Thursday June 9, 3:40 PM

China's migrant workers a high AIDS risk - expert

Wan Shao Ping, a medical doctor and project officer with the China-UK HIV/AIDS Prevention and Care Project in southwestern Sichuan province, said poorly educated migrant workers had highly risky sexual practices.

Wan told a health seminar in Hong Kong that there were at least 100 million such workers in China.

"The Chinese government is now putting a lot of attention on HIV/AIDS but we have to focus on the most risky group, this floating population," Wan told Reuters.

"Otherwise, they will carry the virus all over the country and it will cause a tragedy in China's public health system.

"According to surveys, 10 percent to 48 percent of males in this floating population exhibit highly risky sexual behaviour," Wan said, adding that they often visited prostitutes.

"And in this risky group of males, 70 percent have never used condoms," he said, adding that most of them were unaware of the dangers of HIV and AIDS.

Among the women, many often resort to becoming sex workers when they cannot find other work.

"These women have up to four customers a day. They spread the virus and the men take the virus all over the country," Wan said.

"So their threat to China's HIV/AIDS problem is huge."

Although China's official estimate of 840,000 HIV/AIDS cases has raised eyebrows among international health experts, the country has recently paid more attention to the epidemic after ignoring it for years.

It has sent teams of counsellors to villages across the country to teach safe sex. But Wan said that was not enough and that more effort must be put into educating migrant workers.

Tuesday June 7, 7:18 PM

China urges needle exchanges, free condoms in newly aggressive AIDS strategy

As part of an aggressive new anti-AIDS push, China's Health Ministry is urging the promotion of free condoms and drug needle exchanges _ strategies previously considered taboo by the conservative communist government.

The "proposed guidelines for high risk behavior intervention" urge local governments to tailor those measures to high-risk groups in what would be one of the boldest nationwide campaigns yet against the disease.

The most striking proposal calls for combining methadone treatment with needle exchanges to promote safe behavior among drug users _ a group almost completely ignored in past.

"Under the national health system's launching of a people's war against drugs, drug eradication, AIDS prevention, and daily tasks must be closely joined," said a copy of the guidelines posted on the Health Ministry's Web site.

China launched a new national anti-drugs campaign last month. Its newly aggressive approach on AIDS won praise Tuesday from Randall Tobias, the U.S. global AIDS coordinator.

"I'm very encouraged by the commitment that the senior leadership of the government has made," Tobias said at a news conference in Beijing.

He warned, however, of massive challenges still to be overcome in the countryside, where AIDS has often spread through unsanitary blood buying schemes.

"It will be a very long journey," Tobias said.

Washington is providing China with US$35 million (€28.5 million) for AIDS work from 2004-08.

At the news conference, Tobias and actor and anti-AIDS spokesman, Pu Cunxin, rolled up their sleeves and took a blood test to demonstrate the safety of AIDS testing in front of Chinese photographers.

China says it has 840,000 people infected with the HIV, the virus that causes AIDS, and 80,000 have the full-blown disease. But health experts say the true figures are much higher and warn that China could have 10 million people infected by 2010 unless stronger measures are taken.

The communist government only recently became open about its AIDS epidemic after years of denying it was a problem, although independent activists are still frequently detained and harassed.

Most victims are thought to have become infected through sharing needles during intravenous drug use. Widespread prostitution is also a chief cause of infection, one that experts warn could spread the virus into the wider population.

The guidelines say prostitutes should be encouraged to require customers to use condoms, seek reproductive health services and be treated for venereal disease. People infected with sexually transmitted diseases are to be given free condoms, they say.

They also call for disease prevention education to be carried out at places where gay men gather, along with work sites and other areas where migrant workers reside.

Tuesday June 7, 3:44 PM

Report: 24,500 HIV-AIDS patients in Myanmar lack anti-retroviral drugs

Thousands of HIV-AIDS patients in military-ruled Myanmar lack access to life-prolonging anti-retroviral drugs because of a funding shortage, a U.N. representative was quoted as saying Tuesday.

