WASHINGTON
(Reuters) - U.S. prisons should make condoms available to inmates and test for
HIV as part of a broader effort to curb the spread of AIDS among blacks, hit
disproportionately hard by the incurable disease, experts urged on Thursday.News (Updated November
19, 2006)
[Home] [Previous news]
Fri Nov 17, 12:25 PM ET
The United States vowed its support to help Southeast Asian nations fight AIDS and bird flu and improve the region's ability to cope with the aftermath of natural disasters.
In a joint statement, they said they had set priority areas in which they could improve cooperation between Washington and the 10-member Association of Southeast Asian Nations.
It includes programs to be implemented on improving ASEAN's capacity "to combat emerging infectious diseases," including HIV/AIDS and avian flu.
Washington will also help ASEAN states respond to, and recover from, the impact of natural disasters, combat corruption, promote intellectual property rights protection and study how to develop alternative energy sources.
The statement was issued on the eve of a summit between US President George W. Bush and leaders of seven ASEAN states on the sidelines of the Asia Pacific Economic Cooperation (APEC) meeting in Vietnam.
Three ASEAN members, including military-ruled Myanmar, are outside APEC.
"This is a significant development," a Singapore foreign ministry spokesman said.
"The US has played a unique and irreplaceable role in promoting stability and growth in East Asia, and ASEAN and the US have enjoyed a long-standing, close and fruitful relationship."
Indonesian President Susilo Bambang Yudhoyono said in a speech to business executives here on the margins of the summit that the Asia Pacific region was estimated to account for 70 percent of deaths caused by the world's natural disasters.
More than 200,000 people were killed in Indonesia when a tsunami triggered by an earthquake hit the province of Aceh in December 2004.
It would cover areas such as recruitment, transfers and promotions, and would be applied first in all state government offices, the Hindustan Times said, quoting Maharashtra's health secretary, Vijay Satbir Singh.
The state would ask private-sector firms to adopt the policy after a few months, the paper said.
"Authorities who know about the HIV-positive status of an employee would be required to keep it confidential," Singh was quoted as saying.
There are an estimated 650,000 HIV-infected people living in Maharashtra, India's wealthiest state. The policy, the first for an Indian state, was likely to be announced on Dec. 1 to coincide with World AIDS Day, the paper said.
India recently overtook South Africa as the country with the highest number of people living with HIV -- an estimated 5.7 million, according to the United Nations.
Although India reported its first case 20 years ago, it has yet to enact a law to prevent discrimination against patients, many of whom face acute stigma at home and in the workplace.
General provisions in the Indian constitution against discrimination only apply to the government, state agencies and the public sector, and not private firms, where much of the hostile treatment of HIV-positive people is reported to occur.
She is one of just 18 nurses, five clinical officers and one doctor that staff this district hospital, where the ARV clinic alone provides treatment to 926 patients.
"Each ward is supposed to have three or four nurses, and one nurse is supposed to attend to 10 to 12 patients a day," said Nafere. "But here one nurse is attending to more than 100 patients a day. Do you think she can provide good services?"
The shortage of healthcare workers is a global crisis, but developed countries can afford to throw money at the problem, attracting nurses and doctors from developing countries with vastly better salaries and working conditions.
While the HIV/AIDS epidemic has multiplied the need for doctors and nurses in southern Africa, the pool of workers has shrunk. Those remaining in their countries face a daily, demoralising struggle to manage impossibly heavy patient loads with scare resources. Many take their skills to the private or NGO sectors or flee the profession altogether. An unknown number of others have succumbed to the disease (see sidebar).
In Malawi, the fourth poorest country in the world, where UNAIDS has put HIV prevalence at 14 percent, the health worker shortage is so acute that the ministry of health and international donors are now treating it as an emergency.
