LONDON,
June 2 (Reuters) - Nearly 3 million people in the developing world now get AIDS
drugs -- 1 million more than a year ago -- but two-thirds of those in need still
lack access to treatment, the World Health Organisation said on Monday.News (Updated June 8, 2008)
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02 Jun 2008 11:04:07 GMT
By Michael Kahn
LONDON,
June 2 (Reuters) - Nearly 3 million people in the developing world now get AIDS
drugs -- 1 million more than a year ago -- but two-thirds of those in need still
lack access to treatment, the World Health Organisation said on Monday.
The increase in use
reflects deep cuts in the price of branded medicines and widespread availability
of cheap generics. The total represents 31 percent of the 9.7 million people
living with HIV in low- and middle-income countries who need the reatment,
officials said. Most live in sub-Saharan
"The answer to the HIV
epidemic is preventing new infections," said WHO HIV/AIDS Director Kevin De
Cock. "An additional 1 million people came on to therapy but another 2.5
million became newly infected with HIV, so we have to do better with
prevention."
The WHO report estimated
that meeting universal prevention and treatment targets means funding would have
to quadruple to $35 billion in 2010 and $41 billion in 2015.
The AIDS virus infects an
estimated 33 million people globally, mostly in poor, sub-Saharan
There is no cure or vaccine
but antiretroviral therapy -- suppressing replication of HIV by interfering with
its genetic workings -- can keep people healthy for years even if they never
eradicate the virus. This means people must take them for life.
Leading manufacturers of
AIDS drugs include GlaxoSmithKline <GSK.L>, Gilead <GILD.O>, Roche
<ROG.VX>, Pfizer <PFE.N>, Merck Inc <MRK.N>, Bristol-Myers
Squibb <BMY.N> and Abbott Laboratories <ABT.N>.
The WHO also reported
progress in preventing HIV in children with nearly 500,000 women receiving AIDS
drugs to prevent transmission to their unborn children.
This was up from 350,000 in
2006, although diagnosing HIV in infants remains a major hurdle, the WHO said.
During the same time period, 200,00 children got antiretroviral drugs, up from
127,000 a year earlier.
"There is a long way
to go but it is a substantial increase," De Cock said in a telephone
interview.
While price cuts have
helped make the life-saving drugs more widely available, crumbling health
systems in poor countries pose a major challenge, De Cock added.
In particular, difficulties
in training and retaining health care workers due to a "brain drain"
of the most skilled personnel to richer countries will slow future delivery of
drugs, the WHO said.
"Obstacles include
weak health care systems, a critical shortage of human resources and a lack of
sustainable, long-term funding," the WHO report said. (Editing by David
Cowell)
Thu Jun 5, 1:56 PM ET
WASHINGTON
(AFP)-US President George W. Bush on Thursday scolded members of the Group
of Eight industrialized nations due to meet in July for not making good on
pledges to help fund Africa's war on HIV/AIDS.
"At the last G-8, our partners stood up and made strong commitments to help Africa deal with malaria and HIV-AIDS. They have yet to make good on their commitments," said Bush, who plans to attend the July G8 summit in Japan.
"I'll remind them: It's one thing to make a promise; it's another thing to write the check. And the American government expects our partners to live up to their obligations," the US president said in a speech.
The Group of Eight -- Britain, Canada, France, Germany, Italy, Japan, Russia and the United States -- ended its June 2007 summit by pledging 60 billion dollars to combat AIDS, malaria, and tuberculosis in Africa.
Of that, 30 billion dollars had already been pledged by the United States.
Thu Jun 5, 10:50 AM ET
WASHINGTON
(AFP) -Two studies support breastfeeding by HIV-positive women in developing
countries, showing that an extended anti-HIV regimen can curb babies'
infection rates and breastfeeding improves survival in those infected by
their mothers.
A clinical study in Malawi followed 3,016 babies of HIV-positive mothers for two years. Breastfed infants who received prolonged preventative treatment had HIV infection rates less than half of those who received standard care.
Newborns whose mothers are HIV-positive were treated with anti HIV drugs during the first 14 weeks of life, to reduce the likelihood they will be infected while breastfeeding.