Myanmar's health department can provide the drugs to only about 500 of the 25,000 victims infected with the AIDS virus who need them, the Flower News journal reported.

"The World Health Organization and other (agencies) have been providing assistance for the treatment, but it is not sufficient and more funding is needed," said Dr. Sit Naing, a local representative of the United Nations' AIDS agency.

The average monthly cost of the drugs was about 30,000 kyats (US$30; €23) per patient. The report did not specify how much additional funding was needed to treat patients in need.

Myanmar's military government says more than 300,000 of the country's 54 million people have HIV-AIDS, but health experts believe the actual figure is higher.

The U.S. Central Intelligence Agency's World Factbook estimates that Myanmar's population is significantly lower _ about 43 million. That estimate takes into account excess mortality caused by AIDS, according to the CIA's Web site.

UNAIDS, the U.N. body coordinating the fight against the disease, estimates that more than 600,000 people in Myanmar, aged 15 to 49, are infected with HIV.

The Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria has pledged US$19.2 million (€15.7 million) to combat HIV-AIDS in Myanmar out of a total package of US$35.6 million (€27.59) for the country.

Mandela to urge rich world to act against AIDS

TROMSOE, Norway (Reuters) - Anti-apartheid icon Nelson Mandela will on Saturday urge the rich world to do more to fight AIDS and will warn the youth of the north of a pandemic that has ravaged sub-Saharan Africa.

The 86-year-old former South African president is to host a star-studded concert under the midnight sun in Tromsoe, a small Norwegian city across the Acrtic Circle as part of his "46664" anti-AIDS campaign.

International stars, including Annie Lennox, Peter Gabriel and former Led Zeppelin frontman Robert Plant are to join Mandela in pressing the G8 group of industrialised nations to promise at their July summit more action and resources in the battle against the deadly disease.

Organisers also say the Nobel Peace Prize winner hopes to spread the message about AIDS to the youth of the nearby Baltic states where millions of lives are in danger.

"We want to begin to raise awareness in Europe, in the developed part of the world about the pandemic," John Samuel, chairman of the Nelson Mandela Foundation, told Reuters.

Mandela retired from public life last year but has remained one of the leading international voices on AIDS.

The concert, which was sponsored by the Norwegian parliament is part of the Mandela 46664 campaign -- named after his prison number during 27 years in jail under apartheid white-rule.

He has held two concerts in South Africa and plans further events in Florence, Italy and in India over the next year.

Mandela, who has appeared frail in recent public engagements, rested in his hotel room for the day out of the cold and wet conditions but is due to meet the musicians on Saturday ahead of his speech.

His wife Graca Machel had been with him, but returned to Mozambique on Thursday following the death of her sister.

SPREADING FAST

AIDS has ripped through communities in sub-Saharan Africa where about 25 million people are infected with the virus that causes AIDS, and millions more contract HIV each year.

South Africa is the country hardest hit with an estimated 5.3 million of its 45 million population living with HIV while in Botswana and Swaziland rates are as high as 40 percent.

The disease is spreading fast elsewhere in the world and already more than a million people are infected in Russia and the other former Soviet states. In India an estimated 5 million people are HIV positive.

"HIV and AIDS is a pandemic and as a pandemic it threatens the lives of all of us, one way or another we are all affected," Samuel said.

Officials and soldiers from Norway's army were on Friday putting the final touches to a giant stage adorned by a massive portrait of Mandela and flanked by the sea and the towering snow-capped Tromsdalstinden mountain.

© Reuters 2005. All Rights Reserved.

DURBAN, South Africa, June 9 (Reuters) - South Africa's leading AIDS group challenged the government on Thursday to quadruple the number of people getting free HIV drugs by the end of the year to 200,000.

The figure of 200,000 roughly equals the number of citizens the disease kills each year.

The Treatment Action Campaign, nominated last year for a Nobel Peace Prize for its campaign to speed anti-retroviral (ARV) drug delivery in the country hardest hit by the AIDS pandemic, gave the government low marks for its roll-out.