"There is a profound human resources crisis in this country," said Dr Michael O'Carroll, a technical advisor the government has appointed to oversee a six-year US$275 million plan to address the problem. "The World Health Organisation says no developing nation can expect to go anywhere without a ratio of one physician to 5,000 of the population. We have one doctor per 60,000, which puts us in one of the worst situations in the world."
Sixty-four percent of nursing posts in Malawi are unfilled and there are 100 doctors working in public hospitals serving a population of 12 million. Anyone requiring the attention of a neurologist, dermatologist or a number of other specialists must travel outside the country.
District hospitals like Nkhata Bay, with an average of 250 beds, should have 175 nurses, said O'Carroll. None has more than 40. "That leads to some very serious issues from a patient point of view, but also for the health workers themselves. You have large numbers of people crying for services and you have nurses that are on their feet 18 hours a day. It's a situation that creates an enormous amount of tension," he said.
Given the scale of the problem, it is something of a miracle that Malawi has managed to keep its ambitious anti-AIDS treatment plan on target. As of the end of September, 70,000 Malawians were accessing antiretroviral (ARV) treatment, about 62,000 of them at public health services. According to the five-year plan, an additional 40,000 patients will begin receiving treatment in 2007 and another 45,000 in each of the following three years.
Dr Bizwick Mwale, director of Malawi's National AIDS Commission, admitted that human resources would be the biggest challenge.
In 2005, with funding from Britain's international development agency (DFID), pubic healthcare workers received a 52 percent wage top-up and a campaign was mounted to lure nurses back from the private sector. Money from the Global Fund to Fight AIDS, Tuberculosis and Malaria is being used to expand the capacity of Malawi's training institutions and provide extra incentives for health workers in remote, rural areas.
Until these efforts yield results, some of the countries that have lured health workers from Malawi are loaning their doctors to fill the gap. About 25 percent to 30 percent of Malawi's doctors are sourced from overseas: some are United Nations volunteers; others come with Britain's Voluntary Services International or through agreements with European governments.
None of these measures is enough to keep pace with the additional 90,000 HIV-infected Malawians who need ARV treatment every year. As ARV clinics at district hospitals rapidly reach their limit, the treatment programme will need to roll out to smaller health centres, where qualified health workers are even scarcer. The only way to move forward, said Mwale, was "to simplify the delivery of ARV treatment".
By developed world standards, Malawi's approach is fairly basic: clinics mainly use diagnostic assessments rather than laboratory tests to determine when patients are ready to begin treatment, and nearly 95 percent of patients are prescribed the same combination of three drugs. After the first six months on treatment, patients are only required to return to clinics once every two or three months.
The next step is to train less qualified health workers to administer the drugs. Rural health centres are usually staffed by one or two nurses and medical assistants, and several health surveillance assistants (HSAs). HSAs are Malawi's least qualified health workers.
Recruited locally, they receive just 10 weeks of training but are an invaluable resource because of their close links with the community. There are 5,200 of them, but the government plans to double that number and train about 1,000 of the new recruits to work exclusively in HIV/AIDS. The eventual goal, explained Mwale, is for HSAs to assist patients who merely need to receive their new drug supplies.
Not everyone is comfortable with cutting corners when it comes to ARV treatment, but no one can deny that the situation demands extreme measures.
"I'm quite worried about further and more rapid scale-up, given the human resources restrictions we're facing," said O'Carroll, "but we have life-saving drugs and we're going to give them to as many people as we can, now."
Sarah Nafere has no plans to leave Malawi for greener pastures, but so far she has seen little evidence of the government's efforts to retain its health workers: "Salaries for we Malawians are not adequate, but I can't leave my relatives suffering here because of money," she said. "If the government can motivate us, if they can renovate our buildings and give us enough money, I think we can improve, we can work happily."
Thu Nov 16, 2006 6:16 PM ET
By Will Dunham
WASHINGTON
(Reuters) - U.S. prisons should make condoms available to inmates and test for
HIV as part of a broader effort to curb the spread of AIDS among blacks, hit
disproportionately hard by the incurable disease, experts urged on Thursday.
