Kaisernetwork.org (Washington, DC)
29 July 2008
Global Challenges
Latin American, Caribbean Health, Education Ministers To Attend Meeting Ahead of AIDS Conference in Mexico
[Jul 29, 2008]
Ahead of the XVII International AIDS Conference, health and education ministers from 16 Latin American and Caribbean countries will attend a meeting in Mexico on Aug. 1 to develop a common strategy to fight the spread of HIV/AIDS in the region, Mexican Undersecretary for Prevention and Health Promotion Mauricio Hernandez said recently, Prensa Latina reports. "Education for prevention is the most important task that we want to carry out as a joint effort by the governments," Hernandez said, adding that 17 health ministers and 12 education ministers have confirmed their participation in the meeting.
According to Hernandez, a consensus exists among the meeting participants to further government policies that promote comprehensive sex education. In addition, there is a need to focus on young people, Hernandez said, adding that more than 500,000 people ages 14 to 24 in the region are HIV-positive. Hernandez also said that although young people do have knowledge about contraceptive methods, a minority of the population practices safer sex in many countries in Latin America and the Caribbean (Prensa Latina, 7/24).
HIV/AIDS Increasingly Affecting Women in Mexico, Experts Say
In related news, health officials and experts have said recently that HIV/AIDS is increasingly affecting women in Mexico, Xinhuanet reports. According to Jorge Saavedra, director of the National Center for the Prevention and Control of HIV/AIDS, women account for 20% of new HIV/AIDS cases recorded in Mexico, and AIDS-related deaths among women in the country also are increasing. Saavedra added that women are more likely to contract the virus from their husbands or stable sex partners, who often are undocumented immigrants to the U.S. Undocumented immigrants to the U.S. have been a primary source of HIV transmission for Mexican women, Manuel Yanez, professor at the Metropolitan Autonomous University, said, adding that such immigrants often have more sex partners. In addition, undocumented immigrants are more likely to have sex with commercial sex workers without using condoms and use injection drugs, placing them at an increased risk of HIV, Yanez said. He added that although many women know that their partners have sexual relations with other people, they have no power to negotiate sex. According to Axela Romero, general director of the Holistic Health for Women, women in the country also do not have the power to negotiate safer-sex practices because of fears of being mistreated or abused. "So we have women whose husbands swear to keep the fidelity but have sex with other women without protection," Romero said (Xinhuanet, 7/29).
Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference.
Link to this story.
Keeping Kenyan Girls in School, Providing HIV/AIDS, Sex Education Could Reduce Future HIV Cases, Experts Say
[Jul 29, 2008]
Reducing the school dropout rate for girls in Kenya and providing adequate HIV/AIDS and sex education could reduce HIV incidence in the country, experts said recently, IRIN News reports. Rosemarie Muganda-Onyando -- executive director of the Centre for the Study of Adolescence in Nairobi, Kenya -- said, "Young people do not have the information they need, and the dropout rate, particularly for girls, is still too high." She added, "Dropping out of school ensures a life of poverty for these girls, and many of them also wind up HIV-positive because the male-female power dynamics become even more slanted against them."
In 2003, Kenya introduced no-cost primary school education, but an estimated one million school-age children still are not attending school. In addition, up to 13,000 Kenyan girls drop out of school annually as a result of pregnancy, and about 17% of girls have had sex before age 15. HIV prevalence among Kenyan women between ages 15 and 24 is about 5%, compared with 1% for their male counterparts, IRIN News reports. According to the Kenya Demographic and Health Survey of 2004, educated girls were less likely to marry early and more likely to practice family planning. In addition, their children had a higher survival rate. UNICEF also found that uneducated girls are more likely to contract HIV, compared with girls who have had some schooling.
Kenya's Ministry of Education has an HIV/AIDS prevention and sex education curriculum, but no specific classroom time is set aside for it, which leaves schools and teachers to fit the subject in at their discretion. In addition, schools in remote, rural areas, as well as low-income urban areas, often do not have the resources or guidance to teach sex education. Christopher Barassa -- principal of Genesis Joy Primary and Secondary School in Mathare, Nairobi's second largest slum -- said that the school does not "have sex education or HIV education" because the government has not provided any material or training. Muganda-Onyando said, "Not enough teachers have been trained for this type of education, so children are leaving school with academic qualifications and not many life skills." She added, "One of the big problems has been the breakdown of our traditional African systems, where an aunt or grandmother was responsible for sex education ... people say discussions about sex are taboo in Africa, but this is not true. We lost those systems through colonization and modernization, and they haven't been replaced."