"Nationally it's a C veering towards D," Campaign spokesman Mark Heywood told journalists at an AIDS conference in Durban.

"Monitoring the programme is absolutely critical to ensuring that it expands. The number of people dying and getting sick continues to increase."

South Africa launched a public ARV programme in 2003 amid rising outcry over a slow response to a disease estimated to infect more than 5 million of the country's 45 million people.

But the Treatment Action Campaign and other organisations say the roll-out has been slow, with just 42,000 people receiving the life-saving drugs through the public sector by the end of March this year.

Health Minister Manto Tshabalala-Msimang, who has echoed President Thabo Mbeki in publicly questioning the emphasis on ARVs for AIDS treatment, opened this week's conference by saying she would not "chase numbers" in expanding the programme.

She stressed the government would not be rushed into distributing drugs without proper medical systems in place.

The TAC conceded that South Africa had prolonged thousands of lives since since the ARV programme was introduced.

But it said roll-out was patchy, especially in rural areas, due to a lack of government leadership and the loss of doctors, nurses and pharmacists who move abroad or switch careers rather than battle a poor health infrastucture and heavy bureaucracy.

But Treatment Action Campaign organisers said South Africa could still achieve 200,000 patients on drugs by the year's end.

It said simple changes such as shifting patients doing well on ARV treatment to local clinics could free up government certified ARV medical centres to process new applicants.

PIECE OF CAKE?

South African Medical Association President Kgosi Letlape said it would be a "piece of cake" to expand proper ARV care with help from the affluent private sector -- an offer he said had been made often but not accepted by health authorities.

"We are a house divided in this country, and if we stay a house divided we'll never overcome this epidemic, Letlape said.

South Africa's public ARV programme is the second largest in the world after Brazil's. Including private sector patients, the country has some 100,000 people on ARV treatment -- out of an estimated 700,000 who need it.

Ironically, free ARVs can spell financial disaster for HIV/AIDS patients, many of whom claim government disability grants which are often the sole income source in a country with official unemployment of more than 26 percent.

But as drugs reduce symptoms, sufferers see grants halted.

Prisoners, drug users and sex workers will be the major beneficiaries of a $34.2 million grant to Russia, approved on Thursday, the Geneva-based fund said in a statement.

Currently only 1,500 people in Russia, where about 1 million are living with HIV/AIDS, receive antiretroviral drugs, according to the Fund and United Nations health agencies.

"The Global Fund grant will enable a ten-fold increase to 15,500 over the first two years of the programme, rising to 75,000 in year five," it said, adding the grant could be extended to be worth $120.5 million over a five-year period.

The grant, its second to Russia for AIDS, aims to provide treatment and support to infected prisoners, intravenous drugs users, commercial sex workers, homosexuals and pregnant women seeking to prevent mother-to-child transmission of the virus.

"These target populations are the focus of the grant as they represent over 85 percent of diagnosed cases of HIV/AIDS in Russia," the fund said.

The AIDS epidemic in Russia is driven by heterosexual transmission via the country's 2 million to 4 million injecting drugs users, who often also engage in commercial sex work, thereby acting as a bridge to the general population, it said.

The seroprevalence rate of the HIV virus in the Russian prison system is more than 2 percent, or five times higher than in the general population, it added. Russia has 870,000 prisoners, according to the fund.

The Global Fund, a public-private partnership, was set up in 2002 to fight the three diseases which kill 6 million people a year.

SINGAPORE, June 8 (Reuters) - One of Asia's largest gay and lesbian festivals held annually in Singapore has been banned after authorities in the conservative city-state ruled it was "contrary to public interest".

It is the third time in six months Singapore has outlawed a gay event, signalling a marked change in government policy after it had recently shown greater tolerance towards homosexuality.

"Police assessment is that the event is likely be organised as a gay party, which is contrary to public interest in general," a police spokesman said on Wednesday.

"Nation.05", a gay dance party which has been staged yearly in Singapore since 2001, will be moved to the Thai tourist island of Phuket. Last year's party drew more than 8,000 revellers.

