Analysing the impact of Global Fund cutsback to top
26th Jan 2012
In November 2011 AVERT reported on cuts to the Global Fund to Fight AIDS, Tuberculosis and Malaria’s eleventh round of funding, which was replaced by an emergency funding mechanism to provide support for essential services for existing recipients only. This announcement came at a time when real progress and developments were being seen in the response to HIV and AIDS, as demonstrated by the UNAIDS World AIDS Day report, and the news has hit many countries hard.
A recent report analysing the impact of Round 11 cuts highlights the potential reversal of progress that has been made in the fight against HIV, focusing on specific country case studies. The Republic of South Sudan, for example, now faces a funding gap of 80% in its National AIDS Plan. The country was reliant on Round 11 funding to cover antiretroviral treatment costs, implementation of a new HIV prevention strategy, and responding to the high number of HIV positive displaced persons returning to the country.
The Global Fund is the largest funder of HIV and AIDS interventions, providing one fifth of all funding for HIV services at global level. It has been instrumental in strengthening and linking health systems and community systems to ensure sustainability of interventions, and placing emphasis on human rights, involvement of people living with HIV and reaching key populations.
There is an urgent need for donor governments to bring forward their pledges to the Global Fund to ensure that further resources are available as soon as possible and for bilateral donors to focus on the gaps left by Round 11 cuts. There is also a responsibility for national governments to invest further resources in HIV interventions.
Older people missing from HIV programmes in Ugandaback to top
20th Jan 2012
Older members of the population have been highlighted as a group that is missing in the response to HIV and AIDS in Uganda. HIV prevention, treatment and care programmes often exclude this group while they remain an at risk group with specific needs. Indeed at global level, statistics primarily focus on the 15-49 age group, leaving over 50s out of the picture, although they represent 14% of HIV prevalence.
Uganda is often held up as a model for Africa in the fight against HIV and AIDS. Strong government leadership, broad-based partnerships and effective public HIV education campaigns have all contributed to a decline in the number of people living with HIV. However, HIV and AIDS still represent a significant public health issue in the country. It is thought that the failure to take into account the needs of older people is due to a focus on younger people of reproductive age. Evidence shows, however, that condom use among older people is very low and HIV testing less common.
This highlights a need for greater focus on older people in HIV programmes in Uganda, and indeed elsewhere, where people over 50 are often seen as caregivers to others affected by HIV, rather than a separate at risk group.
Source:AllAfrica
HIV initiatives fall by the wayside in Haiti’s earthquake recovery back to top
13th Jan 2012
January 2012 marks the two-year anniversary of the devastating earthquake in Haiti, and whilst millions of dollars have been funnelled into the humanitarian and peacekeeping response, efforts to avert an HIV crisis have been largely underemphasised. In the aftermath, there has been limited information published on HIV in the country. Past experience in fragile states suggest that HIV prevalence rates can be adversely affected and appropriate measures need to be put in place to avert such an occurrence.
Many resources have been targeted towards sanitation in Haiti. Cholera is presenting a major public health risk and is now home to the deadliest cholera epidemic in the world, after reporting zero cases before the earthquake. However reports of an increasing paid sex trade and incidences of sexual violence are leaving people concerned over the lack of response to HIV. This coupled with a culture of stigma and discrimination surrounding HIV and AIDS, will only fuel the spread of the epidemic.
Haiti's AIDS epidemic is among the most severe in the region, yet HIV prevention programmes and increased levels of condom use had seen signs of decreasing infections in the country before the earthquake. What is clear is that the earthquake aftermath has further fragmented efforts to reach those in need. The priority of aid organisations should be to ensure that people living with HIV and AIDS get medication, and ensure the swift return of HIV prevention, treatment, care and support services.
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US funding cuts for harm reduction programmesback to top
10th Jan 2012
The United States Congress has placed a ban on the use of federal funds for domestic and international needle and syringe exchange programmes under the 2012 budget. This decision comes two years after an overall ban on funding such programmes was repealed and signed into law by President Obama.
Needle and syringe exchange programmes are one of the main harm reduction measures that aim to curb the spread of blood-borne viruses, such as HIV and Hepatitis C, among injecting drug users (IDUs). Making clean syringes available to those who need them is a proven and cost-effective HIV prevention method. In the US, people who inject drugs account for 12% of new HIV infections, making them one of the most at risk groups in the country. Injecting drug use is also a major driver of the HIV epidemic in other parts of world where the US government has previously funded harm reduction programmes.