The current standard is one shot at birth and a week's treatment with another anti-HIV drug.
"In poor countries where sanitation is a problem, exclusive breastfeeding appears to confer the greatest benefits to infant health and survival, even in mothers with HIV" said Duane Alexander, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which sponsored two studies appearing in the online version of the New England Journal of Medicine (NEJM).
"Extended treatment with nevirapine greatly reduces the chances that infants will be infected with HIV through breast milk," he added. "The National Institutes of Health is now sponsoring additional studies to determine the most effective treatments to prevent the spread of HIV through breast milk."
In the Malawi study, after nine months, 5.2 percent of infants treated with nevirapine, and 6.4 percent of those treated with the two antiretrovirals over the same period, contracted HIV from their mothers compared to 10.6 percent for those who received the usual short-term preventative care.
A second clinical study also published in NEJM and carried out in Zambia, meanwhile found that breastfeeding appeared to improve survival rates of newborns whose mothers passed HIV on to them.
The studies may offer new insight into difficult choices parents face in developing countries as they decide between breastfeeding and possibly passing HIV through breast milk, and formula feeding which can undercut natural immunity against other diseases.
Tue Jun 3, 2008 10:34 AM BST
By Tan Ee Lyn
NEW DELHI (Reuters) - Vast distances are a major hurdle to India's efforts to curb its soaring HIV rate.
India, which has the world's third largest HIV-positive caseload, gives drugs for free to HIV/AIDS patients. But doctors say this is not enough to stop the spread of HIV which is making inroads in rural India, especially among women infected by itinerant husbands, and also children.
For three days a month, Sambit squeezes into a crowded and often filthy train for a three hour journey to Delhi to receive HIV treatment.
"There's no seat and I am very weak," said the 30-year-old former tailor, who asked that his full name not be revealed. He can't afford lodging in Delhi and can barely afford the train tickets.
"I need to borrow money from my family for all these trips," he said.
Many patients in the same position simply give up treatment, an anathema in HIV therapy as it gives rise to drug resistance. These patients may then need more powerful second line treatment, which is not freely available in India.
"Travel can affect drug compliance. Patients who don't get family support, women who may not like to travel alone will just give up," said a doctor at a New Delhi hospital, who spoke on condition of anonymity because he did not have permission to speak to reporters.
There are 147 "antiretroviral therapy" or ART centres in the country, part of a government drive that has been encouraged by the World Health Organisation in a bid to prevent HIV from becoming a major health problem.
Delhi has nine such centres and is far better served than many other states. Up to 6,000 patients receive treatment in Delhi, nearly half of these live outside the capital.
The government now plans to build "link centres", small facilities that are closer to where patients live so people like Sambit can obtain their medications more easily.
"They just come to pick up the drugs if they have no side effects and they go home ... that saves transport and other costs," Rao said, adding that the plan was to have as many as 500 such centres all over India.
INFECTION FIGURES AREN'T GOING DOWN
India has 2.47 million HIV cases, according to the latest figures, but health workers say the number is rising rapidly and spreading to new population groups.
"Our numbers are going up," said Loon Gangte, South Asia coordinator of the Collaborative Fund for HIV Treatment Preparedness.
"It's not confined to high risk groups, it's going into the general population. It's not a problem of sex workers, drug users or truck drivers. These people have wives and children at home and the disease is making its way into the general population."
Sujatha Rao, director-general of the government's National AIDS Control Organisation, says doctors are increasingly seeing women infected by their husbands.
In some clinics, 1 out of 100 women who come for ante-natal care checkups are HIV positive, she said.
"It is a generalised epidemic," she said. "We have pockets where the prevalence is more than 1 percent among ante-natal care mothers, so we need to intensify our work."
Out of India's 611 districts, HIV prevalence is more than 1 percent of the population in 156 districts.
"The epidemic is getting deeper into (certain) rural, general areas of the country ... it is migrant-related. They go to work and then they take back the infection to their homes," she said.
Even though HIV drugs are free, only about 155,000 people have access to retroviral drugs, up from 20,000 just two years ago.
Health expert say there are many people who do not know they are infected or who do not know that treatment is available.
