UNAIDS head: World is losing HIV fight - Yahoo! News

UNAIDS head: World is losing HIV fight - Yahoo! News: "UNAIDS head: World is losing HIV fight By MARGIE MASON, AP Medical Writer

JAKARTA, Indonesia - The world continues to lose an ugly battle to HIV/ AIDS that shows no sign of letting up after 25 million people have died a quarter-century into the epidemic, the head of the U.N.'s HIV/AIDS joint program said.

"I think we will see a further globalization of the epidemic spreading to every single corner of the planet," UNAIDS head Peter Piot told The Associated Press in a telephone interview from Geneva.

UNAIDS on Tuesday was scheduled to launch a 630-page report that takes stock of where the world currently stands with nearly 40 million people living with HIV/AIDS. It documents countries' progress and failures, and projects what must happen to keep some regions from experiencing disaster. The report was set to be released a day ahead of a High Level Meeting on AIDS in New York, a week prior to the 25th anniversary of the first documented AIDS cases on June 5, 1981.

"It won't go away one fine day, and then we wake up and say, 'Oh, AIDS is gone,'" Piot said. "I think we have to start thinking about looking at the next generations. There's an increasing diversity in how the epidemic looks."

Piot said that there is still time to stop it from worsening, but action is needed now on a number of fronts.

"Ultimately, it depends on how the leadership reacts, how the international community will continue to respond and how ready communities are to face the problem," Piot said. "Intervention is very low ... for many critical populations in many countries. We need to really intensify the response to AIDS."

Piot said the picture is not hopeless, with examples of progress in nearly every part of the world. He said Thailand and Uganda were two of the only previous examples where exploding epidemics were curbed, but a handful of other countries, including Kenya and Zimbabwe, are also starting to show promise.

Epidemics are diversifying, Piot said, with some driven by unprotected sex, others by dirty needles and some a combination of the two overlapping each other. Those trends must be identified and targeted.

Currently, about 1.3 million people in poor countries have access to antiretroviral treatment, but about 80 percent still are not receiving drugs.

Sub-Saharan Africa continues to be the epicenter of the virus, Piot said. The overall percentage of adults infected in some of the hardest-hit countries continues to climb, with several rates reaching double digits.

"In think in Africa, it is only comparable in demographic terms to the slave trade regarding the impact it has had on the population," Piot said. "In southern Africa, HIV prevalence continues to go up, and they're already the world record."

Piot said that the sheer population of Asia, home to most of the world's population, makes it a potential problem because even small gains in overall per capita infections equal huge numbers — especially in countries like China and India, with over 1 billion people each. More than 5 million people are infected in India alone.

The Asia-Pacific region has 8.3 million people living with the virus, the second-highest after sub-Saharan Africa.

Papua New Guinea, which shares an island north of Australia with Indonesia's easternmost Papua province, has one of the region's worst epidemics in a country plagued by political instability, poverty and rampant sexual violence against women. Piot said it's the only place in the region that resembles an Africa-style epidemic.

Piot said Eastern Europe and Central Asia have become a new front where infections have expanded as people have access to more money and started buying injecting drugs — instead of just shipping them through — from countries like Afghanistan.

"Absolute numbers are still low, but when you look at the spread of the disease, we know from experience where that leads," Piot said. "The Middle East is the last part of the world where HIV is not spreading rapidly.""

Scranton Desperate for Support Counts On School Children While Adults Dismiss Him

Politician makes point of saluting supporters: "Politician makes point of saluting supporters
students pin hopes on candidate. Scranton wants to end youth brain drain if elected governor.
Monday, January 30, 2006
By KURT BRESSWEIN
The Express-Times
PEN ARGYL | Rich and James Paul did something Sunday for Republican gubernatorial hopeful Bill Scranton, and Scranton wants to help the Paul brothers in Harrisburg.

The Lower Saucon Township teenagers -- Rich is a senior at Moravian Academy and James, a freshman at Saucon Valley High School -- made red, white and blue "Scranton 2006" pins for a rally at Weona Park.