This change in US policy comes at a time when global HIV funding cuts have already affected existing harm reduction programmes and there are growing concerns over the impact of reduced services on new HIV infections among IDUs.
Source:Harm Reduction International
Vaccine success in monkey trial provides clues to combatting HIVback to top
9th Jan 2012
HIV researchers are cautiously optimistic about the success of a new trial conducted on monkeys, which might provide vital clues in the search for an HIV vaccine. The study showed one vaccine combination to avert the monkey’s risk of contracting Simian Immunodeficiency Virus (SIV), the virus that HIV is generally believed to originate from, by 80%. Dan Barouch, the lead author and virologist stated that the results “give us a blueprint for how we should move forward in vaccines to test and what kinds of responses we hope they’ll induce.”
The study, published in Nature this month, was conducted on groups of rhesus monkeys who were given a range of combination vaccines that included an initial vaccine, followed by a booster shot of a different vaccine six months later. After another six months, the groups were exposed to “a strain of SIV that differed from the vaccine strain, and against which monkeys have trouble mounting a strong immune response.” Seventy-five percent of the monkeys who received no vaccine developed SIV after a single exposure, whilst only 12% of the monkeys on the most successful vaccination combination contracted SIV.
Whilst the results of the study are positive, researchers are hesitant to overplay the success of any animal trials. However, in combination with earlier studies, its outputs will provide useful for future vaccine research. Efforts are now under way to produce an HIV vaccine version of the SIV vaccine in this trial.
For more information on animal testing, and the role they play in HIV and AIDS research, please see our page: HIV Drugs, Vaccines and Animal Testing.
Source:Nature
Service launched to mitigate HIV drug stock-outsback to top
21st Dec 2011
A new service is being launched by the biggest funder of HIV and AIDS interventions at international level, the Global Fund to Fight AIDS, Tuberculosis and Malaria, aiming to tackle the issue of drug stock-outs. The Global Fund has created an email address for anyone to report and draw their attention to potential stock-outs of antiretrovirals, anti-TB drugs, antimalarials or other life-saving drugs within Global Fund-supported programmes.
Antiretroviral drugs (ARVs) are the main type of treatment for HIV and AIDS. Their effectiveness is dependent on taking the right combination of drugs as prescribed at the right time and exactly as the directions state. If a person does not have regular access to ARVs, due to stock outs for example, this can seriously affect their ability to adhere correctly to the drugs. Gaps in treatment result in the virus not being properly suppressed and increase the person’s chance of becoming resistant to the medication.
Anyone who is aware of stock-out risks is being asked to email STOCKOUTS@theglobalfund.org stating the location, which drugs are at risk and any other useful information.
Source:Global Fund
Banking on HIV & AIDS awareness in Zimbabweback to top
20th Dec 2011
A local bank in Zimbabwe that seeks to empower women to manage their own finances is also taking sexual health issues into their own hands. The Women Development Savings and Credit Union bank in Gokwe is providing male and female condoms and information about HIV and AIDS to its customers to support women’s health in the community.
Zimbabwe has an estimated HIV prevalence of 14.3% (UNAIDS 2009) among the adult population and is one of the worst affected countries in the world. Around half of the people living with HIV in Zimbabwe become infected during adolescence or young adulthood and education campaigns have primarily targeted young people. As a result, knowledge about HIV and AIDS is higher than the average for sub-Saharan Africa.
The bank in Gokwe, which has reached more than 2000 local women and their families, seeks to make a difference to the lives of women from marginalized, rural and poor areas. They acknowledge women as the centre of the family and that by providing them with information on HIV and AIDS this knowledge reaches the community more widely and averts the spread of the epidemic.
Source:AllAfrica
Pakistan to combat HIV and AIDS through a new harm reduction projectback to top
19th Dec 2011
Pakistan is to scale-up its efforts to reduce HIV transmission amongst injecting drug users (IDUs) through a new five-year project focusing on harm reduction. The $43 million project is funded by the Global Fund and will be implemented by the National AIDS Control Programme and the Nai Zindagi Trust. It will be targeted primarily at IDUs and their partners.
