HIV/AIDS Remains Unprecedented Challenge for Sub-Saharan Africa

By, Joe DeCapua, VOA News, May 14, 2008

The World Bank says HIV/AIDS will remain an unprecedented economic, social and human challenge in sub-Saharan Africa for years to come. A new report by the bank calls on African nations to increase efforts at slowing or preventing HIV infection. It estimates there are 22-and-a-half-million people on the continent living with HIV/AIDS, and it says the disease is the leading cause of premature death.

Elizabeth Lule is manager of the World Bank’s AIDS campaign team for Africa. In Washington, she spoke to VOA English to Africa Service reporter Joe De Capua.

“We see, I think, some progress, definitely some positive results with HIV prevalence declining in a number of countries, like Kenya, Zimbabwe, Cote d’Ivoire, Mali and Burkina Faso. But we also see a very diverse picture with a hyper-epidemic in southern Africa and very high prevalence rates in South Africa, Swaziland, Lesotho and Botswana and the burden of disease increasing in those countries,” she says.

With the HIV/AIDS epidemic more than a quarter of a century old, will it continue indefinitely? Lule says, “Definitely for another generation I would say and depending on whether we make the right investments in the right interventions and address the drivers of the epidemic, which are specific to each country. But we have a large pool of survivors from HIV/AIDS and as you know there is no cure…. With anti-retrovirals we have more people surviving, but who are living with HIV/AIDS. And the new infections, although they have stabilized, the absolute numbers actually continue to grow of people living with HIV/AIDS partly because of population growth in African countries.”

The World Bank report says businesses have been hit hard by the disease, claiming the lives of many young, productive workers. It says, “Some private firms in Southern Africa recruit two workers for every job in anticipation of losing staff to the disease.” This continues despite anti-retrovirals being able to make HIV/AIDS more of a chronic disease than a death sentence.

Lule says, “It’s happening because the coverage of people on anti-retrovirals remains dismally low. Only 30 percent of people who need treatment are actually getting it, partly because of very weak health systems. The fact is that human resources in Africa remain a big problem because of the brain drain, but also HIV/AIDS kills off health workers.”

The bank report says that “more than 60 percent of the people living with HIV/AIDS in Africa are women; and that young women are six times more likely to be HIV positive than are young men. As a result of the epidemic, an estimated 11.4 million children under age 18 have lost at least one parent.”

Lule says that interventions are needed to protect young women, who are often vulnerable to infection from older men, who may have multiple partners. Poverty also plays a role, often causing many women and girls to become prostitutes to raise money to feed themselves and their families.

The World Bank’s “Agenda for Action through 2011” includes: advising countries on the complexities of AIDS fund that’s available from such sources as the Global Fund and PEPFAR and building stronger health and financial systems.

Source: http://www.voanews.com/english/Africa/2008-05-14-voa30.cfm

HIV/AIDS Cases Increasing Among Commercial Sex Workers in Uganda

By, Kaiser Network, May 12, 2008

HIV/AIDS cases are increasing among women and girls involved in commercial sex work in Kampala, Uganda, HIV/AIDS advocates said recently, Uganda's Monitor reports.

Robert Kanwagi -- coordinator of the Breaking the Ice Project, which is being implemented by the group Reproductive Health Uganda in Kampala -- said a recent survey found that HIV prevalence among the sex workers in the city was as high as 47.2%, compared with the national prevalence of 6.7%. The survey also found that HIV prevalence is as high as 60% among sex workers ages 25 to 29 and that 59.6% of sex workers were found to have other sexually transmitted infections, such as syphilis and gonorrhea.

Kanwagi, who was speaking at a training workshop on HIV and gender issues, said poverty is the primary reason that women become commercial sex workers. He also said that sex workers lack the authority to negotiate safer sex and that those who offer unprotected sex are paid more money than those who use condoms. The Breaking the Ice Project was launched in July 2007 to expand access to HIV/AIDS services among sex workers in Kampala.

RHU National Program Manager Peter Ibembe said HIV/AIDS is spreading among women and girls because of social, economic and cultural factors that deny them access to HIV prevention and treatment services. "A poor woman or girl may not be able to deny a man sex because she needs money," he said, adding, "Because of their lack of decision-making power in matters of sex, as well as other factors like poverty, they become more exposed to the risk of becoming infected than men" (Nafula, Monitor, 5/9).

Mother To Child HIV Transmission Can Be Prevented

By, Huliq.com, May 2008

Pregnant women with HIV who are diagnosed early and properly treated can deliver healthy children.