The National Minority AIDS Council advocacy group, backed by U.S. black lawmakers and medical leaders, issued a series of recommendations aimed at U.S. policymakers to slow the epidemic among blacks, 10 times more likely than whites to have AIDS.
"In 2006, AIDS in America is a black disease," said Phill Wilson, executive director of the Black AIDS Institute in Los Angeles.
With U.S. black men seven times more likely than whites and three times more likely than Latinos to be imprisoned, the council's report said incarceration has become "one of the most important drivers of HIV infection among African-Americans."
More than half of new U.S. HIV infections are in blacks, according to the Centers for Disease Control and Prevention.
While blacks make up 13 percent of the U.S. population, more than 40 percent of U.S. prisoners are black. The AIDS rate among prisoners is three times the rate in the general public.
HIV, the virus that causes AIDS, most often is spread through sexual contact or intravenous drug use.
Behavior like unprotected homosexual sex and injection drug use raises HIV infection risk in prisons, and the problem is compounded when black men infected in prison then transmit the virus to others after their release, the report stated.
The report urged prisons and jails to make available condoms, along with HIV prevention education programs.
It said condoms are banned or unavailable in 95 percent of U.S. prisons. It said state prisons in Mississippi and Vermont make condoms available, as do county jails in New York City, Philadelphia, Washington, D.C., San Francisco and Los Angeles.
'DOES INDEED OCCUR'
"HIV transmission does indeed occur in prison," said the report's author, Robert Fullilove, professor of clinical sociomedical sciences at Columbia University in New York.
"We certainly need to have each of the prison systems think more thoroughly about the impact that failure to provide condoms can have if there's significant (HIV) transmission within the walls of their facilities," Fullilove added.
The report stated, "Nonprofit organizations, government and public health agencies must be allowed to discuss the relationship between substance abuse and HIV risk and to distribute condoms in prison facilities."
The report also urged prisons to provide voluntary, routine HIV testing of inmates upon entry and release.
It also recommended that governments expand substance abuse prevention programs, drug treatment services and clean needle exchange programs to cut HIV infections caused by injection drug use.
Other recommendations included: expanding HIV prevention education programs, combating discrimination against homosexual and bisexual blacks and supporting more affordable housing to promote stable black communities.
CDC estimates that about 1.1 million Americans are infected with HIV, with blacks making up 47 percent of them.
The HIV virus attacks the immune system and renders the body vulnerable to numerous life-threatening infections and cancers. About 40 percent of the roughly half million Americans who have died of AIDS were black.
The report cited several factors to account for AIDS hitting U.S. blacks hardest, including less access to medical insurance, distrust of the medical establishment and greater homelessness, drug use and levels of incarceration.
HARARE, 16 November (IRIN)
- Zimbabwe's government is launching a five-year plan to combat HIV/AIDS in the
agricultural sector after realising the impact of the pandemic on farming.
The agriculture ministry, which concedes that it has lacked a clear policy on HIV/AIDS, intends to establish an agricultural management information system to monitor various issues related to health and service delivery, and accurately assess the cost of HIV/AIDS to farming communities and the extent to which farmworkers and agricultural-sector employees are vulnerable to the disease.
According to the Zimbabwe Demographic and Health Survey, 18.1 percent of sexually active adult people in a population of about 11.5 million are infected with HIV - the sixth highest prevalence in the world.
"HIV and AIDS is affecting personnel from the agricultural sub-sectors, that is, the ministry of agriculture and its departments, the parastatals under the ministry, private-sector providers, the farming community and agri-business. Therefore, the integrity of the sector should be protected against the impact of HIV and AIDS. In the absence of a strategy, the agricultural-sector response to HIV and AIDS has been erratic and uncoordinated," the ministry said in a statement.
