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Kaisernetwork.org (Washington, DC)

Africa: Daily HIV/Aids Report

6 December 2007

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New regulations for HIV-positive people visiting the U.S. are more restrictive than the old rules , which prohibited issuance of visas to people living with HIV, critics of the rules said recently, the San Francisco Chronicle reports.

Under the old restrictions, HIV-positive people could visit the U.S. by applying for a waiver to the rules. According to the Chronicle, the waiver process was "cumbersome," and some critics said it was "slow, arbitrary and unfair." President Bush in December 2006 requested the waiver process be streamlined with new administrative rules. Federal authorities occasionally have granted some short-term exceptions to the rules, such as allowing HIV-positive researchers to attend scientific conferences in the U.S., according to the Chronicle.

The new rules were proposed by the Department of Homeland Security and took 11 months to draft. According to some critics, the new rules would require that visitors prove they are bringing with them to the U.S. an "adequate supply of antiretroviral medicines." However, Veronica Nur Valdes, a DHS spokesperson, said the current waiver rules already require that HIV-positive visitors "must be traveling with an adequate supply of drugs." Applicants for a waiver also would have to agree to not extend their visit to the country, and visits would be limited to two 30-day stays annually, according to Victoria Neilson, legal director for Immigration Equality. HIV-positive people who are found to be violating the rules could be permanently banned from entering the U.S. According to the Chronicle, in an effort to cut red tape, the new rules would remove a requirement that applications for a waiver be reviewed by the U.S. Citizenship and Immigration Services and instead would leave waiver decisions to U.S. consular offices worldwide. A public comment period on the new rules is scheduled to expire Thursday.

Reaction

According to the Chronicle, opponents of the new rules are using the deadline for public comment to criticize the rules, as well as the policy that HIV-positive people require special visas to enter the U.S.

Paul Volberding, chief of medicine at the VA Medical Center in San Francisco and an adviser to Physicians for Human Rights, said the new rules are more discriminatory than the old ones. U.S. citizens "travel to other countries for pleasure and business without restrictions," Volberding said, adding that the U.S. places "barriers against those from other countries for a chronic, treatable disease that is not casually spread." He added that requiring local consular offices to make decisions on waiver applications could fuel discrimination because applicants would have to disclose their HIV status to officials in their communities.

Susannah Sirkin, deputy director of PHR, said that only 13 nations worldwide impose similar restrictions on HIV-positive visitors. "These policies are totally counterproductive to our own country's programs to address the global AIDS crisis," she said, adding, "To put possibly more restrictive policies on the table does not serve any public health interest." Nur Valdes said the new rules will improve the process, adding that local consular offices will determine whether waiver applicants have a "controlled state of HIV infection" (Russell, San Francisco Chronicle, 12/6).

Link to this story.

Global Challenges

India Should Target HIV Prevention Efforts at High-Risk Groups, Commentary Says

[Dec 06, 2007]

India should focus its HIV prevention efforts at high-risk groups in light of recent data that found the number of people estimated to be living with HIV/AIDS in the country is half of previous estimates, Lalit Dandona and Rakhi Dandona of the Administrative Staff College of India wrote in a commentary published in the Dec. 1 issue of the Lancet, ANI/Cheers News reports (ANI/Cheers News, 12/4).

Indian Health Minister Anbumani Ramadoss in July announced that the number of people estimated to be living with HIV/AIDS in the country is about 2.47 million, or half of previous estimates, according to United Nations-backed government estimates. The new estimate decreases India's HIV prevalence from 0.9% to 0.36%, Ramadoss said. The new estimate was calculated with the assistance of international agencies, such as the United Nations and USAID. The earlier estimate was based on blood samples taken from pregnant women and high-risk groups, such as injection drug users and commercial sex workers. The new estimate was based on a population-based survey that took blood samples from 102,000 people to determine HIV prevalence among the general population (Kaiser Daily HIV/AIDS Report, 9/5).

According to the authors, in light of the new estimate, India should target its HIV prevention efforts toward high-risk groups -- including commercial sex workers, injection drug users, mobile populations, people with other sexually transmitted infections and men who have sex with men. Other areas of focus should include counseling, testing, blood transfusion safety and preventing mother-to-child transmission of the virus, the authors wrote.

They also said that it is vital for the public health approach to HIV control in the country to become more scientific. "The establishment of a reliable estimate of HIV burden in India is only an initial step," the authors wrote, adding that what is "needed now is more scientific effort to understand the dynamics of HIV spread in India and the impact of interventions on HIV control" (ANI/Cheers News, 12/4).

The commentary is available online.

Link to this story.

Ukrainian President Yushchenko Says Government Has Inadequately Addressed HIV/AIDS

[Dec 06, 2007]

Ukrainian President Victor Yushchenko on Tuesday in a meeting with Cabinet ministers and the Ministry of Health said that the government's work in fighting HIV/AIDS in the country has been inadequate, UNIAN News Agency reports. There are more than 119,000 HIV-positive people and more than 21,000 people living with AIDS in Ukraine, he said.

According to Yushchenko, the government's purchases of antiretroviral drugs lack transparency, which has led to an inconsistency in the supply of medications and compromises in quality. He urged the Office of the Prosecutor General to conduct an investigation of all purchases made by the health ministry. He also highlighted issues with financing HIV/AIDS programs. Although budget growth provided financing for HIV/AIDS programs in 2007, only 50% of the available 98 million hryvnyas, or about $19 million, have been used to fight HIV/AIDS during the past 10 months, according to Yushchenko.

In addition, Yushchenko emphasized that the 112 million hryvnyas, or about $22 million, provided in the draft budget for 2008 is insufficient for treatment, prevention and the purchase of necessary medical equipment. Yushchenko called for all corresponding expenses to be included in the draft budget, saying that he will not sign a budget law that does not include expected expenses from the health ministry (UNAIN News Agency, 12/4).

"I can express a clear assessment of what the government, particularly the health ministry and the relevant subordinate organs, are doing," Yushchenko said. He added, "Unfortunately, it seems to me that there is no work in the system of government that has failed more than the fight against HIV/AIDS." The World Bank estimates that the number of HIV-positive people in Ukraine will increase to 820,000 by 2014 and that people ages 20 to 34 will account for 75% of all new cases by the same year (Ukrainian News, 12/4).

Link to this story.

HIV/AIDS, Gender-Based Violence Interlinked, Zambian National Assembly Speaker Mwanamwambwa Says

[Dec 06, 2007]

Amusaa Mwanamwambwa, speaker of the Zambian National Assembly, recently said that gender-based violence and HIV/AIDS are interlinked and that increased efforts should be made to address the relationship, the Times of Zambia/AllAfrica.com reports.

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