Scranton supporter David Molony, of Catasauqua, paid the Pauls for the pins through their company, A.T.L.A.S. The young entrepreneurs started the company with students from three other high schools to compete in a Junior Achievement program.

Echoing campaign comments incumbent Gov. Ed Rendell made four years ago, Scranton said he wants to improve Pennsylvania to help retain its young people.

"This is what all of this comes down to, is these two guys and people like them, the young men and the young women everywhere," Scranton said.

"I've been around to every county in this state in the last year," he continued. "And there is a sense out there not only that Rich and James may go somewhere else, but there's also a sense that they're not being well served by Harrisburg."

Primary is May 16

About 100 people turned out Sunday for Scranton's remarks. The event was catered by Gwen Flynn, a Palmer Township resident who works for Flynn's in Phillipsburg.

Scranton, the lieutenant governor for eight years under Gov. Richard Thornburgh, is seeking the Republican nomination in the May 16 primary election to challenge Rendell.

The other Republican hopefuls are former Pittsburgh Steeler and sportscaster Lynn Swann and Jim Panyard, retired president and chief executive officer of the Pennsylvania Manufacturers Association.

Scranton gets local support

The Republicans' Northeast Central caucus that covers Lehigh and Northampton counties voted Saturday with the Northeast caucus to back Scranton. The state Republican committee is scheduled to endorse a candidate Feb. 11.

Scranton spoke Sunday as the Republican candidate, setting his sights on what he called a Rendell administration that "has utterly failed." Scranton said he wants to lead an "economic transformation" by limiting the amount the state budget can grow each year.

Seeks to trim taxes

He also wants to cut taxes on business to create more jobs in the state. He spoke of greater local control over raising earned-income taxes and of extending the sales tax to more, as-yet-undetermined goods. He wants voters to be able to veto large increases in school property taxes.

Scranton wants to reform an education system that he said has become uncompetitive with those of China and India.

"It isn't slate and it isn't coal that's the driver of our economy," he said. "It is knowledge and information whether it is used on the farm or in a store or in a manufacturing plant or in a software company. And we need to provide it."

Reporter Kurt Bresswein can be reached at 610-867-5000 or by e-mail at kbresswein@express-times.com.

The Associated Press contributed to this report."

Botswana Adopts Radical Approach to HIV - Yahoo! News

Botswana Adopts Radical Approach to HIV - Yahoo! News: "Botswana Adopts Radical Approach to HIV By ALEXANDRA ZAVIS, Associated Press Writer
Sun Jan 29, 6:35 AM ET



GABORONE, Botswana - When Botswana first offered free AIDS treatment, health authorities in one of the world's most infected countries braced for a rush of patients. It did not happen.

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It turned out that most people were so afraid of the deadly disease, and the frequent social ostracism, that they did not want to know if they were infected.

That reluctance to seek help in one of the few African nations able to provide it prompted a radical rethinking of how testing is done here. Now, HIV tests are offered as a part of any medical visit.

In most places, patients are left to ask for a test themselves, then put through extensive counseling to prepare them in case HIV infection is found. But despite decades of education campaigns, the World Health Organization estimates less than 10 percent of infected people in the African countries at the epicenter of the AIDS pandemic realize they have the virus.

The decision of this southern African nation to start routine testing initially caused alarm among international health advocates, who worried that patients' rights to confidentiality and informed consent would be compromised.

"I think the first right of a human being is to be alive. All other rights are secondary," counters Segolame Ramotlhwa, operations manager for the national treatment program known as Masa, or New Dawn.

He argues that confidentiality was being confused with secrecy, making doctors reluctant to even suggest testing for a disease that has infected more than a third of Botswana's adults.

Doctors here believe pulling patients aside for special counseling is intimidating and helps fuel the stigma that keeps patients from seeking help.

"In fact, we found that people who had not made their minds up quite often were definitely against it once the pretest counseling was done," said Dr. Howard Moffat, medical superintendent at Princess Marina Hospital in the capital, Gaborone.

