HIV prevention efforts given boost after Indian homosexuality law repealed

In a landmark ruling an Indian high court has decided to reverse a law that has criminalised consenting adult sex between men for the last 150 years. In the past the law has not only stigmatised men who have sex with men in India but also hampered HIV prevention efforts in the country.

Commonly known as section 377, the criminalisation law of sex between men has been largely responsible for having a negative effect on HIV prevention in India. Those populations who are stigmatised in society are forced to be secretive about their activities meaning they miss out on opportunities to access vital HIV prevention, treatment and care services. The result is the further spread of a preventable infection.

It is hoped with the oppressive law now repealed, HIV and AIDS responses can be scaled up and targeted effectively so that those who are at risk can seek the HIV/AIDS services they so desperately need.

(UNAIDS 02.07.09)

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Pressure grows for lifting of HIV travel ban to USA

In July 2008 it was announced that the travel ban on HIV positive people entering America would be lifted but a year later this has yet to be implemented.

Recently a British man, Paul Thorn, who is HIV positive was scheduled to speak at a conference in Seattle but, after filling out the visa form on entry into the country, was denied access. The news comes at the same time as the International AIDS Society reiterated its desire to hold its biannual conference in Washington D.C in 2012.

Despite the announcement that the ban would be lifted there has been no mention from the current administration of when this is going to happen and in the mean time HIV positive people continue to be denied entry unless they have previously obtained a special visa.

(The Seattle Times 17.06.09)

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Dr Eric Goosby confirmed as new Global AIDS Coordinator

The US Senate has confirmed that Dr Eric Goosby will be the new Global AIDS Coordinator, responsible for all PEPFAR operations.

Dr Goosby has been working in the field of HIV/AIDS for 25 years and held a previous post as Deputy Director of the White House National AIDS Policy Office under President Clinton.

While the announcement is welcomed by many it is still unclear as to which office Dr Goosby will report to after the creation by President Obama of a new position of Global Health Coordinator.

(UNAIDS 22.06.09)

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South African AIDS epidemic “remains dire” with one in three women aged 25-29 infected

The latest South African National Study on AIDS & HIV entitled “A Turning Tide Among Teenagers?” suggests that fewer young people aged 15-20 are becoming infected, but at the same time one in three females are already infected in the 25-29 age group, one in four men in the 30-34 age group, and “the overall situation remains dire”.

The report also shows that HIV prevalence has either stayed the same, or has increased since 2002 in the most affected provinces. In KwaZulu Natal the prevalence has increased by 4% to 15.8% and in Mpumalanga it has stayed the same at 15.4%.

With an increasing number of people receiving antiretroviral drug treatment, which is leading to a decrease in the number of deaths, increases in prevalence are increasingly hard to interpret. However it is clear that the number of HIV positive people continues to be alarmingly high, and a stable prevalence suggests that whilst deaths may finally be decreasing, large numbers of people continue to be infected. 

(South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008 09.06.09)

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President Zuma recommits to AIDS treatment targets, but source of funding unclear

In his first state of the nation address President Jacob Zuma has reaffirmed the South African Government commitment to provide antiretroviral drugs for 80% of those in need by 2011. It is unclear though where the money to fund this is going to come from, with 70% of the current AIDS budget already being spent on treatment.

“With the American PEPFAR money currently frozen at 2008 levels, and with no new commitments from the Global Fund, it is very unclear where the money is going to come from to pay for all the additional people needing treatment. And every time a person with HIV starts treatment, the South African government is effectively giving a commitment to fund that person’s treatment for however long they need it.” Annabel Kanabus, Director of AVERT.

(BBC, 05.06.09)

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Obama administration continues ban on needle-exchange funding

The newly released American 2010 fiscal budget proposal indicates the funding prohibition on needle-exchange programmes as a method of HIV prevention for injecting drug users is still in place.

This has come as a surprise to many advocates as previously President Obama has announced publicly his support for the ban to be lifted. Jeff Crowley, director of the National AIDS Policy, issued a statement soon after the release of the report saying the administration, “is committed to moving forward to address the federal ban on syringe-exchange programmes as part of a national HIV/AIDS strategy”. However this statement was made with no explanation for the continuation of the ban in the 2010 budget.

(San Francisco Chronicle 11.05.09)

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AIDS activist Hogan not re-instated as health minister in South Africa’s new cabinet

Jacob Zuma, the new South African president, announced yesterday the replacement of Barbara Hogan as health minister with Dr. Aaron Motsoaledi. AIDS activists famously danced in front of the former health minister and TAC activist’s apartment in September when she provisionally took over from Manto Tshabalala-Msimang, however Zuma has now moved Hogan from the health ministry to the ministry of public enterprises. Her deputy Dr. Molefi Sefularo will remain in his post.