According to IRIN News, CSA runs programs aimed at lowering the dropout rate for girls by teaching them about sexual and reproductive health, including HIV. "The projects train teachers to impart life skills, create safe spaces in schools where girls can freely discuss the issues they are facing and foster mentor-protege relationships between older and younger students, so the younger ones have somewhere to turn," Muganda-Onyando said. The initiative has been implemented in more than 100 schools in Kenya and has had positive results so far, IRIN News reports (IRIN News, 7/25).
Link to this story.
Asian Development Bank Manual Aims To Reduce Spread of HIV in Workplace
[Jul 29, 2008]
The Asian Development Bank recently released a manual that aims to reduce the spread of HIV/AIDS in infrastructure project workplaces by providing project developers with information and hands-on tools, the Thai News Service reports. The manual, titled "More Safety: A Resource Manual for Health and Safety in Infrastructure," highlights four steps to increase HIV prevention messages and reduce HIV risk factors in workplaces.
According to the manual, the first step is to establish an HIV prevention management team composed of three to four part-time workers. The team will be responsible for fueling HIV prevention activities in the workplace and local communities. The second step requires the team to assess workers' knowledge of HIV and risky behavior among workers that puts them at increased risk of the virus. After assessing knowledge and risk, the team can then develop an HIV prevention plan, according to the manual.
The third step involves training managers to be HIV/AIDS advocates, provide HIV education to workers and the community, and provide condoms at work sites. The final step in the manual involves monitoring and evaluating workplace HIV prevention strategies.
The manual was developed with a grant from the Poverty Reduction Cooperation Fund and the United Kingdom's Department for International Development, the Thai News Service reports (Thai News Service, 7/28).
The manual is available online.
Link to this story.
Science & Medicine
Six-Week Course of Antiretroviral Nevirapine Did Not Clearly Reduce Risk of HIV Among Breastfed Infants, Study Finds
[Jul 29, 2008]
A six-week extended course of the antiretroviral drug nevirapine did not clearly show a reduced risk of mother-to-child HIV transmission among breastfed infants, according to a study published Saturday in the journal Lancet, the New York Times reports. According to the Times, breastfeeding "presents a life-and-death dilemma" for HIV-positive mothers in developing countries. Although using formula can reduce the risk of MTCT, when formula is mixed with dirty water, it can increase the risk of death among infants from causes such as diarrhea and malnutrition. In most developing nations, women will continue to breastfeed because it is traditional, formula is expensive and because using formula "announces" that a woman is HIV-positive, according to the Times. At least 150,000 infants contract HIV through breastfeeding annually, experts estimate.
In an effort to prevent MTCT, researchers have "stumbled into their own terrible dilemma," the Times reports. A single dose of nevirapine can prevent MTCT, but a single dose is not always effective. In addition, nevirapine can have side effects, and some infants develop liver failure, rashes or low white blood cell counts. Resistance to nevirapine also develops quickly, meaning that an infant who receives nevirapine and still contracts HIV will be unable to combination therapies that contain it or any related drug (McNeil, New York Times, 7/29).
For the study, researchers administered nevirapine to infants in Ethiopia, India and Uganda whose mothers were HIV-positive (Britt, Bloomberg, 7/25). The infants were randomly assigned to receive a single dose of the drug, while the other half received a six-week course (Bollinger et al., Lancet, 7/26). The study found that infants who took daily doses of nevirapine for six weeks reduced their risk of MTCT by 15% (Bloomberg, 7/25). "Although a six-week regimen of daily nevirapine might be associated with a reduction in the risk of HIV transmission at six weeks of age, the lack of a significant reduction in the primary endpoint -- risk of HIV transmission at six months -- suggests that a longer course of daily infant nevirapine to prevent HIV transmission via breastmilk might be more effective where access to affordable and safe replacement feeding is not yet available and where the risks of replacement feeding are high," the researchers wrote (Lancet, 7/26).
However, three members of the research team led by Mrudula Phadke of the Maharshtra University of Health Sciences in Nashik, India, in a letter to the journal wrote that it is "wrong that a drug that has not shown significant benefit and which has serious toxic side effects in 38.4% of babies should be tried for longer." The study's design of six months was based on the 10 to 14 days that it takes nevirapine to build up in infants' blood, the three researchers wrote in the letter, adding that the finding that incidence was lower after six weeks "does not reflect the effect of six weeks of treatment at all." Instead of using nevirapine, HIV/AIDS experts should focus on methods to make infant formula more available and acceptable to HIV-positive mothers in developing countries, the researchers added.