A study by University College London examined 5151 HIV positive pregnancies between 2000 and 2006. Women who got proper treatment during pregnancy delivered only 1.2% HIV positive infants. This is a significant improvement, compared to 1990s when mother to child HIV transmission rates were 20%.

The study found that the key to success is the combination of antiretroviral therapy (ART) and antenatal testing for HIV.

Antenatal testing diagnoses HIV in very early stages before the disease seriously affects health. In 2000 HIV early diagnosis rates were 70%, compared to 95% in 2005. The testing method is very successful in early detection, giving more survival chances to patients.

Antiretroviral therapy is very successful when given during at least the last 14 days of pregnancy. ART cuts the risk of mother to child HIV transmission to 0.8%. It is known that C-section delivery cuts the risk for HIV infant delivery, but the study suggests that a proper treatment can allow natural delivery of healthy children.

The study is very promising, but it also mentions that the combined treatment is very expensive even for those living in developed countries. Only 10% of women in these countries can afford such treatment. This is why about 1800 HIV infected infants are born each day.

The study urges the need that the treatment must be affordable for all women. This combined treatment can significantly reduce mother to child HIV transmission rates and ensure delivery of healthy infants. This means that the treatment is extremely important to have a healthy population. -- HULIQ

Source: http://www.huliq.com/58970/mother-child-hiv-transmission-can-be-prevented

U.N. Launches Workplace HIV Program

By, Kaiser Networks, May 7, 2008

United Nations Secretary-General Ban Ki-moon on Tuesday launched U.N. Cares, a new workplace HIV program that will provide such services as training, counseling and testing for U.N. staff and their families, Xinhua/China View reports. The program aims to meet 10 minimum standards -- such as insurance coverage and condom access -- by the end of 2011 by making staff, time and resources more available. U.N. Cares will work in conjunction with the organization's advocacy and support network for HIV-positive employees, as well as address workplace stigma and discrimination. Fifteen U.N. bodies to date have pledged about $1.3 million to U.N. Cares, and Ban on Tuesday said that the U.N. Secretariat will provide about $350,000 as part of an initial contribution.

"Since the early 1990s, the impact of the virus on our work and on the communities we serve has been historic in magnitude," Ban said, adding, "At the same time, our workplace, our staff and our families are profoundly affected." According to Ban, the launch of U.N. Cares represents a "milestone in the U.N. response to HIV." Ban also pledged to make the United Nations a model workplace in its response to HIV/AIDS, adding that the organization's "performance will be only as good as the commitment and contribution of every one of us." In addition, Ban called on U.N. staff to learn essential information about HIV, take measures to protect themselves from contracting the virus and participate in U.N. Cares programs (Xinhua/China View, 5/6).

Why some carriers don't get sick

By, Charlie Fidelman, Montreal Gazette, May 5, 2008

Despite the odds, a tiny group of people infected with the human immunodeficiency virus manage to stay healthy, never showing symptoms of illness.

So what is shielding this special group of HIV-infected people, dubbed "elite controllers," whose bodies control HIV so well the virus remains virtually undetectable? A team of Canadian and U.S. scientists believes it has solved part of the mystery.

Led by Rafick-Pierre Sékaly of the Centre Hospitalier de Université de Montréal, the team has discovered a "memory T cell" mechanism that protects these rare patients from viral diseases.

Published in the advance online edition of the journal Nature Medicine, the researchers explain how a protein in some people's DNA shields against life-threatening immune illnesses.

Moreover, when injected into sick tissue, this key protein - once modified - was able to reverse cell death in defective HIV cells.

The discovery means researchers might have a reliable target for an HIV vaccine, experts said.

It also opens the door to finding new therapies for other killer immune diseases.

"We're also focusing on cancer, another problem for which you need memory T cells," said Elias Haddad, adjunct professor in microbiology and immunology at U de M and McGill University.

Here's how it works: First, it's important to know that HIV infection is characterized by the slow death of memory T cells, which are vital in the defence against immune diseases, Haddad said.

The study compared three groups: an HIV-negative sample, an HIV-positive group whose infection was under control with medication, and a third group (the elite controllers) whose HIV showed no symptoms.

"They were better than healthy," Haddad said of the elites.

The secret of the elite controllers lies in a key protein called FOX03a. This protein induces "bad genes" to kill T cells, Haddad said. But in the elite group, which can fend off HIV infection without medication, the immune system remained resilient "keeping an anti-viral memory," Haddad explained.

