TOKYO,
July 25 /Xinhua-PRNewswire/ -- The World Health Organization (WHO) warned today
that the failure of Asian nations to combat the spread of highly lethal,
drug-resistant strains of tuberculosis (TB) is a threat to global public health
security.
Only 1% of the estimated 150 000 people with multidrug-resistant TB (MDR-TB) in
WHO's Western Pacific Region, which covers East Asia and the Pacific, are
getting appropriate treatment. Each untreated TB patient could infect five to 10
people a year.
MDR-TB raises the risk of a TB epidemic that would be costly and complex to
control. Drugs to treat MDR-TB are about 100 times more costly than the regimen
for normal TB.
"MDR-TB does not stop at borders," warned Dr Shigeru Omi, WHO Regional
Director for the Western Pacific. "An uncontrolled local epidemic threatens
the stability of global health security. TB anywhere is TB everywhere."
With 2 billion people traveling on airlines every year, and the internal
migration of millions, diseases are on the move.
"We are more vulnerable than ever to the MDR-TB threat," Dr Omi said.
"Countries must act responsibly to safeguard global health."
Dr Omi was speaking as health ministry officials from countries with a high
burden of TB, global TB experts and representatives of donor agencies meet in
Tokyo, Japan, to review progress and plan policy at the 6th Technical Advisory
Group Meeting to Stop TB in the Western Pacific Region.
Despite the discovery of a cure half a century ago, TB remains the leading
infectious disease killer of adults after HIV/AIDS. In Cambodia, China, the
Philippines and Viet Nam -- some of the countries most affected by TB -- it is a
top killer.
MDR-TB is a serious problem in China and the Philippines, and of concern in
Mongolia, the Republic of Korea and Viet Nam. The Western Pacific Region has the
largest number of MDR-TB cases among WHO regions, although the concentration of
cases is higher in parts of Eastern Europe.
While Eastern Europe's situation has been well-recognized and is being
addressed, MDR-TB -- but not standard TB -- is severely neglected in the Western
Pacific Region.
"No country in the Region is rushing to fight MDR-TB," said Dr Pieter
Van Maaren, WHO's Western Pacific Regional Adviser for TB. "There is a
waiting list for treatment in every country. In some cases, available funds are
not being used due to bureaucratic barriers or poor awareness of what can be
done. The lack of knowledge on MDR-TB has even led to patients being prescribed
the wrong drugs, especially in the private sector."
Many countries do not have adequate laboratory facilities to detect MDR-TB. Even
if they do, action may not be taken. In one country, half the MDR-TB cases
detected three years ago have yet to be treated. Most MDR-TB patients in the
Region have little hope of acquiring appropriate drugs and die as a result.
"It comes down to complacency. There needs to be a change of
attitude," said Dr Van Maaren. "Politicians should commit to action.
They need to wake up and realize what is at risk. This is a disease that you can
transmit in a cough to your children."
Earlier this year, WHO released a report showing the highest levels of drug
resistance ever recorded. MDR-TB now accounts for 5% of the 9 million new TB
cases worldwide. In China, one of every 10 new TB cases is MDR-TB.
MDR-TB is caused by mismanagement of standard TB treatment, but current trends
-- mobility, migration and crowded, urban housing -- are fuelling it. Poor
health services and laboratory facilities also exacerbate it.
While MDR-TB may not cause an immediate outbreak of disease, it has a heavy,
long-term toll. "This is a chronic, lingering, wasting disease. It is
similar to what AIDS was a decade ago," Dr Van Maaren said. "It causes
a slow death. Once it enters into a country, it is difficult to get rid
of."
Like HIV, MDR-TB also kills working-age adults and causes poverty.
Mismanagement of MDR-TB can result in extensively drug-resistant TB (XDR-TB), a
form of TB resistant to all the most effective drugs. XDR-TB has been described
as "virtually uncurable". A 2005 outbreak of XDR-TB in South Africa
killed 52 of 53 TB patients co-infected with HIV.
Note to Editors:
The 6th Technical Advisory Group Meeting to Stop TB in the Western Pacific
Region will he held 21-24 July. It will be followed by a one-day international
TB symposium co-hosted by the Government of Japan and Japanese NGO to promote
international cooperation to fight TB (commencing 13:00, 24 July 2008).
