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HIV Update International Volume 2, Number 21 In this edition:
Uganda Provides Free HIV Drugs for Pregnant Mothers [Xinhua News Agency, 6/13/02]
Religious Leaders to Address AIDS Crisis The historic meeting -- the first of its kind -- shows that religious leaders are showing an increasing interest in confronting the killer disease, which is devastating the continent. It marks a major turnaround in attitudes. The Catholic Church, for example, has come under fire for its steadfast refusal to endorse the use of condoms as a form of protection against the HIV virus, which causes AIDS. At the end of the three-day assembly, delegates will adopt a Declaration and Plan of Action outlining the commitment of religious communities to address the rights and needs of children affected by AIDS. "At times religious leaders have not done enough on HIV/AIDS. Through our silence and denial we have contributed to increased stigma and exclusion of people living with HIV/AIDS and their families," said Twaib Mukuye, Deputy Mufti of the Ugandan Muslim Supreme Council. "This meeting demonstrates our renewed commitment to confront a disease that is decimating our communities. As spiritual leaders we are here to publicly launch a continent-wide Jihad on AIDS," he added. In recent years, there has been significant progress in tackling the AIDS pandemic in Africa. More and more governments, aid agencies and civil society groups have broken the taboo and started talking to people about AIDS. Some Christian churches have apologized for their earlier head-in-the-sand approach. "We raise our voices to call for an end to silence about this disease -- the silence of stigma, the silence of denial, the silence of fear. We confess that the Church herself has been complicit in this silence. We have raised our voice in the past, (but) it has too often been a voice of condemnation," Anglican primates admitted in April. Meanwhile, the pandemic has continued to roll ahead. Every day, 15,000 people are infected with HIV, 7,000 of them young people. Nearly 14 million children under 15 have been orphaned by AIDS in Africa. Carol Bellamy, director of the U.N. Children's Fund (UNICEF), says this is because there is a second "wall of silence" that needs to be broken down. "This second wall of silence is much more intimate and personal -- and consequently much harder to breach than the first. It is the silence between husbands and wives, parents and children, boyfriends and girlfriends, teachers and students, health workers and patients and also between religious leaders and the people they serve," she says. "It exists because of our discomfort to acknowledge the disease and the factors that drive it. Our reluctance and hesitation to educate our young (people) about sexuality and the dangers of growing up. And our failure to dispel the stigma and counter the discrimination around it. "The second wall of silence is about intimacy, it's about sexuality, it's about relationships. The second wall of silence is about things (that) we usually hold deeply personal, hidden and private. It's this hiddenness that's driving the epidemic." Africa's religious leaders are in a unique position to break this wall of silence. Faith-based groups are in the forefront of service-delivery efforts to the poor and suffering. More than 85% of Africans are active members of religious institutions. Spiritual leaders are among the most trusted and relied-upon sources of information and health care for millions of rural people. Religious leaders can use their respected positions to combat the stigmas and stereotypes associated with AIDS -- something governments and outside advocates have long struggled, and often failed, to do. "Religious leaders have tremendous influence throughout Africa and particularly at the community level where they have the moral authority to advocate for compassionate care and support for those who are HIV-positive and for all vulnerable children," explained Pat Youri, director of the Hope for African Children Initiative. Their "frontline" contacts are another bonus, according to the Hope for African Children Initiative, which is sponsoring the Jun. 10-13 event. Appealing to the religious leaders, Bellamy said: "You're the ones who have trusted personal relationships and the confidence of the people you serve. You have moral authority. And you are on the front lines of this pandemic." "Your colleagues are found in every city, every town, every village and rural district on the continent. You can spread the word about what it takes to confront and beat this terrible disease through your mosques, through your temples, through your churches, through your lay people, your women's groups and your youth organizations. "You have a unique power within your organizations, which, if mobilized, could change the face of this epidemic. The challenge is to realize it," she said. Stephen Lewis, special envoy of the U.N. secretary-general for HIV/AIDS in Africa, laid down this challenge to Africa's spiritual leaders. "When the history of the AIDS pandemic is written, you want it said that every religious leader stood up to be counted; that when the tide turned, the religious leaders did the turning; that when the children of Africa were at horrendous risk, the religious leaders led the rescue mission. "It's what all of us beg you to do. I submit to you that it's what your God, of whatever name, would want you to do," he urged. [Inter Press Service, 6/10/02]