Vulnerability in the agriculture sector was heightened by factors such as worker migrations during harvests, which led to long periods away from their families when they often stayed at centres that "have been identified as hotspots for HIV infection".
"The Ministry of Agriculture and its departments, parastatals and commercial farms have experienced an increase in absenteeism of staff due to illness, attendance of funerals and the need to care for the sick," the ministry commented.
More disturbingly, there has been a "decline in crop varieties, and changes in cropping patterns, as high labour-demanding cash crops may be abandoned", with subsistence farmers being forced to sell cattle and donkeys used for draught power to meet care and treatment expenses.
Around 70 percent of the population depends on agriculture, which provides more than 60 percent of the raw materials used in the manufacturing sector and contributes up to 45 percent of the country's exports.
Low literacy levels in farming communities, caused by a shortage of farm schools, made it difficult to communicate anti-AIDS messages effectively, while "poor housing conditions on commercial farms and in research station compounds result in overcrowding and a breakdown of social norms, ... [which] encourages risky sexual behaviour."
Government's response to HIV/AIDS in the sector has been limited to appointing people to a few positions in the agriculture ministry's headquarters in the capital, Harare, and provincial offices, who merely hand out condoms and basic information without any clear strategy.
The fight against HIV/AIDS in agriculture has been carried out mainly by community-based nongovernmental organisations, farmers' unions and HIV/AIDS service organisations, some of whom have established nutrition and herbal gardens, and community fields for infected and affected people.
Gift Muti, deputy secretary-general of the General Agricultural and Plantation Workers Union (GAPWUZ), which represents some of Zimbabwe's 400,000 farmworkers, welcomed the "positive" initiative, but cited poverty as one of the main reasons for the spread of HIV/AIDS.
"From even before independence [in 1980], farm workers have tended to be poorly paid and live in abject poverty. This makes it easy for them to be infected because women are easily forced into prostitution, while sex is the main source of entertainment, since farm owners only provide them with beerhalls," Muti told IRIN.
Muti, whose poorly funded organisation distributes food to sick farmworkers, said it was common for girls younger than 18 years to marry, while divorce and extra-marital affairs were run of the mill among farmworkers.
Since the government launched its fast-track land reform programme in 2000, in which farmland was redistributed from white farmers to landless blacks, Zimbabwe's economy has gone into freefall. An annual inflation rate hovering around 1,000 percent has seen unemployment rise above 70 percent, while shortages of foreign currency have caused food, fuel and electricity to become scarce commodities.
News from the International HIV/AIDS Alliance 16 November 2006 - for immediate release
A global HIV services gap exists which sees 95% of injecting drug users, 89% of men who have sex with men, and 84% of sex workers without access to basic HIV services. The International HIV/AIDS Alliance is urging action at a session of the International Development Committee taking place on Thursday 16 November.G8 and UN Member State commitments to universal access to HIV prevention, treatment, care and support by 2010 will not be achieved unless services are delivered to marginalised and vulnerable populations, such as sex workers, injecting drug users and men who have sex with men.
At this session the Alliance is also urging: the UK to sponsor a resolution for the creation of a Special Rapporteur on HIV and Human Rights at the UN Human Rights Council; the International Development Committee to convene an international meeting to begin the process of developing an International HIV and Human Rights Action Plan; and the UK Government to appoint a Special Representative for Sexual Minority Rights.
The International Development Committee's session will be looking at the UK's progress in delivering HIV prevention, treatment, care and support services to marginalised populations and the extent to which policy and programming is effectively addressing newer epidemics in Asia, Eastern Europe and Latin America.
Alliance senior policy adviser Joseph O'Reilly will tell the committee that "global commitments to universal access to HIV prevention, treatment, care and support mark a significant development in global AIDS policy. However, so far we have seen little or no attention to the needs of marginalised populations in national planning for universal access."