Some health professionals believe India's HIV problem is closely intertwined with poverty and that the government must tackle poverty if it seeks to curb the spread of HIV.
"Many of these people are very poor, they worry about food, shelter. So they may not think their HIV status is a problem because they don't even know where their next meal is coming from," said Errol Arnette of the help group Sahara.
"A lot of AIDS patients die of TB because it's hard for hospitals to keep them (in hospital). HIV patients are just thrown in a corner because of heavy stigma."
(Editing by Megan Goldin)
03 Jun 2008 17:09:29 GMT
Source: IRIN
Reuters and AlertNet are
not responsible for the content of this article or for any external internet
sites. The views expressed are the author's alone.
Mangalika, executive
director of the HIV/AIDS advocacy grassroots group, Lanka Plus, said the stigma
stemmed from ignorance. "People don't know about the virus and because of
that they are scared, and fear can do so many things."
Officially, 862 citizens
were living with HIV by July 2007, but according to UNAIDS the real figure is
probably closer to 5,000. Although this represents a prevalence level of less
than 0.1 percent, a recent study concluded that
The 2007 study by the
Centre for Policy Alternatives (CPA), a US-based non-profit organisation, noted
that high numbers of migrant workers, commercial sex workers, military
personnel, internally displaced people and drug users, combined with a high
incidence of unsafe sexual practices and escalating rates of sexually
transmitted diseases (STDs), were a recipe for a potential HIV epidemic.
High levels of stigma and
discrimination against people living with HIV were also factors in the spread of
the virus, the study said.
A March 2008 report on
"Over half of all
respondents would not want to work or live in the same house with someone with
HIV, and a third did not think a student with HIV should be allowed to attend
school," the report said.
Knowledge about HIV
prevention was also quite low. The researchers found that "While most knew
that HIV was sexually transmitted, over 50 percent of the respondents
incorrectly identified HIV as being transmitted by mosquito bites," and
"over a third of respondents did not know that condoms provided protection
from HIV."
Low prevalence masks risk
Local activists told IRIN/PlusNews
that the ignorance could also partly be due to the very small number of openly
HIV-positive people in
"The low prevalence
rate has created ignorance of HIV in society," said Swarna Kodagoda,
executive director of Alliance Lanka. "Ignorance has created fear; but
little by little the figures [for HIV infection] are increasing, and if we don't
create more awareness we could run into a larger problem."
The UNGASS report confirmed
the findings of the CPA study that the low prevalence rate obscured the
potential for an epidemic due to a large, emerging population of sexually active
young people, increasing commercial sexual activity, internal and external
labour migration, and a large contingent of armed forces.
Grassroots initiatives
Acknowledging the problem,
and the importance local civic groups can play in creating awareness of the
disease, the World Bank awarded grants of US $40,000 each to Alliance Lanka and
Lanka Plus for implementing grassroots HIV/AIDS education programmes over a
period of 18 months, with the goal of reducing the prevailing stigma against the
disease.
"I heard from all the
participants [applying for grants] that stigma is a huge constraint to fighting
the disease," said Praful Patel, the World Bank Vice-President for
Alliance Lanka plans to use
its grant to set up 48 mobile information stands, three people-friendly
permanent centres for HIV counselling and information, and occupational training
for at least 12 HIV-positive people in three selected towns, including the
capital, Colombo, where HIV-prevalence rates are highest.
"The information
available will not be limited to HIV, but will deal with other diseases and
related subjects," Kodagoda said. "We will be talking of HIV in the
overall health context, not in isolation; that way we might be able to make
people more aware."
Financial training
Lanka Plus will use its
grant to provide financial assistance and management support to groups of
HIV-positive recipients, rather than individuals, to set up and manage small
businesses. "That way, if one member falls sick, the business will not get
completely disrupted," said project coordinator Milinda Rajapaksha.
Alliance Lanka agreed with
the importance of entrepreneurial assistance to HIV-infected people. Kodagoda
told IRIN/PlusNews that his organisation planned to help those who underwent
training in an occupation to obtain finance for starting businesses.
"We want to see them
standing on their own feet, so people will see they are not a burden," she
said. "They will be role models to show others that despite the virus you
can lead a normal life."