Africa's Clerics Are Urged to Help AIDS Orphans The AIDS pandemic has already left 14 million African children parentless. Many are now cared for by aging grandparents. Others, barely able to care for themselves, are heads of households, minding younger siblings. And hundreds of thousands more live on harsh African streets. As HIV infection has laid waste to communities across Africa, however, the continent's religious leaders have remained largely silent. But Sunday, some of Africa's top clerics gathered in this capital to discuss how the religious community could make up for lost time and become a new voice for the legions of children devastated by AIDS. "Through our silence and denial, we have contributed to increased stigma and exclusion of people living with HIV/AIDS and their families," said Twaib Mukuye, a leader of Uganda's Muslim community. Now "we are here to launch a continent-wide jihad on AIDS." Enlisting leaders of various religious denominations--from traditional healers to Roman Catholic priests--has become a key strategy for U.N. officials and community leaders lobbying on behalf of the 25 million people in sub-Saharan Africa living with HIV. Some African clerics have campaigned for affordable AIDS drugs. Others, including Catholic priests, have challenged the Vatican's opposition to birth control, including condoms. But for the most part, clerics have been reluctant to preach about AIDS and prevention. "We still hear sermons from preachers who say people who are infected deserve that," said Ludfine Opudo, who heads the Kenya chapter of the Society for Women and AIDS in Africa, an advocacy group. "These same people can do immense good if they speak with one voice about people who lose their jobs because they have AIDS, or about children who are disinherited after their parents die, or talk about the general stigma of having AIDS in a developing country," said Opudo, who is HIV positive and the mother of an 8-year-old girl. In Africa, the burden of caring for AIDS orphans has fallen mostly on nongovernmental organizations, along with relatives and friends of the deceased. During the last three years, Leonora Obara has seen her family grow to 10 children, thanks to the five AIDS orphans she has taken into her small home in the Umoja estate, about 15 miles outside Nairobi. After her husband's brother and his wife both died within the last eight months, Obara faced the prospect of watching two nephews and a niece join thousands of Nairobi street children who have nowhere to go. But three years ago, Obara, a 39-year-old social worker, had already brought home two young children who became orphans when one of her clients died. At first, her husband objected to her taking in the orphans, saying their meager annual income--a little more than $10,000--was already stretched thin. He agreed when Obara, a devout Seventh-day Adventist, pointed to scriptures extolling the virtues of caring for widows and orphans. The decision to take in the orphans meant that the Obaras had to rent another room adjacent to their small two-bedroom apartment, which is constructed of concrete blocks. Now, eight girls, ranging in age from 2 to 12, sleep in a small kitchen that has been converted to accommodate five bunk beds. The two boys sleep in a separate room. Her rent, grocery and education bills have increased dramatically, but Obara said she manages to survive without help from anyone. "I don't have a lot of money, but we have a little compassion for these children," she said softly. Many of the 120 clerics attending the three-day gathering here on children and HIV/AIDS will visit orphanages run by nongovernmental organizations, church groups and individuals to see how they could be replicated in their own countries. Clerics will also be given tutorials on caring for and supporting AIDS orphans and developing national strategies to lobby on behalf of AIDS patients. Mercy Manci, a traditional healer from Pretoria, South Africa, who is representing an association that promotes traditional African medicinal systems, said the various religious groups have to forget their theological differences and implement a coordinated plan to help AIDS orphans. The stakes, she said, are high. "Because society has been late in stopping the deaths of their parents, we have to work quickly to save the next generation--before it's too late," she said. [Los Angeles Times, 6/10/02] Zambian Women to Receive Anti-Retrovirals The anti-retroviral drug 'Nevirapine' will be provided under a scheme known as 'Linkages Ndola Project' funded by the United States Agency for International Development (USAID). Tuesday issue of the privately owned Post newspaper quoted the project co-coordinator Jean Tshiula as saying that the pilot scheme officially kicks off next Saturday. Tshiula said his organization has trained 63 healthcare providers, including nurses, pharmacists, midwives and clinical officers who will administer the women during the first year. He said that the anti-retroviral to be imported from Germany has no side effects, adding that the drug has already been tested in Uganda and the US. Zambian First Lady, Maureen Mwanawasa promised pregnant mothers living with HIV in other parts of the