The symposium will be attended by Her Imperial Highness Princess Akishino, who
is president of the Japan Anti-Tuberculosis Association (JATA), as well as Mr
Yuji Tsushima, Chairman, Parliamentary Group for Promoting "Stop TB
Partnership" (Former Minister of Health and Welfare); Ms Kyoko Nishikawa,
Senior Vice-Minister of Health, Labour and Welfare; and Vice-Minister for
Foreign Affairs Mr Osamu Uno. Also attending is Dr Shigeru Omi, WHO's Western
Pacific Regional Director.
By JIM ABRAMS, Associated Press WriterThu
Jul 24, 6:45 PM ET
The
House voted Thursday to triple money to fight AIDS, malaria and tuberculosis
around the world, giving new life and new punch to a program credited with
saving or prolonging millions of lives in Africa alone.
The 303-115 vote sends the global AIDS bill to President Bush for his
signature. Bush, who first floated the idea of a campaign against the
scourge of AIDS in his 2003 State of the Union speech, supports the
five-year, $48 billion plan.
Passage of the bill culminated a rare instance of cooperation between the
White House and the Democratic-controlled Congress. It was "born out of
a willingness to work together and put the United States on the right side
of history when it comes to this global pandemic," said Rep. Barbara
Lee, D-Calif., a leader on the issue.
The current $15 billion act, which expires at the end of September, has
helped bring lifesaving anti-retroviral drugs to some 1.7 million people and
supported care for nearly 7 million. The President's Emergency Plan for AIDS
Relief, known as PEPFAR, has won plaudits from some of Bush's harshest
critics both in Congress and around the world. Both Democrats and
Republicans hailed it as one of the most significant accomplishments of the
Bush presidency.
The United States, said Rep. Howard Berman, D-Calif., chairman of the
House Foreign Affairs Committee, "has given hope to millions infected
with the HIV virus, which just a few years ago was tantamount to a death
sentence."
According to a study by UNAIDS and the Kaiser Family Foundation, the
United States provided one-fifth of AIDS funding from all sources —
governments, international aid groups and the private sector — in 2007.
About 40 percent of the $4.9 billion disbursed in 2007 from the G-8
countries, Europe and other donor governments came from the United States.
The legislation approves spending of $5 billion for malaria and $4
billion for tuberculosis, the leading cause of death for people with AIDS.
It authorizes spending of up to $2 billion next year for the international
Global Fund to Fight AIDS. The measure also provides $2 billion, on top of
the $48 billion, for American Indian water, health and law enforcement
programs.
While some GOP conservatives questioned the sharp spending increase,
others said the U.S. aid had important security as well as moral
implications and gave a needed boost to America's reputation abroad.
The pandemic, said Rep. Ileana Ros-Lehtinen, R-Fla., top Republican on
the Foreign Affairs Committee, "is leaving a trail of poverty,
despondency and death which has destabilized societies and undermined the
security of entire regions." The program has enhanced the U.S. image
around the world, she said. "Even in the most remote areas of Kenya or
Haiti, for example, people know about the PEPFAR program."
PEPFAR has focused on nations in sub-Saharan Africa that have been
devastated by AIDS, but it has also provided assistance in the Caribbean and
other areas hit by the pandemic now affecting some 33 million worldwide.
Even with advances in treating the disease, there are still about 7,000 new
HIV infections every day around the world.
The new bill, like the current law, states that 10 percent of funds
should be allocated for orphans and vulnerable children. It sets as a goal
preventing 12 million new HIV infections, treating more than 2 million with
anti-retroviral drugs, supporting care for 12 million people infected with
HIV/AIDS and training at least 140,000 new health care workers and
paraprofessionals.
It increases attention on women and girls, including stressing the
importance of preventing gender-based violence.
Pamela W. Barnes, president and CEO of the Elizabeth Glaser Pediatric
AIDS Foundation, applauded the bill's target of reaching 80 percent of
HIV-positive pregnant women with services needed to prevent transmission to
their children. "We are still only reaching 34 percent of pregnant,
HIV-positive mothers with the medicine they need to keep their babies
HIV-free," she said.
