning as youngsters for example their school education to provide an income which creates a circle of non education – difficult to employ – unemployed with all the consequences of alcohol abuse, drugs, prostitution etc. If you meet a 14 year old responsible for a family then you know what I mean…

You might realise by now – looking at and confronting HIV means not only a direct benefit for the company but also to the society, your company is working in. Healthy worker in a stable and healthy family environment and they again in a stable social environment are the basics for good business.. So what can you do as a small, medium and big company?

Be aware of the pandemic – don’t be ignorant – that’s the first rule – and if I say ignorant I mean not only that you acknowledge that HIV / AIDS is also around you – but that also this is not a black pandemic, but a south African one, a rainbow one.. The virus is an ideal South African – he does not discriminate against race or gender or profession or education or sexual preferences… Be focused like you are focused on other aspects of your business: If you are a big company – consider a proper HIV / AIDS programme, if you have not done yet. Do it yourself or get in touch with those doing it already – gain from their expertise in setting up mechanism within your company to deal with prevention, treatment, care and support.

60-80% of mining, manufacturing, financial services and transport companies have implemented HIV and AIDS awareness programmes, the most hard hit companies have full fledged  workplace HIV programmes that now even develop in so called wellness programs and they stretch further than just the employee covering also his/her family. As a smaller firm, you cannot do it – it is financially not feasible. But you can connect with your nearest clinic and make sure that your employees are knowledgeable about HIV and AIDS and that they are aware of the services of the neighbouring clinic. VCT should be always on the agenda and a proper HIV/AIDS policy – every company is able to spell out to their employees how stigma and discrimination is not an option and that the moral codex of the company and the mission statements starts with the fellow colleagues and not only with the customer.

HOPE Cape Town, my organisation is more than willing to give advice or assist in setting up such a policy.

All in leading positions in a company should also lead in this field. Senior staff, GM, CEO’s, Board members should be able and without shyness to talk to their employees about HIV and AIDS. Even if you organise prevention workshops or there like, I am always amazed to see that the senior staff seems to know it all and that there is a definite “no show” from a certain level of the hierarchy onwards. Not sure that this is leading by example.. Or the senior staff knows it all – but why then invite an expert…? Or do you think that there is no transmission for CEO’s and managers? I can tell you something: HIV and AIDS is such a dynamic field that information you gathered last year might not be correct this year. To give you an example: Until recently the criteria for commencing treatment was a CD 4 count of 250 and lower – which meant that in most in instances the person had to become very sick before treatment was offered. That changed and now people receive much earlier treatment with the result

I guess that is enough for now, thanks for listening to this for South Africa very serious topic – and help that we can get to a new generation of South Africans without HIV or AIDS.

Information and figures are taken from various websites

Filed under: HIV and AIDS, HIV Treatment, HOPE Cape Town Association & Trust, Politics and Society, Reflection, Society and living environment, , , , , , , ,

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