The Alliance is highlighting: Without a sea change in approaches to reducing the vulnerability of marginalised populations and addressing human rights violations against these groups, universal access to HIV prevention, treatment, care and support will not be realised. Support for AIDS programming from donors must be flexible enough to respond to diversity in the nature of different epidemics. Donors must guard against avoiding funding work that is politically sensitive or ideologically bound.
The Alliance's submission is available at www.aidsalliance.org/IDC
Ends
LAHORE, 14 November (IRIN) - Leaning against his brightly painted truck, Muhammad Rafiq, 30, looks furtively at the two condoms he holds in his hand. "I plan to use these soon, but I hope I can remember to do so when the time comes," he says, a little shyly.
Rafiq, from the town of Kohat in Pakistan's North West Frontier Province (NWFP), is an exception. A long-distance truck driver who regularly transports goods from the southern port city of Karachi to Lahore and up to Peshawar along thousands of kilometres of highway, he says he "quite often" uses a condom, and generally only has sex with women.There are thousands of truck drivers like him, many of them young men from northern parts of the country. Displaced from their home, families and social environments, they are one of the groups most vulnerable to HIV/AIDS, mainly because of the dangerous behaviour they engage in, including multiple sex partners and drug use.
The huge truck terminal at Mauripur in Karachi, one of the busiest in South Asia, sees 20,000 trucks pass through it each day. The terminals in Lahore, including the ones located at Badami Bagh in the congested heart of the city where Rafiq parks his truck, are less busy, but still accommodate thousands of the giant, rumbling vehicles, gaudily decorated with lights, coloured paper and mobiles that spin in the slipstream, arriving from destinations outside the city each day.
According to limited research carried out on the subject, very few among the thousands of long-distance truck drivers in the country are as cautious as Rafiq, who says he picked up information on HIV/AIDS from television, and is anxious to protect his wife from the "incurable illness."
Others among the small gang of truck drivers who Rafiq hangs out with while in Lahore generally confess they do not use any protection. "It is all in Allah's [God's] hands anyway. Besides, a condom is not always available," says Dilshad, from the Attock area of northern Punjab.
He adds that he knows a former truck driver who now has AIDS, but refuses to provide details as this man has sworn him to secrecy. "He was diagnosed by a doctor in Karachi, but he has not told anyone, not even his wife, because of the stigma," explains Dilshad.
"We are aware that long-distance truck drivers are among the groups most at risk from HIV/AIDS," said Raza Hussnain, coordinator of the Islamabad-based Amal Human Development Network, an NGO which since 1994 has been working on raising awareness about HIV/AIDS.
Talking to IRIN, Hussnain explained that the organisation worked with "marginalised communities, and aimed to raise awareness and change the lives of affected people."
The task is not an easy one. There seems, in the minds of many of the truck drivers, to be a strong association of condoms with contraception, but not with protection against sexually transmitted diseases (STDs) including HIV/AIDS.
These gaps in knowledge are largely due to limited official awareness-raising efforts. Categorised by the World Health Organization (WHO) and UNAIDS as a low prevalence, but high-risk country with regards to HIV infection, Pakistan has recently witnessed a rapid rise in rates on infection, mainly among injecting drug users.
According to UNAIDS, about 85,000 people in Pakistan, or 0.1 percent of the adult population, are infected with HIV/AIDS. Heterosexual transmission (52.55 percent) and contaminated blood or blood products (11.73 percent) are the most commonly reported modes of transmission for HIV/AIDS in Pakistan.
This is one of the reasons why the country's long-distance truck drivers are seen as a group particularly at risk. Away from home for prolonged periods of time that sometimes stretch into months, most truck drivers are believed to engage in regular sex with both female and male sex workers, including 'hijras' or transvestites.
The limited studies carried out indicate HIV infection stands at around 1 or 2 percent among female sex workers and long-distance truck drivers.
Among injecting drug users, the rate is much higher. According to a 2004 UNAIDS study, 10 percent of injecting drug users in the town of Larkana, in Sindh province, tested positive for HIV/AIDS.