The disagreement among the study's authors is unusual, Lancet editors Pia Pini and Sabine Kleinert wrote in an accompanying commentary. They added that NIH, which funded the study, said there was no "breach of research integrity." They added, "In our opinion, publication of these important data, with complete disclosure, is the best course of action." Jeffrey Stringer and Benjamin Chi from the University of Alabama-Birmingham wrote in an accompanying commentary that "[e]xtended infant prophylaxis with nevirapine is simple enough to be implemented almost anywhere. It represents a long-awaited, if partial, solution to a mother's impossible choice. We should not delay" (Bloomberg, 7/25).
The study is available online. The letter also is available online.
Link to this story.
Opinion
Editorial, Letter to Editor Respond to HIV/AIDS Vaccine Research
[Jul 29, 2008]
Two newspapers recently published an editorial and a letter to the editor in response to the cancellation of an NIH vaccine trial. Summaries appear below.
Editorial
"For nearly two decades, scientists have worked to develop a shot that would ward off the HIV infection that leads to AIDS," but "trial after trial has failed, with the latest and most disappointing setback" announced earlier this month with the cancellation of the NIH trial, a San Francisco Chronicle editorial says. With about 40 million people worldwide living with HIV, there is "no question that work" to develop a vaccine "will continue," the editorial says, adding that more "money than ever is spent on prevention and treatment" and that each year, "more people are receiving treatment, though this help comes after infection." Although educational "programs are also credited with holding down the numbers of people who could" contract the virus, what "everyone is waiting for is a fail-safe vaccine, a medical brick wall that can stop an infection from taking hold," according to the editorial. An HIV/AIDS vaccine "remains frustratingly distant," the editorial says, adding, "For starters, the federal initiative must continue. That means a larger budget for" NIH. Private biotechnology companies "remain leery of heavy investments in a vaccine that could be quickly copied by rivals or face heavy public pressure to limit prices," according to the editorial. It adds that although HIV/AIDS vaccine research is a "towering challenge," it is "one that can't be avoided. An AIDS vaccine must be found" (San Francisco Chronicle, 7/28).
Letter
Joseph O'Neill, New York Times: "Congress, policymakers and AIDS activists, along with researchers, must also rethink their approach to HIV vaccine discovery," O'Neill, former director of the White House Office of AIDS Policy, writes in a Times letter to the editor. According to O'Neill, the "lion's share of financing comes from American taxpayers and is distributed almost exclusively to academic centers." He adds, "The sector most adept at developing vaccines, our biotechnology and research-based pharmaceutical companies, have remained largely on the sidelines." In addition, "[h]ope of return on investment that would have motivated an all-out effort has been eroded by years of popular activism and sanctions ... and overreliance on the academy's ability to develop practical solutions to health problems," O'Neill writes, adding that a multisectoral "approach and redirection of some public resources to stimulate market forces is warranted: the promise of a substantial financial prize to the inventor of an effective vaccine, advance-purchasing commitments and other means of motivating private capital would be a good place to start" (O'Neill, New York Times, 7/25).
Link to this story.
Recent Releases in HIV/AIDS
Report Examines Donor Funding for Health Issues in Low-, Middle-Income Countries
[Jul 29, 2008]
"Donor Funding for Health in Low- and Middle-Income Countries, 2001-2006," Kaiser Family Foundation: The report examines trends in official development assistance for health issues provided by donor governments, such as the U.S. and European countries, and the European Commission and multilateral institutions. According to the report, health funding increased from $7.2 billion in 2001 to $20.1 billion in 2006, an increase of 179%. In addition, health funding represented 17% of overall official development assistance in 2006, an increase from 13% in 2001. The U.S., including funding for the President's Emergency Plan for AIDS Relief, is the single largest donor for health and accounts for one-quarter of all commitments in 2006, according to the report. European nations collectively represent one-third of health assistance, with the European Commission providing an additional 6%. Despite these recent increases, the World Health Organization's Commission on Macroeconomics and Health estimates that funding still does not meet the need (KFF release, 7/28).
A Webcast of a briefing held by the Kaiser Family Foundation and the Center for Strategic and International Studies about outcomes of the recent Group of Eight industrialized nations summit in Japan is available online.
Link to this story.
Be the first to Write a Comment!
Copyright © 2008 Kaisernetwork.org. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com). To contact the copyright holder directly for corrections — or for permission to republish or make other authorized use of this material, click here.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
