Global Challenges

U.N. Report Finds Donors Providing Less Aid to Developing Nations

[Sep 05, 2008]

Despite rising food and energy prices and slowing economic growth worldwide, aid to developing nations has been on the decline, according to a United Nations report released on Thursday by U.N. Secretary-General Ban Ki-moon, the New York Times reports. The report found that aid decreased by 8.4% in 2007, following a 4.7% decrease in 2006 (Macfarquhar, New York Times, 9/4). Aid had increased steadily between 1997 and 2005 (AP/USA Today, 9/4). In addition, although the Group of Eight industrialized nations in 2005 pledged to increase aid to Africa by 2010, only $4 billion has been delivered to the continent, according to the report (New York Times, 9/4).

The report -- the first detailed account of commitments to meet the Millennium Development Goals, which include curbing the spread of HIV/AIDS, tuberculosis, malaria and other diseases -- found that aid from donor countries averaged 0.28% of their national incomes. As of last year, the only countries that had met pledges to raise that figure to 0.7% were Denmark, Luxembourg, the Netherlands, Norway and Sweden (Morris, Financial Times, 9/4).

Ban said that the report "sounds a strong alarm," adding that the "main message is that while there has been progress on several counts, delivery on commitments made by member states has been deficient and has fallen behind schedule. We are already in the second half of our contest against poverty. We are running out of time." Lead author Rob Vos of the U.N. Department for Economic and Social Affairs said that over the last two years, "we see ... that development assistance has been going down by all the major donors -- the United States, Japan, but also the European Union." Vos added, "On average, the European Union gives more in relative terms vis-a-vis their national income than the other principal donors, the United States and Japan. But we can say to all of them that they have to step up their efforts to meet the commitments they've made" (AP/USA Today, 9/4).

According to the report, the distribution of medicine to treat HIV/AIDS, malaria and TB has improved, but the supply of affordable drugs remains inadequate. In addition, although debt relief has been provided to 33 out of 41 eligible countries, 52 countries in 2006 spent more money paying off debts than on public health, and 10 allocated more money to debt payments than education (New York Times, 9/4).

Ban said that in order to meet the 2010 targets, commitments for official development assistance from industrialized nations would have to increase by $18 billion annually, including $7.3 billion to Africa. He added that the U.N. plans to host a meeting of world leaders on Sept. 25 "to step up efforts to reach the Millennium Development Goals" (AFP/The Nation, 9/4).

Link to this story.

Ugandan Text Messaging Program Aims To Increase Awareness, Knowledge of HIV/AIDS

[Sep 05, 2008]

A text messaging program using mobile phone technology is being used in western Uganda to increase awareness of and knowledge about HIV/AIDS, IRIN/Plus News reports. The AIDS Information Center in Uganda and Celtel, a local mobile phone network, have partnered with Text to Change, a nongovernmental organization that uses a bulk short message service platform for HIV/AIDS education. The pilot program, launched on Feb. 14, sent an introductory SMS to a list of 15,000 Celtel subscribers asking if they would like to participate in a no-cost interactive quiz about HIV. TTC offered incentives to participants, such as handsets and airtime for correct answers.

The trial program lasted for six to eight weeks and one question was sent each week. Questions -- such as, "What is the difference between HIV and AIDS?", "Have you ever tested for HIV?" and "How is HIV transmitted?" -- were sent to participants, and 2,500 of the 15,000 subscribers contacted responded to each question. After they sent an answer in reply, the participants received a SMS in return either correcting or confirming an answer. Participants were encouraged to go for HIV testing at the end of the trial period. According to Robert Natlaka, AIC's representative, requests for HIV testing at AIC's central facility in the Mbarara district of southwestern Uganda increased by 100% over the six-week period of the trial program. Natlaka said that approximately 225 participants went to the Mbarara center for testing and that others went to AIC partners throughout the district.

TTC public relations officer Bas Hoefman said that if there were "better sensitization and awareness" of the campaign and the questions were written in local languages, more people would respond to the questions. In the next year, TTC plans to expand the program into other districts.

The number of mobile phone users in Uganda is expected to reach six million by the end of 2008, according to the Ugandan Communications Commission. A 2006 Uganda Demographic and Health Survey showed that up to 50% of people in urban areas have mobile phones, compared with 10% in rural areas. According to DHS, about 30% of women and 40% of men in Uganda have comprehensive knowledge of HIV/AIDS, even though almost everyone in the country has heard of the disease (IRIN/PlusNews, 9/4).

Link to this story.

Advocates in Swaziland Call for Democratic Reforms, Social Spending To Address Issues Such as HIV/AIDS

[Sep 05, 2008]

About 1,000 people in the Swazi city of Manzini held a protest on Wednesday, calling for democratic reforms and increased social spending to address issues such as HIV/AIDS in the country, Reuters Africa reports. The protesters were critical of what is anticipated to be an expensive celebration over the weekend for the 40th birthday of King Mswati, which coincides with the country's 40th anniversary of independence from the United Kingdom. Mswati has "courted controversy for his lavish lifestyle" while two-thirds of people in the country live in poverty and 40% of adults live with HIV/AIDS, according to Reuters Africa (Matsebula, Reuters Africa, 9/4).

More than 1,500 women, many of whom are HIV-positive, last month protested against a foreign shopping trip taken by eight of Mswati's 13 wives in what appeared to be the first demonstration in the country by HIV-positive people questioning how money should be spent. Swaziland is facing shortages of medicines, including antiretroviral drugs. The protest was organized by Positive Living, a nongovernmental organization that aims to help women living with HIV (Kaiser Daily HIV/AIDS Report, 8/25)."What is it we are celebrating?" Phille Mlotshwa, who helped organize last month's protest, asked, adding, "Is it the world's highest AIDS rate? The collapse of the health and education system? What are we showing the world that we have achieved?" (Nullis, AP/Minneapolis Star-Tribune, 9/4).