Ministry of Health findings have found that over 20 percent of female sex workers in Karachi and Lahore had sold sex to injecting drug users and condom use was very low during those encounters.
High intravenous drug use among truck drivers means that the unsafe sexual practices they routinely engage in make them extremely vulnerable to infection.
"Most of us smoke 'charas' [marijuana] or other substances. It is essential if we are to survive the long, relentless hours of monotony on the roads. But now more and more of the truck drivers have also started injecting drugs," says Rafiq. He believes the use of injected drugs is most common among "the younger drivers, some just out of their teens."
While the drivers often seem to be at least vaguely aware of AIDS, they have little real idea of how they can protect themselves from the virus. Many argue that their way of life - the sex with both women and men and the drugs - are a part of a culture of migrant workers in the country that has "been just the same for decades."
"We need some recreation, something to do to relax – otherwise how would we be able to continue with the work we do? Women, sometimes 'hijras' or drugs offer us this relaxation," says Asif Jan, a 25-year-old trucker from Lahore.
Many also confess that rather than doctors, they turn to traditional healers, or 'hakeems', when they are ill or suspect they have contracted an STD. Several hakeems based at tiny clinics on the Grand Trunk Road that winds its way up to Peshawar are well known to the truck-drivers, who depend on their powders and potions.
The lack of interaction with orthodox medical practitioners, coupled with a somewhat confused understanding of the HIV/AIDS issue, means the truck drivers, regularly seen gathered at roadside cafes near the truck terminal in Lahore, are at high risk of infection.
Observes say an awareness programme targeting the group and its specific culture is desperately needed to help reduce their vulnerability and save them and their families from the dangers they face from HIV/AIDS.
JOHANNESBURG, 14 November (IRIN) - South Africa's Ministry of Health has confirmed that close to 6,000 HIV-positive people had died while receiving antiretroviral (ARV) drugs since the government rollout began in 2004.
Health department spokesman Sibani Mngadi said the deaths were a concern, but constituted just below 3 percent of the number of HIV-positive people accessing treatment at government ARV sites during the same period."The number of people being treated with antiretroviral therapy through our [government's] 'Comprehensive Plan on HIV and AIDS' has increased [by] 60,000 in the past year to 235,378 by the end of September 2006," he told IRIN/PlusNews.
He said there might be a number of factors resulting in the death of patients on ARVs, but "they would all be just speculation" without the proper monitoring systems in place.
Doctor Henry Sunpath, of McCord Hospital in the eastern port city of Durban, disagreed with Mngadi and pointed out that the factors encouraging the deaths were all too real.
"These could be anything from fear of stigma and discrimination from both family and community to confusing information about the benefits of ARVs, as publicly expressed by the Health Minister Manto Tshabalala-Msimang herself," said Sunpath.
Tshabalala-Msimang has consistently drawn international criticism for supporting the views of well-known AIDS dissidents, and her controversial promotion of remedies including garlic, beetroot and the African potato as effective means of treating HIV/AIDS.
Sunpath's sentiments are shared by Dr Francois Venter, an HIV specialist at the University of Witwatersrand in Johannesburg, who charged that "it is conflicting views such as these which ... [motivate] scores of people who still turn down or prematurely quit ARV therapy because they are too afraid of the exaggerated side effects."
Some side effects of ARV medication could be fatal, he said, but these were easily avoided with the proper monitoring and care of patients, as were the rare cases of lactic acidosis (a condition caused by the buildup of lactic acid in the body) in patients using Stavudine (also known as Zerit or d4T), which is included in South Africa's free programme.
Venter also pointed out that some could be caused by patients reporting to treatment sites when they were already in the advanced stage of infection.
"This is why the government, together with civil society organisations, needs to share a common goal in the effective rollout of ARVs to the huge numbers in need, with no fatalities in the process," Venter added.