By CLARE NULLIS, Associated Press WriterThu Jun 5, 2:09 PM ET
South
Africa's health minister said Thursday that HIV infection rates among
pregnant women declined for the second straight year and claimed it was
proof of the success of government policies.
South Africa has an estimated 5.4 million people infected with the virus, the highest total in the world.
Health Minister Manto Tshabalala-Msimang said that a new survey showed that 28 percent of women screened at prenatal clinics last year had the virus that causes AIDS, down from 29.2 percent in 2006.
She said that overall, 37.9 percent of women aged 25-29 were infected with HIV, down from 38.7 percent in 2006. Full results of the annual survey will be released in the coming weeks, she told parliament.
After prolonged delays in providing lifesaving drugs to AIDS patients, South Africa, where 900 people die each day of the disease, has made big strides in the past year in rolling out treatment. At the end of February, more than 450,000 people had started therapy, the health minister said. This is about half the number estimated to be in need of drugs.
"Taken together, these figures do indeed suggest that we have a trend of decreasing prevalence overall," the minister said. She attributed this to "intensive prevention campaigns which are beginning to make a difference."
Some experts suggest, however, that the decline is due more to a natural leveling off of the epidemic as infected people die.
Sandy Kalyan, the health spokeswoman for the opposition Democratic Alliance, was scathing on the record of the minister, whose AIDS policies have made her the country's most controversial politician.
"Your persistent denialism that the pandemic is escalating, and your constant flirtation with AIDS dissidents is a disgrace to your ministry," Kalyan said.
Tshabalala-Msimang has long been accused of frustrating the anti-AIDS drive at the behest of President Thabo Mbeki, who has disputed the link between HIV and AIDS.
She has often voiced her mistrust of antiretroviral therapy, and espoused the benefits of garlic, beetroot and lemons.
"All you have managed to incur is the wrath of the people, and of course many honorary titles like Dr. Doolittle, Dr. Beetroot, Dr. No and Dr. Death," Kaylan said.
But Tshabalala-Msimang said that the ministry was boosting funding for HIV/AIDS this year by $45 million to $335 million.
Pointing to the number of South Africans on antiretroviral therapy, the minister said South Africa's program was "the largest in the world" and "contradicts those voices that suggest that this government is not concerned about treatment."
She said it was especially encouraging to note that infections among teens were down from 13.7 percent in 2006 to 12.9 percent last year.
03 Jun 2008 20:07:28 GMT
Source: IRIN
Reuters and AlertNet are
not responsible for the content of this article or for any external internet
sites. The views expressed are the author's alone.
CAPE TOWN, 3 June 2008 - More than 400,000 HIV-positive South Africans
have begun antiretroviral treatment (ART) since the government launched its
programme in 2004. But this impressive-sounding figure still only represents one
third of the estimated number of people in need of treatment, and that number is
expanding by an additional half a million people every year.
If
This was the finding of a
study that compared antiretroviral (ARV) service delivery in three South African
provinces:
Helen Schneider, a
researcher with the Centre for Health Policy at the
A comparison of 16
facilities providing treatment in the three provinces revealed wide variations
in referral systems and staffing levels, but in all three provinces the
researchers found a lack of integration of ARV services with other health
services. Patients frequently had to go to other facilities for the treatment of
TB, or for other opportunistic infections, or for antenatal care.
The study also found that
in many districts there were too few doctors and pharmacists providing ARV
services, creating service bottlenecks. Systems for monitoring and evaluating
patients on ARV treatment were also generally weak, and the use of data to
improve services even weaker.
"These models won't be
sufficient to achieve universal access," Schneider said. She recommended a
shift towards more integrated ARV services, delivered primarily by nurses at
primary health care clinics.
The challenge is not only
to expand the numbers of people receiving treatment, but to safeguard the
quality of treatment, said Dr David Pienaar of the
"We know there's a
need for rapid expansion of ART in South Africa over the next five years,"
he told conference delegates, "but without excellent adherence there's a
risk of individual treatment failure and population-level drug resistance."
Pienaar and his colleagues
had interviewed patients at five ARV clinics in two districts of the Western
Cape to discover what factors determined good treatment adherence.