The final product took months of compromise: Democrats took out a
provision in the existing act requiring that one-third of prevention funds
be spent on abstinence education but allowed for reports to Congress if
abstinence and fidelity spending falls below certain levels. Conservatives
won "conscience clause" assurances that religious groups would not
be forced to participate in programs to which they morally object.
Bush, who originally proposed doubling the program to $30 billion, first
balked at but later accepted the $50 billion bill that passed the House in
April. The Senate diverted $2 billion of the $50 billion to Indian programs
and inserted a provision that more than half of funds for AIDS programs go
for treatment and care.
The Senate also attached a measure, welcomed by AIDS advocacy groups,
that ends a two-decade-old U.S. policy that has made it nearly impossible
for HIV-positive people to get visas to this country as immigrants, students
or tourists.
The bill is named after former House Foreign Affairs Committee Chairmen
Henry Hyde, R-Ill., and Tom Lantos, D-Calif., who wrote the 2003 bill. Hyde
died last November, and Lantos died in February as he was working on the new
bill.
JOHANNESBURG
, 21 July 2008 - The move by the United States Senate to repeal legislation
prohibiting HIV-positive visitors and immigrants has been hailed as an important
step in the fight against stigma and discrimination.
On July 16, the Senate
passed the re-authorisation of the President's Emergency Plan For AIDS Relief (PEPFAR),
which also amends the Immigration Act to lift the ban on travel and immigration
to the country by HIV positive non-citizens.
The US Senate legislation
will authorize $48 billion over five years for AIDS, TB and malaria.
UN Special Envoy for AIDS
Elizabeth Mataka welcomed the move, which she noted had been a long time coming.
"I think countries should look at HIV and AIDS as an epidemic that knows no
borders of any description," Mataka told IRIN/PlusNews.
"Countries should
recognise that the world has become a global village, and restricting HIV
positive people [from travelling] is counter-productive."
UNAIDS described the vote
as a "major step in keeping its commitment to the global AIDS
response".
The action by the US
Senate is a vote of confidence that past and current investments in bilateral
and multi-lateral programs are working.
In a statement, the
International AIDS Society (IAS), custodian of the biennial International AIDS
Conference, applauded the Senate's vote, but called on other countries
"with discriminatory policies and laws restricting the entry, stay and
residence of people living with HIV to follow suit".
Some 67 countries around
the world have a variety of HIV-specific laws that restrict the entry, stay or
residence of people living with HIV, according to a global database on HIV
travel restrictions compiled by the IAS and its partners.
Mataka warned that all
other countries with discriminatory immigration policies were denying HIV
positive people their basic human rights. "You need to deal with AIDS with
a human rights perspective, and by keeping these laws we are violating people's
right to movement," she said.
The IAS, an association of
HIV professionals with more than 11,000 global members, has opposed the "
US
HIV-specific entry bar" since 1990, and does not hold its conferences in
countries that restrict the entry of people living with HIV/AIDS.
"We look forward to
seeing this provision put into law as we move forward in the global movement to
reduce the burden of HIV," said IAS President Pedro Cahn.
IRIN/PlusNews will be
filing daily reports from the next IAS International AIDS Conference, which is
being held in August in
Mexico City
,
Mexico
.
The
International Federation of Red Cross and Red Crescent Societies (IFRC)
launched Tuesday a multi-million dollar appeal for an AIDS treatment
programme in five African countries.
The IFCR is seeking 21 million Swiss francs (13 million euros, 21 million
dollars) for a three-year programme in Burkina Faso, the Central African
Republic, the Democratic Republic of Congo, Guinea and Nigeria.
The programme in the countries, which form the Sahel region of west and
central Africa, will run between 2008 and 2010.
The region, like other parts of Africa, is struggling to cope with the
disastrous consequences of HIV, said Abdourahmane Ndiaye, IFRC's HIV
programme officer for the region.
"Even though the impact may vary from one country to another, HIV is
a major obstacle to development as it affects all key sectors: the economy,
health, education and even food security," he added.
The community-based programme would reach 950,000 vulnerable people,
including 10,000 orphans, 49,000 people living with HIV and 13,000 sex
workers, said the statement.