The HIV and AIDS epidemic in Pakistan is concentrated among several at-risk groups, including IDUs and Hijra sex workers. HIV prevalence among IDUs in Pakistan is estimated at 20.8% (UNAIDS 2010) and this group continues to be the main driver of the epidemic in the country, a consequence of a significant opiate abuse problem. This new project will reach an estimated one-third of IDUs in Pakistan.
Tariq Zafar, Chief Executive of the Nai Zindagi Trust, was quoted in the Express Tribune as saying that “the intervention package includes a needle and syringe exchange, basic medical care, counselling on preventive measures, provision of contraceptives as well as early HIV detection.” Pakistan currently has no programme in place to help avert the spread of HIV among IDUs, after a previous project concluded in 2009. This will be the largest project to minimise HIV transmission that Pakistan has seen, and it is hoped that it will have a significant impact on combating the epidemic in the country.
Source:The Express Tribune
Call for religious leaders to join fight against HIV & AIDS in the Caribbeanback to top
15th Dec 2011
Religious leaders in the Caribbean are being urged to use their influence to educate and empower people to combat HIV and AIDS in the region. This call came during a conference to establish a network of faith-based leaders in Trinidad and Tobago to strengthen the HIV and AIDS response.
The Caribbean has the second highest HIV prevalence after sub-Saharan Africa. Among the adult population the estimated prevalence is 0.9% (UNAIDS 2010). However, among most at risk groups, such as men who have sex with men and sex workers, rates of HIV are much higher. Stigma and discrimination of people living with HIV in the region is very common and homophobia can cause double stigma for men who have sex with men who are also HIV positive.
It is hoped that through their position in the community religious leaders can play a part in educating people and encouraging them to put their knowledge about HIV and AIDS into practice. Talking about issues relating to sex openly can help to break down the taboo surrounding the subject and can empower people, women in particular, to negotiate safe sex.
Source:Trinidad and Tobago Newsday
Tackling gender inequality and HIV in Eastern and Southern Africa back to top
13th Dec 2011
Government and civil society representatives from Eastern and Southern Africa have recently launched a high-level taskforce to strengthen political advocacy around gender equality and HIV in the region. Members will be tasked with promoting country level advocacy and monitoring implementation of the draft Windhoek Declaration for Women, Girls, Gender Equality and HIV, which was drawn up in April 2011.
In Sub-Saharan Africa women are disproportionately affected by HIV, for example young women account for around 70% of young people living with the virus in the region. However, much more needs to be done to empower women and girls to lead advocacy around HIV and AIDS and to address gender inequality issues.
The new gender taskforce aims to lobby governments to ensure that policy development and legal environments are favourable to the protection of women and girls. The group will also challenge cultural norms that can be harmful to women and crucially will involve men and boys in gender equality debates. It is hoped that through these interventions women and girls affected by HIV and AIDS will have a stronger voice and will have greater capacity to overcome the challenges they face.
Source:UNAIDS
Non-surgical circumcision campaign launched in Rwandaback to top
12th Dec 2011
A national campaign to reach two million adult men through voluntary non-surgical circumcision over the next two years is being launched in Rwanda in an attempt to reduce new HIV infections. The decision comes after the Rwandan government deemed the trial of a new non-surgical circumcision device in the country a success.
Voluntary male circumcision as an HIV prevention tool has been hotly debated in recent years. While scientific trials have shown that male circumcision can reduce a man’s risk of becoming infected with HIV during heterosexual intercourse by up to 60% (see AVERT circumcision page), various challenges including ethical issues of promoting circumcision to prevent HIV transmission and ensuring safe circumcision practices have held back the scale-up of circumcision programmes.
The non-surgical procedure to be rolled out in Rwanda involves the PrePex device, which stops the bloodflow to the foreskin. The device stays on for a week until the foreskin has died and the skin can be removed. This procedure is quick and cheap in comparison with surgical circumcision methods. In addition, it can be carried out by nurses meaning that scale up is much more achievable in low resource and remote areas.