"I think the medical profession itself ... played a major role in creating this fear of AIDS and this quite irrational reluctance to be tested."

Since the beginning of 2004, Botswana has treated HIV tests like any other medical procedure. Patients have the option to refuse, but doctors say most don't. They estimate up to 35 percent of the country's 1.7 million people now know their status.

If the test proves negative for infection, a health worker delivers a brief message on the importance of staying that way. If the test is positive, the patient gets help to manage the condition and treatment when needed.

Most people see a doctor only after their symptoms become severe, by which time it may be too late. It takes three to four times more resources to save someone who arrives on a stretcher than someone who is still on their feet, Ramotlhwa said.

When Kelatlhilwe Segole was pregnant, she was not offered an HIV test and unwittingly passed the virus to her 7-year-old daughter. Both are now in treatment, but her husband refused to be tested until he was in a wheelchair.

"I kept telling him, he will die because of not knowing his status," Segole, a fragile-looking 27-year-old, said as she waited in a daylong line for her medicine.

WHO and UNAIDS now endorse routine testing in all HIV-prevalent areas where AIDS drug "cocktails" are available.

Much of the emphasis on voluntary testing and counseling came from AIDS' early association in the United States with gays.

That gave the disease an added taint in Africa, where homosexuality is widely taboo. But AIDS is overwhelmingly a heterosexual disease in Africa, home to more than 60 percent of the world's estimated 40 million infected.

Life-prolonging medicines that have turned HIV into a manageable chronic condition in wealthier countries remain out of reach for all but a handful on this continent. The drugs are expensive, and most countries lack the medical staff and infrastructure to dispense them widely.

A diagnosis of HIV often is a death sentence, experts say. Last year alone, 2.4 million people died of AIDS causes in sub-Saharan Africa.

Botswana was the first country in Africa to offer free medicines to all who need them in 2002, and the government says half the estimated 110,000 people in immediate need are being treated.

Rights activists agree on the urgency of reaching the other half. But they worry that many people consent to an HIV test without being prepared psychologically, noting there is a cultural reluctance to question doctors.

A study of prenatal clinics in Botswana's second city, Francistown, found 90.5 percent of women consented to HIV tests in the first three months of the new policy, compared to just over 75 percent in the last four months of the system requiring patients to volunteer for a test. Many of those women, however, failed to return for their results.

Christine Stegling, of the Botswana Network on Ethics, Law and HIV/AIDS, believes testing numbers are going up because people are starting to see the effects of treatment, not just because they are offered tests more often.

The new approach is also more likely to reach women, who are more frequent visitors to health services because of pregnancies. Men continue to be underrepresented in Botswana's treatment program.

"At the moment it seems like a numbers game, a total drive to get people to know their status. The question is then what?" Stegling said. "I have a feeling that what is happening is health care providers are getting out of communicating meaningfully with their patients.""

Reuters AlertNet - TAJIKISTAN: Interview with the Global Fund to Fight AIDS, Tuberculosis and Malaria

Reuters AlertNet - TAJIKISTAN: Interview with the Global Fund to Fight AIDS, Tuberculosis and Malaria: "TAJIKISTAN: Interview with the Global Fund to Fight AIDS, Tuberculosis and Malaria
29 Dec 2005 08:57:13 GMT

Source: IRIN
DUSHANBE, 29 December (IRIN) - The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to finance a dramatic turnaround in the fight against AIDS, tuberculosis and malaria. These diseases kill over 6 million people each year, and the numbers are growing. In an interview with IRIN, Murotboki Beknazarov, Grant Implementation Unit Manager for the Global Fund in Tajikistan discussed the many challenges they face in the impoverished Central Asian state.

To date, the Global Fund has committed US $4.4 billion in 128 countries to support aggressive interventions against all three diseases. By funding the work of new and existing programmes, they hope to save millions of lives, stop the spread of disease and halt the devastation to families, communities and economies around the world.