country that they will also be served when manufacturers in the US deliver the drugs they pledged to give to Zambia during a recent tour. The country's health minister, Brian Chituwo, recently disclosed that government was working out a mechanism under which people living with HIV/AIDS would receive free anti- retrovirals at all government clinics. [Panafrican News Agency (PANA) Daily Newswire, 6/11/02] H.I.V. Survey in South Africa Suggests Plateau in Infections The reasons for the leveling off were not clear, epidemiologists warned, and it was still too soon to say whether the epidemic would decline from here or had reached what would be a devastatingly high saturation point. Some experts cautioned that the rate of infection could still be quickening. But the health minister, Dr. Manto Tshabalala-Msimang, told reporters in the capital, Pretoria, that for now, "We can confidently say that the prevalence rate has stabilized." Using the results of the survey, epidemiologists estimate that 4.74 million people, of a population of 44 million, are now infected, still the highest number of adults in any country in the world. The survey measures the number of infections year to year among pregnant women, a population considered to provide the most reliable cross-section of social and income groups and one most likely to pass through the health care system. It found an apparent increase in HIV infection among women in their 30s. That more than offset a decrease in infections among younger women, the Health Ministry said. But Dr. Tshabalala-Msimang said the decline in infections among the young indicated that the government's effort to educate young people about the dangers of AIDS might be starting to show results. Among pregnant women under 20, the prevalence rate declined for the third straight year, to 15.4% from 16.1%, and among women 20 to 24, the prevalence rate fell to 28.4% from 29.1%. For women ages 30 to 34, prevalence rose to 25.6% from 23.3%, and among women ages 35 to 39, it rose to 19.3% from 15.8%. Over all, the survey found that 24.8% of pregnant women carried the human immunodeficiency virus, which causes AIDS, up from 24.5%, the health minister said. The percentage differences in many categories were not statistically significant, Dr. Tshabalala-Msimang said, hence the conclusion that the epidemic may be leveling off. Dr. Bernhard Schwartlander, the director of HIV/AIDS programs at the World Health Organization, said the decrease among young people was encouraging but emphasized that South Africa could hardly afford to level off with roughly a quarter of the adult population HIV-positive. "It's good that it's not increasing, but it has stabilized at a very high level, and there is still a very high number of new infections," he said in a telephone interview from Berlin. A plateau in prevalence, he said, is inevitable, as infections eventually reach a saturation point. "The question is, is it going to stay or is it going to decrease." Dr. Salim Abdool Karim, an epidemiologist who is the deputy vice chancellor for research at the University of Natal and a professor of public health at Columbia, said that with the epidemic maturing, it was essential to look beyond the snapshot of the annual survey. More and more people are dying of AIDS, he said, and that means that even if the prevalence rate holds steady, the rate of new infections must be quickening to keep pace with the mortality rate. "The high number of new infections is hidden by the large number of people who are dying," Dr. Abdool Karim said. Why the prevalence appeared to be rising among older age groups was also an important question raised by the survey, which included 16,730 women in public clinics.
[The New York Times, 6/11/02]
WHO Warns of Rapid Spread of AIDS in Afghanistan The United Nations agency is funding the first national survey to investigate the levels of HIV and AIDS in the country while a new nationwide strategy to combat the disease is being drawn up, WHO spokeswoman Loretta Hieber Girardet told reporters. "Currently the major risks in Afghanistan are considered to be intravenous drug use and unsafe blood transfusions," she said. "Afghanistan is one of the world's largest producers of opium. Opium and heroin abuse appear to be more severe in areas where those drugs are produced." The spokeswoman highlighted the fact that neighboring Pakistan, Uzbekistan, Tajikistan and China have all reported outbreaks of HIV among intravenous drug users. Nearly one million Afghans have returned from Pakistan this year and Girardet warned that refugees were particular vulnerable to infection. They were more likely to be subject to "sexual abuse, violence and lack of access to information and education," she said. Poor medical facilities could also contribute to the spread of the disease. "An estimated half of the country's 44 hospitals that perform surgery do not systematically test the blood for HIV before transfusions," said Girardet. "Although WHO and other agencies are working to provide laboratory equipment and training to hospital staff, the safety of blood transfusions cannot yet be guaranteed in Afghanistan." WHO will also take part in a joint working group with the Afghan health ministry which is to draw up a strategy to control the spread of the disease. The strategy is likely to include a major education program and tighter controls in hospitals. Girardet said that "early interventions (were vital) to prevent a potentially rapid spread of HIV in Afghanistan. "Experience has shown that in many war-affected countries HIV can rise within a very short space of time." [Agence France Presse, 6/9/02]