"There's nothing to celebrate," Mario Masuku -- leader of the Peoples Democratic Movement, a banned political party in Swaziland -- said, adding that independence from the United Kingdom was "merely a transfer of power from the colonial rulers to traditional autocracy. The king's resistance to allow democratic change and his super-extravagant lifestyle has taken the country back by decades" (AFP/Moneybiz.com, 9/4). According to Reuters Africa, groups seeking democratic reforms have become more active in Swaziland, and parliamentary elections are scheduled for Sept. 19.

"We are also calling upon government to stop romanticizing corruption but find lasting and effective strategy in dealing with corruption," Jan Sithole, secretary-general of the Swaziland Federation of Trade Unions, said during the protest in Manzini. Sithole added, "Remember, silence means consent with the status quo. This system of government has failed dismally to be responsible to the concerns of the ordinary Swazi citizens and the electorate. Change can only come when civil society and the suffering majority stand up to be counted against such injustice" (Reuters Africa, 9/4).

Link to this story.

Science & Medicine

Seattle Department Finds OraSure HIV Test To Be Less Accurate Than Label Claims

[Sep 05, 2008]

A report by Public Health -- Seattle and King County in Washington state has found that testing with OraSure Technologies' OraQuick test provides less accurate results than the label claims, Bloomberg reports. The OraQuick test is the only rapid test licensed to screen both oral fluids and blood for HIV, according to Bloomberg. Bob Wood, director of the HIV/AIDS control program at the Seattle-based department, said that in 5,460 tests, OraQuick failed to detect at least 8% of 133 people found to be HIV-positive with a comparable diagnostic. This compared with the 0.7% rate given on the test's label.

Elliot Cowan, chief of FDA's Center for Biologics Evaluation and Research Office of Blood Research and Review, said the agency has asked OraSure to investigate the issue. "We're keeping an ear to the phone and making sure they're doing what they're supposed to do," Cowan said, adding, "The ultimate goal is that the package insert appropriately represents the performance of the test." According to Bloomberg, CDC, which recommends testing with blood over oral fluids, also has contacted Seattle officials. Nonetheless, the agency sent a letter to physicians on Aug. 20, voicing support for oral fluid HIV testing and stating that the test has performed well "overall" and is important for increasing the number of people tested for HIV. Richard Wolitski, acting director of CDC's Division of HIV/AIDS Prevention, said, "At this time, based on all the available data, we're not changing our recommendations regarding oral fluid rapid testing."

OraSure Chief Science Officer Stephen Lee said the company tracks the performance of its test and routinely investigates complaints. Lee also said OraSure keeps FDA informed of all the product information it gathers. "All the data that we've accumulated indicates the product continues to perform according to its FDA-approved claims," Lee said.

Wood said that the department has sent its data to physicians and clinics in the area along with a recommendation to test blood rather than oral fluids when possible. "Our recommendation is that people shouldn't use rapid oral tests if they can avoid it, but there are some situations where it can't be avoided and it's better than nothing," Wood said.

According to Wood, Seattle in 2003 began back-up testing of samples screened with OraQuick. A laboratory test, called EIA, showed that OraQuick missed 10 out of 133 patients with HIV antibodies in their blood. Lee said that studies have shown rapid tests to be less sensitive than lab antibody tests, adding that other rapid tests have produced similar results. Seattle officials also tested the samples with a more accurate test that looks for HIV's genetic material. The test can detect more HIV cases because the virus appears in blood before antibodies, according to Bloomberg. When compared with the RNA test, OraQuick missed 17% of cases, according to Wood, who added that the results might be published in a journal in the future (Lauerman, Bloomberg, 9/3).

Link to this story.

Across The Nation

Orlando Sentinel Profiles Home for Transgender People Living With HIV

[Sep 05, 2008]

The Orlando Sentinel on Wednesday profiled the region's first residential home for transgender people living with HIV, which advocates say helps a "unique community that faces discrimination, ignorance and a disproportionate share" of HIV/AIDS cases. Keith Theriot, program manager for Orlando's Housing and Community Development Department, said that the population is "particularly complicated," adding that officials "really want to have a safe and stable environment for our clients that are in need." Michael Vance -- executive director of the Gay, Lesbian, Bisexual Community Center of Central Florida -- said, "When they become homeless, they cannot go to a female homeless shelter because biologically they still have male parts." He added, "But if they go to male shelters, they are often abused, ridiculed and sexually abused."

According to the Sentinel, accommodations for the house were arranged by the city of Orlando's Housing Opportunities for Persons with AIDS program, and the rent is paid by the Center for Multicultural Wellness and Prevention. Residents at the home -- which opened July 1 and is full with four residents -- can access drug rehabilitation services, counseling and medical care to help them become self sufficient. Shannon Minter, legal director for the National Center for Lesbian Rights, said that because many states lack explicit antidiscrimination laws to protect transgender people, they often lose their jobs. "Their options are to die in the streets -- that is literally what happens," Minter said, adding, "There are a significant number of trans-women who are forced into sex work in order to survive, and many end up with HIV." According to the Sentinel, the National Center for Transgender Equality estimates that about three million U.S. residents identify themselves as transgender (Hernandez, Orlando Sentinel, 9/3).

Link to this story.