That's because the FOX03a protein failed to get into the cell nucleus. Instead, the protein was targeted for destruction, he said.

It also worked in reverse to rescue cells.

"You can induce a long-term survival of memory cells in patients whose cells would otherwise die faster, and improve their quality of life," he said.

The immunological factor discovered by Sékaly's team could turn out to be helpful against other viral infections, said renowned AIDS researcher Mark Wainberg, head of the McGill AIDS Centre.

"It's an excellent study and an important discovery in terms of potential for long term solutions."

An estimated one out of 300 people infected with HIV are considered elite controllers, but they're largely invisible to AIDS researchers because they do not get sick.

Sékaly's team is recruiting elite controllers to take part in the next study. It can be reached at hiv_controllers@umontreal.ca

Source: http://www.canada.com/montrealgazette/story.html?id=c4e75d52-213f-474b-94ed-62ee99aa39fe

HIV infections on the rise in Germany

By, M&C News, May 6, 2008

Berlin - Some 2,752 new cases of HIV were reported in Germany in 2007, a 4-per-cent increase over the previous year, the federal institute responsible for disease control and prevention said Tuesday.

The biggest increase in HIV infections - 12 per cent - was reported in homosexual men, the Robert Koch Institute said. Infections among heterosexuals were down by 7.5 per cent.

There was also a drop in infections among drug addicts and immigrants from countries with a high incidence of AIDS, the institute said.

Around 59,000 people are infected with the virus that leads to AIDS in Germany, Europe's most populous country.

The Robert Koch Institute said most of the new infections occurred in large cities, led by Cologne, Dusseldorf and Berlin.

Source: http://www.monstersandcritics.com/news/health/news/article_1403701.php/HIV_infections_on_the_rise_in_Germany

Indians more prone to HIV-AIDS than others

By, The Times of India, Ashish Sinha,April 26, 2008

The biggest ever gene mapping exercise of the "people of India" has shown that Indians are more vulnerable to HIV-AIDS than many other population groups around the world. This is because a protective gene marker against HIV-1 is virtually absent in India, making the population more at risk.

The study also shows that the risk increases as one moves from north to south India. It also says the Indian gene pool is quite varied and the term or description "Indian" is hardly homogenous. It includes several variations across population groups spread across the country's land mass.

On the vulnerability to HIV-AIDS, the study says, "There is a high-to-low gradient from north to south (India). These results are consistent with the observations by Majumder and Dey in 2001, and the antenatal clinical HIV prevalence survey (2005) that reports a high frequency of HIV in south Indian populations."

The study, released by science and technology minister Kapil Sibal on Friday, was carried out by more than 150 scientists and researchers from six CSIR laboratories. A part of the genetic landscaping were the Centre for Genomic Applications (Delhi) and a host of anthropologists.

Gene study largest since Green Revolution

Perhaps the largest scientific endeavour since ICAR's Green Revolution effort of 1970s, the mapping covered four main linguistic families of Indians — Austro-Asiatic, Tibeto-Burman, Indo-European and Dravidian. It also encompassed the mostly endogamous (marrying within the larger social group) Indian population defined by distinct religious communities, hierarchical castes and subcastes, and isolated tribal groups.

The study, a part of the Indian Genome variation initiative, has generated information on over 4,000 genetic markers from more than 1,000 biomedically important and pharmacogenetically relevant genes in reference groups. The study reveals a high degree of genetic differentiation among Indian ethnic groups and suggests that "pooling" of endogamous populations without regard to "ethno-linguistic factors" will result in false inferences.

"We note that the people of India are referred as 'Indian' in many population genetic studies. The implication of such usage is that the Indian population is genetically homogeneous, which, as the results of our study indicate, is evidently not true. However, we have also shown it is possible to identify large clusters of ethnic groups that have substantial genetic homogeneity," it says.

The mapping is expected to help in constructing "specific drug response/disease predisposition maps" to aid policy decision making for drug dosage interventions and disease risk management, especially for complex and infectious diseases.

Source: http://timesofindia.indiatimes.com/India/Indians_more_prone_to_HIV-AIDS/articleshow/2984007.cms

Thai HIV/AIDS programs overlook children, UNICEF Official Says

By, IRIN PlusNews, April 23, 2008

Thailand's HIV/AIDS prevention and support programs have overlooked the needs of children living with or affected by the virus, Scott Barber, chief of UNICEF's HIV Section in the country's capital of Bangkok, said recently, IRIN News reports.