The government is to reveal its revised 'Strategic Plan' in December, which will guide the country's response to AIDS and ensure continuity of the current strategies, as well as introduce additional interventions.
by Catherine Jouault1 hour, 8 minutes ago
With eight HIV positive cases in 2001 and 61
today, Afghanistan is worried a growing use of heroin will add the spread of
AIDS to its long list of problems inherited from decades of war.
The Central Asian country is better known as the world's top producer of opium, the raw ingredient of heroin: about 92 percent of opium comes from Afghanistan's poppies, the United Nations says.
But the fall of the Taliban in 2001 has led to the return of refugees initiated into drug use in camps in neighbouring Pakistan and Iran.
A domestic market has developed, with heroin of good quality made in secret laboratories inside the country and costing relatively little -- at about 300 afghani (six dollars) a gramme compared to 50 afghani for bread.
Counternarcotics Minister Mohammad Zafar said the number of heroin users in Kabul jumped from 7,000 in 2003 to 14,000 last year.
"Forty to 50 percent of refugees use heroin and 20 to 30 percent hashish," he said, putting the total number of drug users in Afghanistan at about one million of its roughly 30 million inhabitants.
"There is a problem because production is always rising. The drug mafia, which could not be operating without protection at a high level, is everywhere and always wants to produce and sell more," Zafar said.
Drug money was also financing anti-government militants including the extremist Taliban, he said.
AIDS could follow the rising drug use, mainly because needles were being shared. Farid Zama, of the Nejat detox centre, said up to 10 people sometimes used a single syringe.
There were 61 confirmed cases of AIDS in Afghanistan today, of which 18 were women and 15 drug users, Health Minister Saifour Rehman said.
"There are between 1,500 and 2,000 suspected cases," he added, with the majority of them using drugs. The shared needles and also the time they spent with sex workers meant they were more likely to get HIV and AIDS, he said.
Rehman, also a doctor, worried about an explosion of the disease.
Authorities were pushing the AIDS 'ABC': Abstinence, Be faithful and wear a Condom, he said. The B is the easiest to get across in this culturally conservative country where religious authorities have a strong influence.
Three nongovernment organisations and a public hospital are also trying to head off what could become a bigger problem for destitute Afghanistan.
The Nejat and Zendegi-e-Nawin detox centres and a section of the Kabul mental health hospital run programmes to help users kick their addiction. Together they have 40 beds for a course that lasts between 10 and 15 days.
The treatment is harsh: shaved heads for hygiene and so hair cannot be torn out in the throes of withdrawal; prison-style uniforms; and cold showers prescribed when the pain gets too much.
French nongovernment group Medecins Du Monde (Doctors of the World) has meanwhile been distributing injection kits since October to cut the risk of disease. The kits are handed out at known places of use and at a centre run by former or currents users.
Heroin substitutes like methadone are not authorised in Afghanistan.
"With the absence of control that we have seen with the disintegration of the country, methadone could find its way out of the pharmacies and into the underground market," said Zafar.
Thu Nov 16, 2:26 PM ET
Greece's HIV rate leapt by more than 25 percent for the second year running in 2006 with 485 new cases, the centre of illness control and prevention (KEELPNO) announced.
The figures up to October 31 demonstrate a "noticeable rise in infections contracted through male homosexual relations," KEELPNO said in a statement. The statistics showed 391 men and 94 women diagnosed with the immune disease.
The authorities announced a "national action plan," after the rise of 2005, which mainly concentrates on awareness.
Greek and international experts have for years decried the lack of information getting through to the general public, particularly through schools where no sex education is taught.
Greece now has 8080 cases of HIV, almost 80 percent of which are men, the centre added.
Two patients were contaminated through blood transfusions in hospital, the centre said. After the contaminations were discovered in March, the health ministry ordered the modernisation of control mechanisms.
The health ministry explained the increase in cases was due to a drop in prevention efforts. The ministry however praised the increasing numbers of people being tested which has been a long-standing cultural problem.