Kaisernetwork.org (Washington, DC)
24 August 2007
Across The Nation
New York Gov. Spitzer Signs Measure Allowing Rape Survivors To Request HIV Tests for Indicted Suspects
[Aug 24, 2007]
New York Gov. Eliot Spitzer (D) on Thursday signed into law a measure allowing rape survivors to request that indicted suspects undergo an HIV test, the Rochester Democrat and Chronicle reports (Wiessner, Rochester Democrat and Chronicle, 8/24). The measure requires that indicted suspects be tested under a court order and that the results be provided to the survivor and the suspect (AP/Long Island Newsday, 8/23). The New York Legislature in June approved the measure. The state's current law requires HIV tests after conviction of rape.
Supporters of the measure, which was submitted by the state Division of Criminal Justice Services, said that the measure would help rape survivors have access to all information about the virus before they decide whether to take antiretroviral drugs for post-exposure prophylaxis. However, some opponents said the bill might give rape survivors a false sense of security if suspects test negative, adding that survivors might stop taking antiretrovirals prematurely (Kaiser Daily HIV/AIDS Report, 6/25).
Spitzer in a statement said that sexual assault survivors "have a right to information that impacts their health, ability to receive timely treatment and peace of mind." Assembly member Daniel O'Donnell (D) said that if the person indicted did not commit the rape, then survivors and officials would be "making decisions" based on false information (Rochester Democrat and Chronicle, 8/24). According to the National Conference of State Legislatures, most states either permit or require HIV testing among rape suspects after conviction, the AP/Newsday reports (AP/Long Island Newsday, 8/23).
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Global Challenges
Girls, Women Trafficked in Asia for Commercial Sex Work Emerging as HIV/AIDS Risk Factor, Report Says
[Aug 24, 2007]
Young women and girls in Asia who are trafficked for commercial sex work are emerging as an HIV/AIDS risk factor, according to a report released by the United Nations Wednesday at the 8th International Congress on AIDS in Asia and the Pacific, the AP/PR-Inside.com reports (Nessman, AP/PR-Inside.com, 8/22). The conference brings together more than 2,500 delegates from Asian countries to discuss fighting the spread of HIV/AIDS, as well as providing treatment and support to people living with the disease. An estimated 8.6 million people living in the Asia-Pacific region are HIV-positive (Kaiser Daily HIV/AIDS Report, 8/23).
The report, titled "Human Trafficking and HIV," focused on the estimated 150,000 to 200,000 people from South Asia trafficked and forced into labor annually, usually as sex workers. According to the AP/PR-Inside.com, the number represents only 50% of the people who are trafficked in all of Asia. The report examined the intersection between HIV and trafficking in Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka, the AP/PR-Insider.com reports.
Although there are few reliable statistics about HIV among trafficked people, one study estimated that 25% of trafficked women in Mumbai, India, are HIV-positive, Caitlin Wiesen-Antin, United Nations Development Programme regional HIV/AIDS coordinator in Asia and the Pacific, said. She added that another study found 60% to 70% of 218 trafficked sex workers from Nepal who were later rescued in Mumbai were HIV-positive. According to Wiesen-Antin, the increase in the number of infrastructure projects across the region, as well as the sex work that accompanies project workers, has the potential to further spread HIV across the Asia-Pacific.
The report recommended that governments work to merge their anti-trafficking and HIV prevention efforts. It also called for a renewed focus on issues that make women more vulnerable to both trafficking and HIV transmission, including gender inequality, violence, poverty and a lack of education (AP/PR-Inside.com, 8/22).
"Both human trafficking and HIV greatly threaten human development and security," Wiesen-Antin said, adding, "Neither HIV/AIDS nor human trafficking have been integrated or mainstreamed adequately, either at policy or programmatic levels" (Sirilal, Reuters, 8/22). Wiesen-Antin said that it is "absolutely critical that we take action now" (AP/PR-Inside.com, 8/22).