"I don't know why there has been a sudden change in the government's sentiments. This is a direct contradiction to previous calls for embracing of diversity," said organiser Stuart Koe, who runs Fridae.com, Singapore's main gay and lesbian Web site.

"We are very disappointed that the government is sending a very strong signal that a big minority of its population is not welcomed. That is very homophobic," Koe told Reuters.

Singapore's gay community has only recently enjoyed greater freedom after former premier Goh Chok Tong announced in 2003 that homosexuals could hold key positions in the civil service without fear of discrimination. But the gay community has come under fire in recent months after a junior health minister in Singapore said a gay and lesbian festival in August last year may have led to a surge in the number of local AIDS cases, a remark that outraged gay activists.

Although Singapore has one of Asia's lowest levels of HIV infection, the number of new infections hit a record high of 311 cases in 2004, up 28 percent from 2003. A third of the newly diagnosed cases were gay men, the health ministry has said.

Gay activists say the remaining two-thirds appeared to be heterosexual men who caught the illness from prostitutes in nearby Southeast Asian countries, such as Indonesia's Batam island, which is just an hour's boat ride from Singapore.

In March, the government rejected an application for an AIDS concert, citing concern over its gay performers. In December 2004, police threw out plans by gay activists to hold a Christmas dance party, saying the event went against the "moral values of a large majority of Singaporeans".

DURBAN, June 7 (Reuters) - South Africa opened its biggest-ever AIDS conference on Tuesday with its health minister publicly questioning whether life-saving anti-retroviral (ARV) drugs alone could turn back the disease.

More than 200,000 are believed to die of AIDS in South Africa every year, with the United Nations estimating that more than 5 million of the country's 45 million people are infected.

"Your response cannot be single-minded -- it's ARVs," Health Minister Manto Tshabalala-Msimang told a news conference at the meeting of 4,000 delegates in Durban. "There are other things you must be able to do: nutrition (and) traditional medicine."

Activists and medical workers accuse President Thabo Mbeki's government of moving too slowly to fight the epidemic.

The government introduced a public ARV treatment programme after the first national AIDS conference in 2003, but only slightly more than 40,000 people enrolled.

Tshabalala-Msimang, who has taken a combative approach over the issue of ARVs, said she was not seeking to "undermine" drugs as part of South Africa's new AIDS management plan, intended to be one of the largest public health interventions in the world.

But she said questions remained about the use of ARVs in countries like South Africa, where more than 10 years after the end of white apartheid rule the bulk of the population is poor and suffers from both poor nutrition and public health care.

"We have to admit that there is no single intervention that can solely solve the challenges faced by people with HIV and AIDS," Tshabalala-Msimang said, noting that her own naturalistic treatment using ingredients such as olive oil, lemon, garlic and beetroot was gaining broader acceptance.

"People should be aware of the benefits and shortcomings of various treatments so they can make informed decisions."

She said the government would not be pressured into speeding the roll-out of ARVs before there was proper infrastructure in place to provide counselling and care.

THE HOLE AT THE CENTRE

Activists have accused Tshabalala-Msimang and other officials of fuelling "denialist" sentiment that seeks to portray the disease as either a racist exaggeration or the work of western pharmaceutical companies seeking to put Africans on anti-AIDS drugs for life.

Mark Heywood of the Treatment Action Campaign (TAC), the country's largest AIDS activist group that was instrumental in persuading the government to adopt public ARV treatment, said two years of progress was threatened by ambivalent leadership.

"It is not the absence of leadership, it's anti-leadership," Heywood told Reuters. "There is a hole at the centre which we hoped would disappear and it hasn't."

Heywood said a recent mortality survey released by the country's statistics agency showed that more than 200,000 people were dying every year from AIDS, and that the numbers might grow unless South Africa -- equipped with some of Africa's best health care infrastructure -- took a firmer position.

"South Africa could be a world leader, but the epidemic is miles ahead of us," he said.

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