God, AIDS, Africa & HOPE

pensées of a Catholic priest

No time to rest…

It is amazing – after 24 hours at airports and in the air back in South Africa and it takes not even minutes to receive the first phone call. How do they know that one is back in the country, just switching on the cell? This week is occupied a lot from work with HOPE Cape Town. The transition phase is ongoing but I get the feel that we are getting there. The website need an update and all the news about the new cooperation with the University of Applied Sciences Neu-Ulm must be beamed up. We started research in the fields of E-learning: How do our people learn best? With paper documents, computers or handheld devices? A 6 months study will hopefully tell us more about it.
But it was great to see the enthusiasm of the students and lectures from Neu-Ulm coming to Cape Town for a week of extensive work. And it was good for our HOPE Community Health worker to see how networking is functioning and how important it is to learn from each other.
Other meetings with fellow priests and friends complemented the week and there was also a second meeting regarding founding a European Club for Cape Town. A club, where one can do networking; but also intellectual and spiritual exchange should take place. And not only once a week or once a month. The club should provide a venue to be accessible every day, just to bump in for a drink and a chat or a business meeting. To make such an idea working one has to look at existing clubs to liaise and form an additional grouping using the facility. I find it an exciting idea and I have the impression that all involved like to work hard to get it off the ground and going.

Ending a time as chaplain at sea means also to write a report about your work, the church wants to know what one has done in this swimming vineyard and even some guests have already taken the opportunity to send greetings from home to their “ex-chaplain”.

Church wise the appointment of Bishop Mueller from Regensburg in Germany to be “God’s watchdog” has created some debate and yeah, I guess, it is debatable. He has a diversity which leaves one sometimes guessing in which direction it explodes. On one hand he is a friend of one of the most acknowledged liberation theologian in South America; on the other hand he dealt with laity in his diocese in a way which is more than questionable. And for the Pius-brothers he seems to be a heretic – denying the virgin birth of Jesus and the teaching of transubstantiation. So it seems nobody is really happy – except the pope I guess and I think we just have to wait and see what is happening. Even if the past might be difficult, there is always the hope that people can change or grow into a job in a way serving God and the people.  All the hasty judgements,be it positive or negative are too early. Let him start and we will see…

Reading also the news on AIDS I see that Uganda starts to have problems related to resistance. This comes not as a suprise, this is indeed one of the biggest challenges we have to keep the virus far away from turning into a nasty resistant one. But the chances are high that it will happen if we don’t watch out very carefully, also here in South Africa.
I also note that the OraSure HIV home kit test is now FDA approved. I remember sitting with the representative of this company quite some years ago and at that time I felt that this test could prove good to make testing easier and avoid the pre-test counselling which I believe we have to stop doing as soon as possible. But local government and the hospitals were not keen at that time even to listen to such a test not performed in a hospital setting.

Well, weekend is coming and I hope there is time for some reading. I just have counted: There are 23 books waiting to be read…

Filed under: General, HIV and AIDS, HIV Prevention, HOPE Cape Town Association & Trust, HOPE Cape Town Trust, Networking, Reflection, Society and living environment, , , , , , , , , , , , , , , , , , , , , , , , ,

21.10.2009 More than four million…

More than 4 million people in low and middle-income countries were receiving antiretroviral therapy (ART) at the close of 2008, representing a 36% increase in one year and a ten-fold increase over five years, according to a report released by the WHO, UNICEF and UNAIDS.

Towards universal access: scaling up priority HIV/AIDS interventions in the health sector highlights other gains, including expanded HIV testing and counselling and improved access to services to prevent HIV transmission from mother to child.

“This report shows tremendous progress in the global HIV/AIDS response,” said WHO Director-General Margaret Chan. “But we need to do more. At least 5 million people living with HIV still do not have access to life-prolonging treatment and care. Prevention services fail to reach many in need. Governments and international partners must accelerate their efforts to achieve universal access to treatment.”

Treatment and care

Access to antiretroviral therapy continues to expand at a rapid rate. Of the estimated 9.5 million people in need of treatment in 2008 in low- and middle-income countries, 42% had access, up from 33% in 2007. The greatest progress was seen in sub-Saharan Africa, where two-thirds of all HIV infections occur.

Prices of the most commonly used antiretroviral drugs have declined significantly in recent years, contributing to wider availability of treatment. The cost of most first-line regimens decreased by 10-40% between 2006 and 2008. However, second-line regimens continue to be expensive. Despite recent progress, access to treatment services is falling far short of need and the global economic crisis has raised concerns about their sustainability. Many patients are being diagnosed at a late stage of disease progression resulting in delayed initiation of ART and high rates of mortality in the first year of treatment.