Conflict, Stigma Hindering Fight Against HIV/AIDS in Region, UNAIDS Official Says
Increasing conflict, stigmatization of HIV-positive people and conservative social attitudes are hindering efforts to fight the virus in the region, Prasada Rao, UNAIDS Asia-Pacific regional director, said at the conference. "The harsh reality is that the grim march of the epidemic in our region continues unabated," Rao said.
According to Rao, recent international HIV/AIDS efforts have focused on India and Thailand, but Bangladesh, China, Indonesia and Pakistan could be the next front lines in the fight against the disease. "These are large countries, and they have the potential of an epidemic to take root, so they need a strong program," he said. Rao added that although there have been some successes in the region, there also are alarming trends, such as efforts from people who oppose condom use and sex education. In addition, increasing conflict in the Asia-Pacific region is hindering HIV prevention and treatment efforts, according to Rao. During the last regional conference two years ago, Nepal was the only Asia-Pacific country experiencing significant conflict, Rao said. He added that eight additional countries currently are experiencing political instability and conflict (Nessman, AP/Guardian, 8/22).
Compulsory Licensing
Rao at the conference also praised Thailand's decision to issue compulsory licenses for two antiretroviral drugs. "Thailand has made a strong statement by invoking a compulsory license for the production of second-line antiretroviral drugs," Rao said. He added, "I urge countries in Asia and the Pacific region to use" World Trade Organization "flexibilities to do more and show more commitment to AIDS responses" (Sathitphattarakul/Treerutkuarkul, Bangkok Post, 8/23).
Colombo Declaration
Representatives at the close of the ICAAP conference on Thursday signed and released the Colombo Declaration, Xinhua/People's Daily reports. The declaration said that countries in the Asia-Pacific have a mix of low and high HIV/AIDS prevalences, adding that countries with low prevalences should work to maintain their statuses by:
Countries also should promote voluntary HIV testing and counseling and provide universal access to antiretroviral treatment, according to the declaration. The document also calls on governments and policymakers to address poverty, gender inequality, social marginalization of vulnerable populations and stigmatization, Xinhua/People's Daily reports.
Conference participants said governments should recognize the rights of women, adding that countries should work to strengthen sexual and reproductive education and reduce mother-to-child HIV transmissions, child marriage and gender violence (Xinhua/People's Daily, 8/23).
Samlee Plianbanchang, WHO's Southeast Asia regional director, said, "In the Asia-Pacific region, we are at high risk of a massive spread of HIV," adding, "This is not only due to the large size of the population and the high burden of sexually transmitted infections, but also due to the prevailing risk behaviors and vulnerabilities as well as inherent social stigma." Experts at the close of the conference said that safeguarding the rights of vulnerable groups -- including sex workers, injection drug users, and trafficked women and children -- is vital and should be done in conjunction with prevention efforts. Conference Chair A.H. Sheriffdeen said, "Governments should recognize rights and listen to the voice of women," adding, "They ... should stop treating drug use as a criminal offence and treat it as [a] public health issue" (Sirilal, Reuters, 8/23).
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U.K., Germany Announce International Partnership To Increase Aid To Fight HIV/AIDS, Other Diseases in Developing Countries
[Aug 24, 2007]
British Prime Minister Gordon Brown and German Chancellor Angela Merkel on Wednesday announced a global health campaign aimed at increasing aid to fight HIV/AIDS and other diseases in developing countries, Reuters reports. The campaign, titled the International Health Partnership, will bring together donor nations -- such as Britain, Canada, Germany and Norway -- as well as the World Health Organization and the World Bank. The partnership, which also aims to reduce child and maternal mortality in developing countries, officially will be launched on Sept. 5. Under the partnership, donor nations will submit long-term health plans, and international groups will pledge to better coordinate funding and on-the-ground efforts (Reuters, 8/22).
Fighting diseases such as HIV/AIDS and reducing child and maternal mortality are included in the U.N. Millennium Development Goals, Brown and Merkel said, adding that the health-related MDGs are least likely to be met by 2015. They added that international aid to address health is "over-complex" and "fragmented" and that a lack of infrastructure in developing countries is hindering efforts to fight HIV/AIDS and other diseases, AFP/Yahoo! News reports. The partnership will link donor support with existing health plans to coordinate health care activities, according to Brown and Merkel.