According to a recent UNICEF report, it is estimated that about 50,000 children under age 15 in East Asia and the Pacific are affected by HIV/AIDS. About 10,000 HIV-positive children in the region were receiving antiretroviral drugs in 2006, a 40% increase from 2005. "Just providing (antiretroviral drugs) is not enough," Barber said, adding that antiretrovirals are "only effective if children take them, and this depends on social support, and the reduction of stigma and discrimination."

Thailand in 2007 endorsed a call made by the Association of Southeast Asian Nations in 2006 to put children at the center of HIV/AIDS strategies in the region, IRIN News reports. Several countries in the region have since implemented national strategies aimed at reducing mother-to-child HIV transmission and addressing the virus among children.

MTCT in Thailand has decreased in recent years, with 80% of HIV-positive pregnant women in the country receiving antiretrovirals. Fiji and Malaysia also have had success in reducing MTCT, according to UNICEF. However, in some developing countries in the region, only 30% of pregnant HIV-positive women receive treatment, IRIN News reports.

Chutima Salsaengjan -- a social worker with the Thai nongovernmental organization We Understand Group, which organizes art and drama programs for children living with HIV/AIDS -- said it is "important to treat [HIV] but also important to help children cope" with the virus. "For children, small things can make a big difference," she said (IRIN News, 4/23).

Thailand: Helping HIV/AIDS children

By, IRIN plusNews, April 23, 2008

As a child, Poel wondered why she fell sick so often, why she was always breaking out in lesions, why she constantly felt tired. The answer seems obvious now - her parents died of HIV/AIDS when she was very young. But the aunt who looked after her never sent her for tests and her status was only discovered when she was admitted to hospital with tuberculosis at 11.

"They gave me medicine," Poel, who lives in Khon Kaen Province in northeast Thailand, and is now 18, told IRIN. "But the pills were very big and hard to swallow. They were made for adults. They should think about the children."

Thailand has long been held up as a shining example of how good policies can help stem the spread of HIV. However, it has overlooked the special needs of children such as Poel.

"Just providing ARVs [antiretroviral drugs] is not enough," says Scott Barber, chief of the UN Children's Fund (UNICEF) HIV section in Bangkok. "They are only effective if children take them and this depends on social support and the reduction of stigma and discrimination.”

In a recent report, UNICEF estimates that across East Asia and the Pacific, some 50,000 children under the age of 15 are affected by HIV or AIDS. About 10,000 received ARVs in 2006 - a 40 percent jump on 2005.

In addition, more countries have national programmes to prevent mothers from passing HIV to their babies and more emphasis is being placed on helping infected children.

In Thailand, parent-to-child transmissions have dropped considerably in recent years, with 80 percent of expectant women receiving ARVs. UNICEF said Fiji and Malaysia have reported similar numbers. But in other developing Asia Pacific nations, fewer than 30 percent of expectant mothers are treated.

Thailand's success is attributed to an aggressive top-down approach. The campaign against HIV/AIDS was instituted more than two decades ago and included a massive public information exercise, efforts to enforce the use of condoms in all commercial sex establishments and, in 2003, a commitment by the government to provide universal ARVs. At least 600,000 people are infected with HIV or AIDS and at least one Thai child is born with the virus every day.

In 2007, Thailand joined its ASEAN neighbours in endorsing a call, made at the 2006 Hanoi Regional Consultation on Children and AIDS, to put children at the centre of the fight against HIV.

Small steps

"For children, small things can make a big difference," says Chutima Salsaengjan, a social worker from the We Understand Group, a Thai NGO that runs art and drama projects for children living with HIV. "It's important to treat the illness, but also important to help the children cope."

For Poel, being diagnosed HIV-positive brought shame and loneliness. "When the people in my village found out, they started to ostracise me," she told IRIN.

Poel said she spent most of her early teens locked up in her bedroom, too afraid to face the world. She hated taking her medicine and going for regular blood tests. It was only when she began participating in art and drama workshops organised by the We Understand Group that her life started turning around. She said she was encouraged to express herself, share her fears and seek support from other children affected by HIV.

The experience inspired her to go back to school and more recently she started mentoring younger members of the art and drama workshops and other HIV-infected youth.

"I like to help people,' she says, admitting that in the process she is also helping herself.

Source: http://www.irinnews.org/Report.aspx?ReportId=77880