QUESTION: On the eve of a new year, could you update us on the fund's activities in Tajikistan for 2005?

ANSWER: This year the United Nations Development Programme (UNDP) continued the activity it started in 2003. We worked on HIV/AIDS prevention among risk groups: injecting drug users, commercial sex workers, and youth. In addition to this, we have begun a project on HIV/AIDS prevention among labour migrants and their family members.

We have opened facilities and equipped them with furniture and medical equipment for labour migrants and their family members in 30 districts of Sogd province (in the north of the country, over 350 km from the capital, Dushanbe), Khatlon province (in the south of the country, over 200 km from Dushanbe), Gorno-Badakhshan Autonomous Province (in the east, over 350 km from Dushanbe), as well as in areas under the national jurisdiction (in the centre).

These areas have been chosen according to recommendations provided by the Ministry of Labour and Social Protection (MLSP) and the health ministry since the majority of labour migrants, who go to Russia and other Commonwealth of Independent States (CIS) countries to seek jobs, are residents of these provinces and areas. The facilities are provided with drugs to treat sexually transmitted infections (STIs). All services in the facilities are free of charge.

Medical personnel of these facilities have undergone corresponding training. We have worked at increasing awareness among labour migrants and their family members on HIV/AIDS and STI prevention in cooperation with the International Organization for Migration (IOM) and the MLSP. Our volunteers conducted field visits and awareness training on protection methods. We distributed information-educational materials published in three languages - Russian, Tajik and Uzbek - to potential migrants in various areas. In 2005, we also started work among unorganised youth, who enter risk groups too.

This year, we conducted work in all penitentiary facilities of the Tajik Correctional Department of the Justice. We have opened [treatment] rooms in all prisons and correctional facilities, which have been established and provided with drugs and equipment to treat STIs. We have made disinfectant drugs and condoms accessible for prisoners.

Q: The number of HIV-infected people in Tajikistan steadily grows. According to the official data, 170 HIV-infected people had been registered by March 2004 and the number of such people had increased to 454 people by 1 November 2005. According to current data, there are 6,000 to 8,000 HIV-infected people in the country. Is it really possible to set up a barrier against HIV?

A: Indeed, at [this point] it is more realistic to prevent the further distribution of HIV. At present, HIV is spread only among certain categories of the population: injecting drug users, commercial sex workers, and labour migrants. And it is easier to amend the situation now rather than when mass transmission of sexual infections takes place. Consequently, it is necessary to increase awareness levels of the population so that people know the methods of HIV transmission, to have people change their behaviour and value their health. It is necessary that this effort is undertaken throughout the country.

Q: Data on HIV-infected citizens of Tajikistan are confidential and disclosure of one's HIV status is a crime. At the same time, there are cases of stigma and discrimination committed by medical personnel against people living with HIV. What measures do you think should be taken to protect the rights and interests of HIV-positive people?

A: Unfortunately, issues of stigma and discrimination against those living with HIV/AIDS are not only committed by medical personnel. Recently, the Law on Counteraction to HIV Infection has been adopted, which stipulates more severe measures concerning those people who allow stigma and discrimination against HIV-positive people. It is important that this law be followed. The Ministry of Health and its structures should carry out certain work to train medical workers how to treat such a category of patients.

Q: Substitutive therapy has been introduced in some countries of the CIS, including Kazakhstan and Ukraine. Could you speak about the positive and negative sides of this method? Is this method applicable under the current conditions of Tajikistan?

A: Substitutive or methadone therapy is a real opportunity to treat people living with HIV. Here there are more pluses than minuses. The fact is that over 70 percent of HIV-infected people in Tajikistan are injecting drug users (IDUs). Introduction of free substitute therapy is a good stimulus for carrying out anti-retroviral therapy. If an IDU receives methadone free-of-charge, he/she will not need to take injecting drugs, in particular heroin.