They found that a patient's
age, gender and education level had much less to do with whether or not they
consistently took their ARV drugs than the distance they lived from the facility
where they accessed treatment: those living more than 20 minutes away from a
treatment site were more likely to report missing doses.
Patients who had a
treatment "buddy", a friend or relative who reminded them to take
their medication every day, were 66 percent more likely to report excellent
adherence, while patients co-infected with TB and HIV were more likely to adhere
to both sets of medication if they could access them at one facility.
Overall, the study found
good levels of adherence, but Pienaar cautioned that the median length of time
patients had been on treatment was only seven months.
Other recommendations
included encouraging patients to be tested earlier and to disclose their HIV
status; to establish more community-based adherence support systems, and moving
towards greater integration of HIV and TB services.
By ELIANE ENGELER, Associated Press WriterFri Jun 6, 4:50 PM ET
Aid agencies in Zimbabwe said Friday the government order for humanitarian groups to suspend work would cut off care and medicine to those living with AIDS.
Aid groups and Western officials also said many in the impoverished African country will starve without food aid, amid allegations that President Robert Mugabe's regime is using food to cement his rule.
On
Thursday, Mugabe's government ordered aid groups to suspend field work
indefinitely, saying they had violated the terms of their agreement. It has
accused at least one group of campaigning for the opposition in the June 27
presidential runoff between Mugabe and Morgan Tsvangirai.
Zimbabwe's National Association of Non Governmental Organizations, after an emergency meeting Friday in the capital of Harare, challenged the government to name charitable, aid and civic groups it alleged were in breach of regulations and specify the accusations against them.
"One cruel direct impact of the ban will be that people living with HIV/AIDS will increasingly die since many NGOs provide assistance in the form of home-based care and anti-retroviral medication," the group said in a statement.
More than 1.3 million people are living with AIDS, according to Zimbabwe's report to UNAIDS for the years 2006-2007. More than 15 percent of adults in the country of 12 million is believed to be HIV-positive, the report said.
Starvation is also a concern in what was once a regional breadbasket but now suffers from the world's highest inflation rate that puts the price of staples out of reach. The halting of private aid group operations leaves poor Zimbabweans dependent on the government and Mugabe's party.
The U.S. ambassador to Zimbabwe, James McGee, said Friday the Mugabe regime is distributing food mostly to its supporters and that opposition loyalists are offered food only if they hand in identification that would allow them to vote in the runoff.
If the situation continues, "massive, massive starvation" will result, McGee told reporters in Washington by video conference from Harare.
State Department spokesman Sean McCormack called the order "a vicious attempt to use food as a political weapon."
"It's just another despicable act in a litany of despicable acts committed by this government against its own people," he said in Washington.
Zimbabwe's U.N. ambassador, Boniface Chidyauskiku, denied those charges.
"There is no use of food as a political weapon. It is the other way around. It is the relief agencies, followed by the U.S. government, that have been using food as a political weapon," Chidyauskiku told The Associated Press. "This is why we have suspended the activity."
The suspension order hampers aid delivery to more than 4 million people and puts at least 2 million at greater risk of starvation, homelessness and disease, according to the U.N. Office for the Coordination of Humanitarian Affairs.
John Holmes, who heads the office, called the decision "deplorable."
He said the U.N. would "do our best to make up for this" shortfall, though much of the world body's aid to Zimbabwe is funneled through private groups.
Life expectancy is only 35.5 years in Zimbabwe, and more than half the population lives on less than $1 a day, according to the U.N.
The government order will halt food distribution from the World Food Program for 314,000 "of the most vulnerable people" in June, said Peter Smerdon, the organization's spokesman in Nairobi, Kenya.
Britain's foreign aid chief called the decision to restrict humanitarian agencies' work "indefensible."
"For Robert Mugabe to use the threat of hunger as a political weapon shows a callous contempt for human life," said Douglas Alexander in London. He added that it was "offensive and absurd" for the government to suggest international NGOs were interfering in politics.
Zimbabwe's social welfare minister, Nicholas Goche, said when ordering the aid groups to suspend operations that they were violating the terms of their agreement with the government, according to a brief statement seen Thursday by the AP.