The leaders hope to create "sustainable health systems" that "deliver improved outcomes," according to a joint statement. They added that the partnership is a "critical step" in meeting the MDGs by 2015. "Our efforts must bring together the private sectors, [nongovernmental organizations], faith groups, international agencies and governments" to "reduce poverty, improve health and provide opportunities for the poor across the world," Brown and Merkel said in the statement (AFP/Yahoo! News, 8/22).
The announcement comes after the Group of Eight industrialized nations in June pledged to increase aid to developing countries. Alison Woodhead, head of health and education for Oxfam, said the partnership could "save lives by coordinating investment in health care that is free, public and well-staffed." Woodhead added that Brown and Merkel should be "congratulated for following through on their G8 promises to improve health care. The challenge for them now is to make sure other countries get on board to ensure maximum impact" (Reuters, 8/22).
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U.S. To Launch Health Care Worker Training Program in Mozambique, Health Minister Announces
[Aug 24, 2007]
The U.S. plans to launch a program to train health care workers in Mozambique in an effort to strengthen the country's health system and fight HIV/AIDS and malaria, Mozambican Health Minister Ivo Garrido announced Wednesday after a meeting with HHS Secretary Mike Leavitt and Mozambican President Armando Guebuza, AIM/AllAfrica.com reports (AIM/AllAfrica.com, 8/22). Leavitt and several U.S. officials are on a 10-day tour of four African countries to highlight programs funded by the President's Emergency Plan for AIDS Relief and the President's Malaria Initiative. Their first stop was South Africa, and they also plan to visit Rwanda and Tanzania (Kaiser Daily HIV/AIDS Report, 8/17).
Guebuza and Leavitt at the meeting discussed Mozambique's health infrastructure and ways to strengthen collaboration on health issues between the two countries. Garrido did not disclose further details on the training program but said priority will be given to health professionals working in rural areas in Mozambique. "We believe that we can do a lot more in this area, being the reason our discussions gravitated around issues such as training of human recourses," Garrido said.
Mozambique has a total of about 800 doctors, and there is about one doctor for every 24,000 residents, according to Garrido. This ratio is "frankly bad, when we consider that on average the developed countries have one doctor for less than 1,000 inhabitants," he said. Leavitt expressed his support for the country's efforts to fight HIV/AIDS and malaria, emphasizing that discussions held with Mozambican authorities will help both countries work together more closely. Current estimates show that Mozambique has an HIV/AIDS prevalence of 16.2%, and malaria is responsible for more than 40% of outpatient visits and 30% of deaths among people admitted to hospitals in the country (AIM/AllAfrica.com, 8/22).
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Recent Releases
PLoS Medicine Examines Effectiveness of Performance-Based Funding To Fight HIV/AIDS, TB, Malaria
[Aug 24, 2007]
"Making Performance-Based Funding Work for Health," PLoS Medicine: Daniel Low-Beer of the Judge Business School at Cambridge University and colleagues examined the effectiveness of performance-based funding to fight HIV/AIDS, tuberculosis and malaria in developing countries. The researchers examined performance-based funding allocated by the Global Fund To Fight AIDS, Tuberculosis and Malaria, which provides money based on demonstrated results and progress toward goals that are set during the initial grant agreement. The study found that 75% of country programs reached their goals and used funding to deliver HIV/AIDS, TB and malaria services. It also found that 21% of the country programs did not reach their goals but demonstrated the potential to increase treatment and prevention efforts and meet future goals. Four percent of the programs had inadequate results, according to the study.
Countries in sub-Saharan Africa and the poorest one-third of participating countries performed no worse than wealthier countries or other regions, according to the study. The researchers said that performance-based funding is effective if goals are set and countries work toward their goals based on individual circumstances. The study concluded that performance-based funding provides an incentive to scale up the fight against HIV/AIDS, TB and malaria (Low-Beer et al., PLoS Medicine, August 2007).
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