Kaisernetwork.org (Washington, DC)
25 November 2008
Global Challenges
Kenya Launches Male Circumcision Program
[Nov 25, 2008]
The Kenyan Ministry of Health on Monday launched a voluntary male circumcision program as part of the country's national HIV prevention strategy, the Kenya Broadcasting Corporation reports.
The ministry has allocated one billion Kenyan shillings, or about $13.2 million, for the program over the next two years (Achienga, Kenya Broadcasting Corporation, 11/24). In addition, Family Health International has received an $18.5 million, five-year grant from the Bill & Melinda Gates Foundation to establish the Male Circumcision Consortium in partnership with the Kenyan government, the University of Illinois at Chicago and EngenderHealth. The President's Emergency Plan for AIDS Relief also is supporting the program. The consortium will conduct research and training on the safest and most effective ways to provide male circumcision as part of an HIV prevention strategy.
The consortium's members have consulted officials from the World Health Organization to ensure the consortium's objectives are in line with WHO and UNAIDS recommendations on male circumcision. The consortium will support the Kenyan government and local partners to develop and implement the national male circumcision strategy. It also will expand a research and training center in Kisumu, Kenya, to train providers, increase capacity of health facilities and monitor outcomes. In addition, the consortium aims to address misunderstandings about male circumcision (FHI release, 11/24).
The program will be launched in six districts in Kenya's Nyanza province before being expanded to the rest of the country (Kenya Broadcasting Corporation, 11/24). The initiative aims to reduce HIV prevalence in Kenya by 60%, Public Health and Sanitation Minister James Gesami said Monday at the program launch. Gesami also emphasized the importance of ensuring that all circumcisions are performed in sanitary conditions. "Traditional circumcisers should use septic techniques by not using one knife on several individuals," he said.
WHO Country Representative David Okello said that circumcision should not be seen as an excuse to practice risky behaviors. "Circumcision should be promoted along with other HIV prevention strategies including safer sex, reduction in the number of sexual partners, plus the correct and consistent use of condoms," Okello said (Ndong'a, Capital News, 11/24).
Gesami added that the health ministry will provide no-cost counseling to couples on the benefits of male circumcision to prevent HIV transmission as part of the program. According to the Daily Nation, two-thirds of HIV-positive adults in Kenya are married or in a relationship, and one spouse is HIV-positive in 10% of marriages. Peter Cherutich, head of the national task force on circumcision, said that counseling is critical for couples and that women "have to be involved for the full benefits [of the procedure] to be felt" (Ngirachup, Daily Nation, 11/24).
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Bill To Implant Microchips in 'Sexually Aggressive' HIV-Positive People in Indonesian Province Generates Support, Criticism
[Nov 25, 2008]
An Indonesian bill that includes a bylaw requiring "sexually aggressive" people living with HIV/AIDS to be implanted with microchips is causing debate between some lawmakers, who argue that the bill is necessary to curb the spread of the virus, and advocates, who say the bylaw is discriminatory and a violation of human rights, the AP/Minneapolis Star Tribune reports. According to John Manangsang, a lawmaker who supports the bill, authorities would be able to identify, track and punish people living with HIV/AIDS in the country's province of Papua who intentionally spread the virus with a $5,000 fine or up to six months in jail. In Papua, the HIV prevalence is 15 times the national average at 61 cases per 100,000 people (Karmini, AP/Minneapolis Star Tribune, 11/24).
According to Reuters, Manangsang said the microchip is "a simple technology. A signal from the microchip will track their movements and this will be received by monitoring authorities" (Anjani, Reuters, 11/22). According to the Jakarta Post, the microchips would only be implanted in people living with HIV/AIDS who are labeled as "aggressive." Manangsang said, "Aggressive means actively seeking sexual intercourse" (Flassy, Jakarta Post, 11/22). According to the AP/Star Tribune, a committee would be created to establish which HIV-positive people should be implanted with microchips and to monitor their behavior. The technical and practical details of the bill are still being decided by lawmakers. The provincial parliament of Papua has given its full support to the measure, which will be enacted next month if it receives the expected majority vote (AP/Minneapolis Star Tribune, 11/24). Manangsang said the program is "one way to protect healthy people" and that "real action" must be taken "because 47% of (the country's) HIV/AIDS (cases) are in Papua."
Critics of the bill say it is discriminatory toward people living with HIV/AIDS and a violation of human rights, the Post reports. Constan Karma, executive director of the Papua AIDS Commission, said the law "will violate the rights of people living with HIV/AIDS because they will be implanted with microchips." Gunawan -- a liaison officer of the West Papua chapter of Save Papua -- said that people living with the virus "do not always have sex, especially those with AIDS." He also questioned how officials would measure aggressiveness. Although reported incidents of discrimination against HIV-positive people in Papua have declined, Enita Rouw -- coordinator of the Papua branch of the Indonesian Network of People Infected with HIV -- said that "stigmatization is still there. So please don't use microchips. We are humans, not animals" (Jakarta Post, 11/22). Tahi Ganyang Butarbutar, an advocate in Papua, said that increased funding for sex education and condom promotion would be more effective for addressing the HIV/AIDS epidemic in the region. He also said the people living with the virus "aren't animals; we have to respect their rights" (AP/Minneapolis Star Tribune, 11/24).
Weynand Watari, a lawmaker who supports the bill, said the region's "health situation is extraordinary, so we have to take extraordinary action." According to the AP/Star Tribune, the HIV epidemic in Indonesia is one of the fastest-growing in Asia, with as many as 290,000 cases in the country's population of 235 million. HIV/AIDS in Indonesia primarily is spread through commercial sex work and injection drug use (AP/Minneapolis Star Tribune, 11/24). According to Reuters, the rapid spread of HIV/AIDS in the Papua region primarily is because of inadequate education programs, lack of condoms and partner swapping rituals that take place in the region (Reuters, 11/22). According to the Post, Manangsang said that people should not concentrate solely on the bylaw but should focus on the entirety of the bill, which requires universal HIV testing "so that preventative measures can be taken early on." He also said that "if we respect the rights of the people living with HIV/AIDS, then we must also respect the rights of healthy people" (Jakarta Post, 11/22).
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Nigerian, Ugandan First Ladies Pledge To Work Jointly on HIV/AIDS Issues
[Nov 25, 2008]
Ugandan first lady Janet Museveni and Nigerian first lady Turai Umaru Yar'Adua last week pledged to work together to address HIV/AIDS in their countries, the New Vision/AllAfrica.com reports. The pledge was made in the Nigerian capital of Abuja during Museveni's four-day official visit to the country. Yar'Adua and Museveni were speaking with members of the Nigerian National Women Coalition on AIDS.
According to Yar'Adua, Nigeria and Uganda share several factors that contribute to the spread of HIV, including the fact that poverty, famine, malnutrition and other diseases are widespread in both countries. She added that addressing such issues jointly would work to the advantage of both nations. Yar'Adua also committed to working with Museveni through the Organisation of First Ladies of Africa Against AIDS.
In addition, Museveni said that more serious HIV/AIDS strategies are needed in Africa, with a focus on prevention. "HIV/AIDS has continued to thrive because we have failed to protect ourselves and our children," she said, adding, "We have failed to exercise self control, say no to premarital sex and live faithfully in marriage as embodied in our cultures" (New Vision/AllAfrica.com, 11/21).
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