CARE International said earlier this week that it was ordered to stop its aid operations pending an investigation of allegations it was campaigning for the opposition. CARE denies doing that.
CARE International's Africa communications director, Kenneth Walker, said the government order will affect the people "very badly."
"Nobody is going to starve to death tomorrow," he said. "But obviously the longer the suspension remains, the more dire the circumstances become."
The suspension of CARE's activities alone immediately affects half a million Zimbabweans, the U.N. said.
The U.N.'s Children Fund said the decision meant more than 185,000 children would not receive food aid, education and health care. With one child in four an orphan and families struggling with skyrocketing inflation, children already have been paying a heavy toll.
Human Rights Watch said the halt of aid groups' work was not surprising.
"This is part of a campaign. There has been extreme campaign of violence, and torture" against opposition supporters, said Carolyn Norris, deputy director of the Africa division with Human Rights Watch. "This is to intimidate and spread fear before the elections."
05
Jun 2008 18:33:55 GMT
Source: IRIN
Reuters
and AlertNet are not responsible for the content of this article or for any
external internet sites. The views expressed are the author's alone.
Since
its formation in the mid-1980s, and all through the 1990s, the Uganda People's
Defence Force (UPDF) lost thousands of soldiers to HIV. President Yoweri
Museveni declared HIV a threat to national security as early as 1987.
But
constant deployment, the heterogeneity of the army, and the fact that the troops
were mainly sexually active men in their twenties, all combined to create
perfect conditions for the rapid transmission of HIV in the force, according to
the UPDF's Lt Col Dr Stephen Kusasira.
"The
army was a mixture of educated and uneducated men from different ethnic
communities who spoke different languages, so communicating the HIV message [was
difficult] in the early days," he said.
"The
real threat, especially at an individual level, is dampened by war," he
noted. "A soldier sometimes can't see the point in wearing a condom to
protect himself against HIV, which, in the era of ARVs [life-prolonging
antiretroviral treatment] may never kill him, and he is more likely to die on
the front line."
Kusasira
added that the UPDF had been working overtime to ensure that the HIV pandemic in
its ranks was managed. The army has set up eight ARV treatment centres
nationwide and has two mobile treatment units for soldiers deployed to remote
parts of the country.
In
The
LDF set up its HIV care and treatment programme in 1998, and has since created
prevention of mother-to-child and home-based care programmes, a mobile clinic, a
condom distribution programme and annual HIV screening of the troops. The
military hospital was recently equipped with isolation rooms for tuberculosis
patients and a 'wellness' clinic providing comprehensive HIV care.
Highly
paid peacekeepers at risk
The
main threat to the Benin Armed Forces (BAF) has come as a result of troops being
deployed to high-prevalence countries on peacekeeping missions; HIV infection in
"The
HIV prevalence within our army is about 2.02 percent, but the troops are
deployed to countries with prevalence as high as eight percent," said Lt
Col Alain Azondekon.
"The
soldiers sent on peacekeeping missions are wealthy – they get paid much more
than the average citizens or soldiers, so many use the money on women in the
countries they are sent to," he commented. "In 2004, nine out of ten
of our troops who returned to
As
a result,
This
appears to be working: studies show that unprotected sex among
Human
rights dilemmas
While
they battle to overcome HIV among their troops, African militaries also have to
deal with the many human rights issues - such as stigma and confidentiality -
associated with HIV.
Kusasira,
of the UPDF, said the army respected the right of HIV-positive soldiers to
confidentiality but encouraged disclosure, particularly to commanders, in case
of deployment to remote areas.
The
UPDF screens new recruits and rejects HIV-positive men and women, drawing
criticism from human rights bodies who feel that in the age of ARVs, an
HIV-positive soldier can perform as well as any other.
"For
us it is less a human rights issue and more of an economic one; caring for
HIV-positive soldiers has been a huge economic burden on our resources, so we
are hesitant to add to it," Kusasira said.
"But
once a soldier is diagnosed HIV-positive, we give him the best treatment and
care we can afford," he added. "And HIV-positive soldiers within the
UPDF are not excluded from promotion or training, even after diagnosis."