Nearly 4.5 million, including some 400,000 children aged below 14 years,
are living with HIV in the five countries, according to IFRC estimates based
on global UNAIDS statistics.
In 2006, 350,000 people died of AIDS in these five countries, where the
disease had already left 1.9 million children orphans.
MOZAMBIQUE: Tourism, beaches and sex - a recipe for HIV
22 Jul 2008 15:41:48 GMT
Source: IRIN
BEIRA
, 22 July 2008 - With its white sand, sunny blue skies and cashew nut trees,
Miramar
Beach
in the port city of
Beira
,
Mozambique
, has all the right ingredients to draw tourists from all over the world.
But that is not all this
idyllic coastline attracts. "The beach is fertile ground for the
propagation of the [HI] virus, because so many people's paths cross there,"
said Victoria Machava, who works for the
Beira
municipal health department.
Miramar Beach is in Sofala
Bay, close to the main Indian Ocean shipping routes and the largest airport in
Mozambique's central region; it is not only ideally situated for tourism but
also for the sex trade.
The explosion in both has
led
Beira
's municipal government and local non-governmental organisations to launch
HIV/AIDS awareness-raising campaigns in areas like
Miramar
to reach tourists, most of whom are European, as well as locals, including sex
workers and fishermen.
Billboards along the beach
warn people about the dangers of HIV, while a group of 15 activists from the
city council provides prevention information and distributes condoms. "The
environment entices people to have sex, but we've noticed that many of those who
come to the beach don't bring condoms with them," said Zito Lazaro, 23, one
of the activists.
High prevalence, high risk
An HIV infection rate of 35
percent - more than double the national average - means
Beira
is the worst-affected city in
Sofala
,
Mozambique
's worst-affected province. According to official figures, half of all new HIV
infections identified in
Sofala
Province
in 2007 were reported in
Beira
- a total of 11,242 cases.
The city's high prevalence
can partly be attributed to its location at one end of the corridor linking
Mozambique
to
Zimbabwe
,
Malawi
and
Botswana
: countries with HIV infection rates that are among the highest in the world.
Truck drivers, sex workers,
fishermen and street children, some of the groups most vulnerable to HIV
infection, mingle with tourists, other visitors and locals on
Miramar
Beach
.
Virgínia M.*, a
31-year-old sex worker, thinks she became infected with HIV during an
unprotected sexual encounter at an eating establishment near the beach. Despite
being aware of the risks, she said money sometimes talks louder: sex with a
condom costs about US$4, but she can charge $10 for unprotected sex.
With support from the
province's AIDS unit, 14 community-based AIDS organisations in the region have
joined forces with the
Beira
municipal government to carry out campaigns in areas with the highest risk. At
the weekends, they give lectures and screen educational films on the beach, in
shops and in night clubs.
"Behind the high
infection rate are high risk factors," said Machava of the city's health
department. "That's why we're fighting not to allow a breeding ground for
the spread of the virus."
*not her real name
KENYA: More education equals less teen pregnancy and
HIV
25 Jul 2008 15:37:14 GMT
Source: IRIN
NAIROBI, 25 July 2008 -
Keeping Kenyan girls in school and ensuring they have access to HIV and sex
education has a dramatic effect on lowering future levels of HIV, according to
experts.
"Young people do not
have the information they need, and the dropout rate, particularly for girls, is
still too high," said Rosemarie Muganda-Onyando, executive director of the
Centre for the Study of Adolescence (CSA) http://www.csakenya.org/index.htm,
which conducts research into teen behaviour and implements programmes for them.
"Dropping out of
school ensures a life of poverty for these girls, and many of them also wind up
HIV-positive because the male-female power dynamics become even more slanted
against them."
Although the government
introduced free primary school education in 2003, an estimated one million
children of school-going age are not attending school. Up to 13,000 Kenyan girls
drop out of school every year as a result of pregnancy, and around 17 percent of
girls have had sex before they turn 15. HIV prevalence in Kenyan women aged
between 15 and 24 is about 5 percent, compared with just one percent for their
male counterparts.
The Kenya Demographic and
Health Survey of 2004 found that better educated girls were less likely to marry
early, more likely to practice family planning, and that their children had a
higher survival rate.