Testing and counselling

Recent data indicate increasing availability of HIV testing and counselling services. In 66 reporting countries, the number of health facilities providing such services increased by about 35% between 2007 and 2008. Testing and counselling services are also being used by an increasing number of people. In 39 countries, the total reported number of HIV tests performed more than doubled between 2007 and 2008. Ninety-three percent of all countries that reported data across all regions provided free HIV testing through public sector health facilities in 2008.

Nevertheless, the majority of those living with HIV remain unaware of their HIV status. Low awareness of personal risk of HIV infection and fear of stigma and discrimination account, in part, for low uptake of testing services.

Women and children

In 2008, access to HIV services for women and children improved. Approximately 45% of HIV-positive pregnant women received antiretroviral drugs to prevent HIV transmission to their children, up from 35% in 2007. Some 21% of pregnant women in low- and middle-income countries received an HIV test, up from 15% in 2007. More children are benefiting from paediatric antiretroviral therapy programmes: the number of children under 15 years of age who received ART rose from approximately 198 000 in 2007 to 275 700 in 2008, reaching 38% of those in need.

Globally, AIDS remains the leading cause of mortality among women of reproductive age. “Although there is increasing emphasis on women and children in the global HIV/AIDS response, the disease continues to have a devastating impact on their health, livelihood and survival,” said Ann M. Veneman, UNICEF Executive Director.

Most-at-risk populations

In 2008, more data became available on access to HIV services for populations at high risk of HIV infection, including sex workers, men who have sex with men and injecting drug users. While HIV interventions are expanding in some settings, population groups at high risk of HIV infection continue to face technical, legal and sociocultural barriers in accessing health care services. “All indications point to the number of people needing treatment rising dramatically over the next few years,” said Michel Sidibé, Executive Director of UNAIDS. “Ensuring equitable access will be one of our primary concerns and UNAIDS will continue to act as a voice for the voiceless, ensuring that marginalized groups and people most vulnerable to HIV infection have access to the services that are so vital to their wellbeing and to that of their families and communities.”

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, , , , , , , , , ,

20.09.2009 Mandatory testing

Mandatory HIV testing ‘violates their rights’
(IOL website 19.09.09)

Mandatory testing for HIV would violate the rights of people, the SA Human Rights Commission said on Friday. This comes after provincial Health MEC Theuns Botha announced plans to introduce legislation in the Western Cape to have every patient at every health facility tested for the virus. Botha says the move is the final onslaught in the fight against the disease.
Currently 200 000 people in the Western Cape are estimated to be HIV-positive and 63 000 are on ARV treatment. Botha has started the ball rolling to draw up legislation which he anticipates will be ready by next March. He said the legislation was necessary as people had “avoidance” behaviour and chose to not be tested.
Dr Mark Heywood, of the Aids Law Project, agrees with the rights commission. The Treatment Action Campaign was divided on the issue, spokesperson Rebecca Hodes said. Steven Ngobeni, the national HIV and Aids health rights co-ordinator for the commission, said yesterday mandatory testing “does not make sense”. People, he said, often did not know their rights, counselling at voluntary testing centres was not up to scratch and universal access to treatment was not readily available.  Both Ngobeni and Heywood said the provincial government would make a greater impact by educating people about HIV and testing.  Heywood said: “There is no way that you could justify a law to introduce mandatory testing.” It was also wrong from a public health and HIV management perspective.  “I would suggest a public campaign to get people to go for testing. Right now people are avoiding being tested as there is too little information and routine offerings are haphazard.”  He said a law would not work. “People will still be scared of a diagnosis and they could in fact completely avoid health care facilities.”  The TAC’s Hodes said mandatory testing in Botswana had been successful but it had been rolled out as part of a broader ARV treatment campaign.
“Some say mandatory testing will increase stigma, others say it will destigmatise the disease. But if testing becomes mandatory there should be proper support,” she said.  Botha said on Friday it was a two-pronged approach – testing as well as getting people into treatment sooner.   “We would introduce people much earlier into a treatment programme,” he said.

An interesting article and I would like to add: We have to make HIV testing as normal as any other testing. Which would mean in a first step to remove all “extra doors & extra benches” for HIV testing, counseling, treatment and so on..” I even think we can stop the pretest counseling. Like any other diseases we have to advise after a diagnose and not before. If somebody has cancer, we also do not put him or her through a lengthy intimate process before he or she is allowed to have a result.

Being HIV positive is a medical condition in this frameset, let’s treat it as such.

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

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