The risk of HIV infection disappears by itself. Many IDUs die because of overdoses. Substitute therapy excludes such a risk since experts will prescribe methadone for IDUs. Drug addicts will be less dangerous to society as if they receive free-of-charge doses daily, they will not be involved in stealing to purchase such doses. The minus is that there could be a risk that drugs meant for patients could "disappear" through criminal structures. At present, the issue of introduction of substitute therapy in Tajikistan is at the discussion stage. In particular, such questions are discussed as who will receive substitute therapy, where and who will carry out work with patients. I think that this question can be solved at the level of heads of the corresponding ministries.

Q: How does the Global Fund to Fight AIDS, Tuberculosis and Malaria cooperate with governmental and nongovernmental structures in Tajikistan?

A: The United Nations Development Programme cooperates with the Ministry of Health, the Ministry of Education, the Ministry of Justice, and the MLSP on various projects as well as with national and regional centers to fight and prevent AIDS. We cooperate with a number of governmental and nongovernmental organisations. We also closely cooperate with the local media.

Q: What are the Global Fund's plans regarding Tajikistan in 2006?

A: Next year we plan to start a real introduction of anti-retroviral therapy, together with the Ministry of Health of the country. Preparatory work in this direction was carried out in 2005. Sixty-eight experts from all regions of the country have undergone a special five-day training session. Training was conducted by international experts, who already have anti-retroviral therapy treatment experience. Three groups of experts from Dushanbe, Sogd and Khatlon provinces have been sent for advanced training to Kiev (Ukraine). Together with the Ministry of Health, we have prepared necessary documentation, for example "Protocol of Anti-retroviral Therapy Treatment." Equipment for this purpose has been purchased. Soon we expect anti-retroviral drugs from abroad. Among 506 HIV-infected people, 50 people have been selected who need anti-retroviral therapy, which they will receive as required. Through state structures and NGOs, we want to take in as many people as possible into the prevention programmes among prisoners, labour migrants, street children and youth as a whole. It would be desirable to expand and improve the current activities.

Since HVI infection has only three ways of transmission and depends basically on human behaviour, it is necessary to strengthen the multi-sectoral approach to prevent and fight HIV/AIDS in 2006 and in the future."

NIH reinstates whistleblower Dr. Jonathan Fishbein

Grassley Hails NIH Reinstatement of Expert - Yahoo! News: "Grassley Hails NIH Reinstatement of Expert By JOHN SOLOMON, Associated Press Writer
Wed Dec 28, 1:55 AM ET

WASHINGTON - A key Senate committee chairman on Tuesday hailed the government's reinstatement of a medical safety expert who was fired after he raised allegations of misconduct in federal AIDS research, saying it was an important step in addressing the problems.

Dr. Jonathan Fishbein's reinstatement by the National Institutes of Health "is an example where we can 'chalk one up for the good guys,'" said Senate Finance Committee Chairman Charles Grassley, R-Iowa. "His allegations led to an acknowledgment by NIH of deep-seeded, systemic problems that are finally being addressed by high-level managers."

The Associated Press reported last week that NIH reinstated Fishbein and gave him time to find another federal job, settling a two-year whistleblower battle that prompted investigations into scientific misconduct and sexual harassment in the government's premier AIDS research program.

Fishbein was among a handful of NIH whistleblowers whose plight was highlighted in Associated Press stories over the last year examining allegations of safety problems with federal AIDS research in the United States and Africa, sexual harassment of female NIH safety workers and the use of foster children to test AIDS drugs.

Grassley, a strong supporter of government whistleblowers, championed Fishbein's case. His committee conducted its own investigation and prompted federal inquiries that are continuing. Nearly a dozen other lawmakers eventually intervened.

"Dr. Fishbein brought to light serious allegations of systemic problems at the National Institutes of Health. Our nation's premier biomedical institution should not tolerate the type of misconduct and sexual harassment alleged by Dr. Fishbein," Grassley said. "As is typical, Dr. Fishbein suffered mightily for being a whistleblower and for exposing the truth, until now.""