According to the United
Nations Children's Fund, uneducated girls are also more likely to contract
HIV/AIDS, which spreads twice as quickly among them than among girls who have
had even some schooling.
The Ministry of Education
has an HIV/AIDS prevention and sex education curriculum that focuses on
upper-primary and secondary school, but no specific time is set aside for this,
leaving teachers and school heads to fit in the subject at their discretion.
"I would like to see
compulsory comprehensive HIV and sex education - and not just the bare bones,
but something that goes further and teaches kids to become responsible for their
actions and take greater control of their future," Muganda-Onyando said.
"Not enough teachers have been trained for this type of education, so
children are leaving school with academic qualifications and not many life
skills."
These were not the only
obstacles: the strong influence of fundamentalist Christians in HIV funding to
Kenya
had also played a part in preventing sex education from being taught in
schools; and "There is also resistance from parents, many of whom feel
school is not the place to learn about sex," she said.
This lack of information
meant girls were not practising safe sex; a 2003 government survey noted that
just 25 percent of women aged 15 to 24 reported using a condom the last time
they had sex with a non-marital, non-cohabiting partner.
Schools ill-equipped for
sex education
Schools in remote, rural
areas and deprived urban areas are often ill-prepared to handle sex education;
many have not seen the government's curriculum. "We don't have sex
education or HIV education; the government hasn't given us any materials or
training so we don't know where to start," said Christopher Barassa,
principal of Genesis Joy Primary and Secondary School in Mathare,
Nairobi
's second-largest slum.
Although registered with
the Ministry of Education and the Nairobi City Council, the school is considered
as 'non-formal' because of its location and lack of facilities; it has no
playing ground or toilets, so the school is surrounded by 'flying toilets' -
faecal matter wrapped in plastic bags and thrown away - and garbage. All the
students are from the slum, and Barassa says keeping them in school can be
difficult.
"Our drop-out rate is
not very high, but teen pregnancy is a real problem," he told IRIN/PlusNews.
The school's policy is to encourage girls to return to school after they give
birth, but many felt too stigmatised or had no help to look after their children
and therefore stayed away.
"When we investigate
the pregnancies, it is almost always an older man ... over twenty and sometimes
over thirty," he said. "We work with the local police to prosecute
them - we recently had a 31-year-old man arrested for marrying one of our
students who was just 15."
He noted that many parents
in the slum had inadequate control because work kept them away from their
children, sometimes for days. As a result, children learnt about sex from the
wrong sources, such as the numerous video halls that allowed children to view
pornographic films.
"The girls also have
to live in one room with their parents until they are mature, and many of them
witness their parents having sex, so they learn about it early," Barassa
said. "Sometimes they get a man when they are still young in order to get
out of that situation."
More sex education, less
sex
The CSA runs projects aimed
at lowering the drop-out rate for girls and teaching them about sexual and
reproductive health, including HIV. "The projects train teachers to impart
life skills, create safe spaces in schools where girls can freely discuss the
issues they are facing, and foster mentor-protégé relationships between older
and younger students, so the younger ones have somewhere to turn," CSA's
Muganda-Onyando said.
"One of the big
problems has been the breakdown of our traditional African systems, where an
aunt or grandmother was responsible for sex education ... people say discussions
about sex are taboo in Africa, but this is not true," she said. "We
lost those systems through colonisation and modernisation, and they haven't been
replaced; these projects are trying to give children back that support
system."
The CSA also establishes
ties with the community, encouraging parents to take an active role in teaching
their children about sex, and to behave more responsibly themselves.
The initiative, which is
being implemented in more than 100 schools around the country, has had positive
results so far: participating schools have noted a significant drop in teen
pregnancy, higher retention and completion rates of school education, and
improved self-esteem and confidence among girls, which in turn has led to higher
scores in exams.
"Girls also need to be
supported with uniforms, books, and other material necessities for school,"
said Principal Barassa. "If a girl has everything she needs for school, she
can stay in school and concentrate on her studies, and she will not look for an
older man to buy them for her in exchange for sex."
TOKYO,
July 25 /Xinhua-PRNewswire/ -- The World Health Organization (WHO) warned today
that the failure of Asian nations to combat the spread of highly lethal,
drug-resistant strains of tuberculosis (TB) is a threat to global public health
security.