Drug Use Aggravating AIDS Epidemic in Nepal The report by Nepal's health ministry and the National Center for AIDS and STD Control said a worsening drug problem was offsetting the gains of a nationwide campaign to encourage condom use. Official statistics say 2,080 people suffer from HIV or AIDS in Nepal, but unofficial estimates put the number far higher at 70,000. About 50,000 Nepalese use intravenous drugs, according to non-governmental organizations. In Kathmandu, 68 percent of men who inject drugs suffer from HIV, up 50% from three years ago. Some 15% of Kathmandu women who shoot up have the virus, the government study said. "The levels of HIV are high in certain population groups and threaten an increasingly larger portion of the population," said the report, noting that nearly half of intravenous drug users started the habit by age 20. "These young people stand little chance of avoiding HIV infection unless there is an immediate and dramatic increase in HIV prevention activities among intravenous drug users as well as a reduction of initiation into drug use," it said. The report said the epidemic may be most serious in the west of the kingdom, where many young men head to the big cities of neighboring India in search of work and may spread the virus back to their wives in Nepal. The study found that 81% of intravenous drug users practice unsafe sex. In the capital, however, the HIV infection rate among prostitutes seemed to stabilize at about 16% due to increased condom use, it said. The study said there were 236 restaurants in Kathmandu that promoted the sextrade, along with 40 massage parlors and 29 other businesses. [Agence France Presse, 6/9/02]
Fiji Red Cross Takes Lead in HIV/AIDS Care In the National HIV/AIDS Strategic Plan 2001-2003, one the seven priority areas in care and support for people living with HIV/AIDS. One of the implementing agencies identified for this key area was the Fiji Red Cross. "Through its 14 branches, the FRC has the capacity to prevent further spread of HIV/AIDS by acting at household level in our communities through a combination of activities that build on their comparative advantages," Adi Salaseini said. These initiatives Adi Salaseini pointed out are: Developing life skills to reduce the risk of infection particularly among young people, safe blood supply, and prevention of HIV/AIDS infection in complex emergencies such as sexual violence and coercive sex. To date there are 85 known cases of HIV and AIDS cases in Fiji since the first one was registered by the Ministry of Health in 1989. The majority of those infected are in the 20-39 age group, which are the most sexually active and economically productive group. SOURCE: Fijilive web site, Suva, in English 7 Jun 02 [BBC Worldwide Monitoring, 6/7/02]
Zimbabwe; Camera to Zoom in On Stigma Attached to HIV/AIDS Petkun, who last week held an interactive dialogue via satellite with African journalists, will conduct the workshops between June 14 and 20, during which he will consult Zimbabwean photojournalists on the best way to use photographic storytelling to reduce the stigma associated with the incurable disease. He said photographers could facilitate change by showing not only the suffering associated with AIDS, but taking pictures of people infected with the virus that causes AIDS to look "normal", revealing the humanity of people living with HIV. Petkun, who has worked in Kenya and Zambia, pledged to mobilize international film and camera giants Kodak and Fuji to donate cameras and film to African photojournalists to help them capture and illuminate the suffering caused by the HIV/AIDS pandemic. He acknowledged that although Africa possessed untapped photographic talent, the cost of high quality cameras was prohibitive, preventing some photojournalists from fulfilling their potential. He said: "AIDS in Africa is a kind of terror and because there are not enough cameras in Africa, I will see if there is some way I can talk to Fuji and Kodak to donate cameras and film to photojournalists who have engaged in the fight against AIDS by taking pictures which attempt to reduce the stigma associated with it." He urged African leaders to stop plundering the wealth of their countries for petty luxuries while their people languished in pain. "In most African countries, you see leaders who cling to power and use wealth for their own benefit," the photojournalist said. "Resources need to go to the people and these leaders need to be more open to discuss the problems of their people." [Africa News, 6/6/02]The HIV Update International is a weekly report of articles, studies and other information related to HIV/AIDS, sexually transmitted diseases and related risk behaviors from around the world compiled from various news sources by the Children's AIDS Fund. The Children's AIDS Fund is a non-profit, non-partisan organization dedicated to helping limit the suffering of HIV-impacted children through direct assistance and resources, as well as through technical assistance for their parents and care-givers. For additional information call (703) 471-7350. |