Source:Medical News Today
Mental health service gap for HIV positive people in Africaback to top
8th Dec 2011
The issue of depression as a common psychiatric disorder among people living with HIV in Africa has been highlighted this week at the International Conference on AIDS and STIs in Africa (ICASA). Self-stigma and depression can lead to adherence issues for HIV positive people on antiretroviral treatment, yet health systems often do not have the capacity to provide the support they require.
Programmes that focus on reducing external stigma (from other people) and the provision of counselling for people living with HIV are common in Africa, as in other parts of the world, yet mental health services to diagnose and treat internalised stigma are not widely available. A study carried out in Ethiopia found that once on treatment, people may experience reduced external stigma as the effects of the virus are less visible, however, the dependency on drugs to live a normal life can lead to self-stigma, depression and failure to adhere to treatment.
Experts are calling for health systems to be strengthened in Africa to integrate mechanisms and services to tackle mental health issues among people living with HIV into primary healthcare activities and to ensure the availability of relevant medication. Further research into the issue of mental health in Africa is also required.
Source:
Ethiopia praised for progress in AIDS response back to top
5th Dec 2011
The scale up in Ethiopia’s national AIDS response was praised last week during World AIDS Day commemoration events in the country. Ethiopia has invested in voluntary counselling and HIV testing services resulting in more than 9.4 million people accessing these services in 2011, and leading to increased access to antiretroviral treatment, moving the country a step closer to Universal Access.
HIV prevalence among the adult population in Ethiopia is estimated at 2.3%, representing 1.3 million people living with HIV (UNGASS 2009). The HIV epidemic is mainly concentrated in urban areas, with an estimated 300,000 people living with HIV in the capital, Addis Ababa, alone.
Recognition of the country’s progress in combatting HIV comes at an important time for Ethiopia, as host of the 2011 International Conference on AIDS and STIs in Africa (ICASA). The conference, which began on 4 December, is an important advocacy platform at continental level, particularly for civil society. The theme of this year’s ICASA conference is ‘Own, Scale-up and Sustain’.
Source:UNAIDS
Chinese law discriminating against people living with HIVback to top
29th Nov 2011
Three potential schoolteachers in China have been denied employment despite passing interviews and written tests, after blood tests confirmed they were HIV positive. Provincial law prohibits employment of civil servants who carry an infectious disease, however a 5-year-old national law secures the employment rights of those living with HIV.
The teachers filed suits in three separate provinces, however all had been dismissed. They have since petitioned to the central government appealing against discriminatory practices towards those living with HIV and AIDS. Fear and stigma is rife in China, Yu Fangqiang, of Tianxia Gong, an organisation that advocates for people with HIV and AIDS said, "the voices to defend the employment rights of people with HIV tend to be drowned out by the majority's sense of fear.”
Despite a delayed response to the AIDS epidemic in the early 90’s, China has since stepped up its response through a range of strategies that target high-risk groups. But there remain many challenges around stigma and discrimination.
Source:Reuters
Concerns over global HIV and AIDS funding cutsback to top
24th Nov 2011
The Global Fund to Fight AIDS, Tuberculosis and Malaria, one of the most important international HIV and AIDS funding mechanisms, announced on 23 November radical changes to their next round of funding. Global Fund Round 11 had already been postponed twice due to funding shortages and yesterday it was revealed it will be replaced by a Transitional Funding Mechanism to provide “emergency relief to current recipients who will run out of money before 2014” (PlusNews), rather than the planned round of new funding.
The Global Fund is funded mainly by national governments, but also receives money from large organisations, individuals and private sector partnerships. The Global Fund Board has reported that $2.2 billion is outstanding in unpaid donor pledges and they are facing a funding deficit of $6 billion. On 22 November, the board made the difficult decision to put emergency funding measures in place.
The Transitional Funding Mechanism will provide funding for the “continuation of essential prevention, treatment and/or care services currently financed by the Global Fund” (Global Fund). Country applicants will have to “demonstrate that there are no alternative sources of funding available to fund the activities proposed” (Global Fund) and fulfill the new eligibility criteria. There will be no scope for new applicant countries to apply or for scale up or improvements in HIV treatment to be funded.
The impact of reduced funding for countries reliant on the Global Fund to finance national HIV, TB and malaria programmes will be considerable. Key stakeholders are urging the Global Fund and donors to make the necessary resources available to ensure sustainability of HIV and AIDS interventions.
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