Dr. Aaron Motsoaledi, a medical doctor and formerly a member of the executive council for education in the Limpopo district, has been described as largely unknown by several South African commentators. Mark Heywood of the TAC said of the move, "I have to say that it's very disappointing" adding that although he may have sterling qualities as a doctor quick action was needed to reassure the HIV and AIDS community of Zuma’s appointment.

With recent reports of an HIV treatment funding shortfall the new health minister will face tough decisions in the coming years as to how he is going to tackle one of the largest HIV epidemics in the world.

Read about the South African government’s response to HIV and AIDS by following the link.

(South Africa Government 10.05.09, AFP 11.05.09, NAM 23.04.09)

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New Global AIDS Coordinator nominated

After being vacant since the end of January, the position of Global AIDS Coordinator looks like it may finally be filled. It was announced yesterday that Dr Eric Goosby, a former Deputy Director of the White House National AIDS Policy Office under President Clinton, has been nominated by President Obama to take over the role.

Dr Goosby has had 25 years experience in the field and is currently CEO and Chief Medical Officer for Pangaea Global AIDS Foundation, a body that helps strengthen health care systems and the scale up of treatment in countries affected by HIV.

Dr Goosby will be responsible for all PEPFAR operations overseas but having expertise in treatment scale up specifically and not HIV prevention and the linked social aspects, the direction that PEPFAR would take under him remains unknown.

(Global AIDS Alliance Fund 27.04.09)

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Expert calls for decriminalisation of drugs to help stop spread of AIDS

Michel Kazatchkine, Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria, has said laws around the use of illicit drugs must be radically changed if the spread of AIDS is to be halted.

Delivering a keynote speech at the 20th International Harm Reduction Association Conference in Bangkok Kazatchkine said laws that treat drug addiction as a crime, subsequently denying thousands of drug users access to safe treatment, are only furthering the spread of the HIV/AIDS epidemic. By denying addicts human rights and using repressive measures such as imprisonment, certain governments are not putting public health needs first. Governments, he argues, need to commit fully to the provision of harm reduction strategies such as needle exchange programmes.

Kazatchkine’s speech will hopefully highlight the need for harm reduction measures to be implemented on a much wider scale by governments worldwide. This needs to be done in order for drug users to access treatment without the fear of stigma or discrimination and thus reduce the risk of exposure to HIV.

(The Observer 19.04.09)

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GSK and Pfizer merge to create new HIV drugs company

GlaxoSmithKline and Pfizer, two of the worlds largest drugs companies, are to join forces to create a new venture that will merge the HIV operations and resources of both companies together.

GSK will own the majority of the new business giving it more control of the HIV market, putting the company in a more powerful position to control drug prices and patents. It is too early, however, to know what effect this move will have on the availability and price of AIDS drugs in developing countries. What is critical is the need for drug prices to be kept low and to ensure affordable second-line therapy is made available in all developing countries.

Annabel Kanabus, Director of AVERT adds, “While the move does not have any positive consequence for developing countries as yet, it is vital that investment in research and development is increased. There is still a desperate need for new drugs to be developed and GSK are now in a good position to do this”.

( The Guardian 16.04.09)

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Study estimates 1.2 million AIDS deaths have been averted in PEPFAR focus countries

A new study into the effects of PEPFAR (the Presidents Emergency Plan for AIDS Relief) funding has shown a 10% drop in the death rate – equivalent to 1.2 million deaths - compared to pre-2003 levels in 12 focus countries in sub-Saharan Africa. Despite this, the number of AIDS cases in the countries studied has continued to rise.

The number of deaths averted in these countries is seen as a result of better treatment access for those living with HIV, something the study attributes to the input of PEPFAR funding. While PEPFAR has undoubtedly had a positive impact, the authors of the report acknowledge that there are other contributing factors beside PEPFAR, such as AIDS funding from other organisations, which could explain the drop in death rate for these specific countries.  

Had PEPFAR chosen other focus countries at a different time the impact of interventions and subsequent results could have been different. There is also a possibility the epidemic was in differing phases among the countries, affecting AIDS death rates independently of interventions. Because of this it is not possible to solely attribute the results to PEPFAR.

What the study has shown is that as more people are accessing treatment and living longer, without sufficient prevention initiatives to reduce HIV incidence, the funding gap between what PEPFAR can provide and what is needed will increase. Without a Global AIDS Coordinator in charge, the future of PEPFAR and whether it can sustain its programme under the Obama administration is yet to be known.

(Annals of Internal Medicine 08.04.09)

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White House announces first national HIV awareness campaign in twenty years

The Obama administration has launched America’s first national HIV/AIDS awareness campaign since 1987 in an effort to tackle complacency and highlight the fact that HIV/AIDS in America still poses a serious health threat to the country.

The communication campaign, entitled ‘Act Against AIDS’, will emphasise that every 9 and a half minutes someone in the USA becomes infected with HIV.  The campaign will be supported by a CDC budget of $ 45 million over the next five years. ‘Act Against AIDS’ will start by targeting specific at-risk communities through media such as video, audio, print and the internet. By encouraging Americans to “get the facts” it is hoped that they will learn how to protect themselves and others from becoming infected with HIV/AIDS.

Despite the renewed initiative the AIDS Healthcare Foundation, the largest HIV/AIDS organisation within America, believe the budget of $ 9 million a year over a 5-year period is grossly inadequate. They argue the campaign will do little to help identify the estimated thousands of people infected with HIV but unaware of this.

(CDC 08.11.09, AHF 08.11.09)

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One in four deaths from TB worldwide is HIV related, say WHO

A new World Health Organisation report released to coincide with ‘World TB Day’ showed that while the total number of new tuberculosis cases has remained stable, twice as many tuberculosis patients are HIV co-infected.

Approximately 1.37 million new cases of tuberculosis in 2007 were in people with HIV, with HIV-TB co-infection accounting for 456,000 deaths. This, the report says, is due to the inclusion of more countries reporting TB cases rather than a rise in cases. It does however show the severity of the situation and highlights the need to address HIV-TB co-infection worldwide.

As the report says, these findings point to the need for doctors to “test for HIV in all patients with TB in order to provide prevention treatment and care”.

(WHO 24.03.09)

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Food crisis in Zimbabwe’s prisons aggravates HIV deaths

From the testimonies of former prisoners and prison guards in Zimbabwe there are a growing number of reports on the escalating rate of prison deaths due to neglect, HIV/AIDS, and starvation.

Some reports have shown over half of all prisoners in the country have HIV/AIDS. With extremely limited access to treatment, overcrowding and filthy conditions the environment is ripe for the spread of opportunistic diseases such as tuberculosis.

The lack of food is a major problem affecting all prisoners (and their guards), with most unable to eat even one meal a day. As one Harare prison officer said;

“We’ve gone the whole year in which- for prisoners and prison officers-the food is hand to mouth…They’ll be lucky to get one meal. Sometimes they’ll sleep without. We have moving skeletons, moving graves. They’re dying.”

Malnutrition means people are acutely vulnerable to disease and the rarely available HIV drugs cannot be taken. Sex is being traded for food, putting more prisoners at risk of HIV. However, with the whole country in a dire situation, the state of Zimbabwe’s prisons is currently not a priority for the government, according to the Lancet. Meanwhile prisoners, most in there for petty crimes, are left vulnerable and dying.

(Lancet 21.03.09)

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Obama to support HIV prevention for injectors with harm reduction strategies in the US

A member of the Obama administration, Assistant Secretary of State David Johnson, has indicated that federal funding for needle exchanges will be fully supported by President Obama.

Harm reduction strategies have been shown to be highly successful in preventing HIV transmission and according to UNAIDS:

“It has been found that countries which have adopted this public health approach to HIV prevention among people who inject drugs have been the most successful in reversing the HIV epidemic.”

The shift in approach breaks from previous US administrations’ prohibition approach to the drug problem and signals a new support for public health. The nomination of Gil Kerlikowske, who has a reputation for drug policies based on harm reduction, as Director of the Office of National Drug Control Policy only confirms this change in priorities. Announcing the nomination of Kerlikowske, President Obama said:

“Never has it been more important to have a national drug control strategy guided by sound principles of public safety and public health.”

AVERT has more about HIV prevention in America and the worldwide issues of Injecting Drug Use and HIV/AIDS.

(Guardian 16.03.09, UNAIDS 11.03.09)

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Pope's comment that condoms “increase the problem” of HIV/AIDS comes under criticism

Speaking on his first visit to Africa, on route to the Cameroon, Pope Benedict XVI has described HIV/AIDS as “a tragedy that cannot be overcome by money alone, that cannot be overcome through the distribution of condoms”, stating that condoms can even “increase the problem”. He did not elaborate on how condoms increase the risk of HIV though. Instead he is bringing a message of abstinence and fidelity as "the only sure way of preventing the spread of HIV and AIDS", to the 230 million Catholics in Africa.

The World Health Organisation has responded that the statement is not only incorrect but also dangerous in a pandemic that is affecting 42 million people worldwide. Condoms when used consistently and correctly are over 90 % effective in preventing HIV transmission. Director of AVERT, Annabel Kanabus, concluded:

“In any comprehensive approach to combating the AIDS epidemic, condoms will need to be a vital component…education on its own will go a long way but it is not enough”.

(Times 17.03.09, Sky News 17.03.09)

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