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Special Edition (No.2) On 13th ICASA Conference September 27, 2003

Study Confirms VCT Evokes Risk Reduction Behaviour

NAIROBI (AANA) September 27 - Although HIV serologic tests have been around 
since 1985, reports from most of African countries indicate reservations 
about testing.

HIV-positive results are often viewed as a death sentence and are 
accompanied by fear, discrimination, stigma and shame.

Yet most presenters at the just concluded 13th International Conference on 
AIDS and Sexually Transmitted Infections in Africa (ICASA), held here 
September 21-26, tout Voluntary Counselling and Testing (VCT) as one of the 
best interventions for preventing spread of the virus, and putting people 
to care for those infected.

Dr Dorothy Mbori-Ngacha, a senior lecturer at the University of Nairobi and 
consultant for Centre for Disease Control (CDC), presenting a VCT research 
document at the ICASA, said "fear of disclosure, fear of AIDS and the 
bodily changes that accompany the disease, and fear of death, has 
contributed to the low number of clients visiting VCT centres".

Dr Mbori-Ngacha said that currently, available data shows that only 10 
percent of the adult population in Africa know their HIV sero-status, 
partly due to unavailability of the testing equipment, but overly due to
fear.

Many factors such as poor infrastructure, large client numbers where few 
VCT centres exist, inadequate staffing and stigma, contribute to the 
relatively low HIV testing uptake figures in most of Africa.

The study, carried out since 1985, however show that once individuals are 
made aware of their HIV sero-negative status, they are willing and able to 
protect that status if empowered with knowledge and skills that would 
enable them to do so.

A study in Kenya, Tanzania, and Trinidad, showed that the proportion of 
individuals reporting risk reduction behaviour was significantly higher in 
both men and women who had gone for VCT, compared with those who had not.

The main argument is that when a person is found to be negative, he or she 
is counselled on how to avoid contracting the virus. Those found positive 
are also counselled not to spread the virus and how to get care and support.

According to a UNAIDS report of 2001, in Uganda and Senegal, the respective 
AIDS prevalence rates are 0.5 percent and five percent lower where VCT is 
appreciated among other interventions.

Experience with VCT in several countries in Africa such as Uganda, 
Zimbabwe, Malawi, and Kenya, indicate that where quality services exist, 
utilisation is high.

VCT describes a situation where an individual voluntarily requests for HIV 
testing.  The centres apply the ELISA technology, which has a high 
sensitivity and specificity of over 99 percent, and require no special 
equipment.

The simplicity of the technology has allowed trained counsellors to perform 
HIV tests even in the remotest parts of Africa, and are seen as important 
entry points for the fight to manage the impacts of HIV/AIDS.

Reported by Henry Neondo.

AIDS Threatens Peacekeeping Operations, Says Case Study

NAIROBI (AANA) September 27 - A UNAIDS case study in Eritrea says that the 
armed forces, particularly those in peacekeeping missions, face grave 
danger in contracting HIV, but could play a critical role in fighting the 
scourge world-wide.

The case study was released during the 13th  ICASA conference held in 
Nairobi last week (September 21-26).

Titled, Fighting AIDS: HIV/AIDS Prevention and Care Among Armed Forces and 
UN Peacekeepers in Eritrea, the study says that military personnel are 
two-to-five times more likely to contract sexually transmitted infections 
(STIs) than the civilian population, and that during conflicts, this factor 
can increase significantly.

And HIV/AIDS in particular, is cited as posing the greatest threat to 
peacekeeping missions, a pillar of the international security system.

"One-third of the officers and soldiers under UN command are stationed in 
Africa, which is home to 70 percent of people living with HIV/AIDS," notes 
UNAIDS.

According to a report from the US State Department of 1995, "world-wide, 
peacekeeping operations may pose a danger of spreading HIV.  The document 
says that peacekeepers could both be a source of HIV infection to local 
populations, or be infected by them, "thus becoming a source of infection 
when they return back to their homes".

For example, says the report, the HIV infection rate was 11 percent among 
Nigerian peacekeepers who returned home from duty in Sierra Leone and 
Liberia in 2000, when the rate in the civilian adult population in Nigeria 
was 5 percent.

A military analyst with South Africa's Institute of Strategic Studies has 
warned that unless the spread of HIV among armies from high-prevalent 
countries is stopped soon, it is possible that many of these countries will 
be unable to participate in future peacekeeping operations.

This, the analyst says, would be a serious blow since soldiers from 
countries with or approaching high HIV prevalence rates (above 5 percent) 
make up 37 percent of all UN peacekeepers.

The UNAIDS case study highlights groundbreaking work done by uniformed 
personnel in Eritrea to fight the epidemic, particularly efforts made by 
the Eritrea Defence Force (EDF) and UN peacekeeping mission to Ethiopia and 
Eritrea (UNMEE).

The study highlights the first large-scale response to HIV by a UN 
peacekeeping mission since the UN Security Council's Resolution 1308 of 
July 2000, that called on member states to address HIV/AIDS in peacekeeping 
operations.

The EDF recognised early on the need to tackle HIV/AIDS among its young 
servicemen and women, given that around 80 percent of the country's youth 
are conscripted in the defence force, of which 30 percent are women.

The report outlines the progress made in raising awareness of and changing 
attitudes towards HIV among soldiers, encouraging voluntary counselling and 
testing, and providing care and support to HIV-positive personnel.

If equipped with the right information, knowledge and tools, the military 
can achieve lower HIV prevalence rates than the national average. Soldiers 
may also become important agents for behavioural change in reversing the 
spread of HIV within the army and beyond.

Reported by Henry Neondo

WHO, UNAIDS Pledge Support To Third World On ARVs

NAIROBI (AANA) September 27 - The World Health Organisation (WHO) estimates 
that out of the five to six million people in need of antiretroviral (ARV) 
therapy in the developing world, only 300,000 have this access.

Speaking at a joint press conference with UNAIDS on September 24, the WHO 
Director of HIV/AIDS Department, Dr Paulo Teixeira, said that such failure 
was to him, negligence by the world community, and in particular,
governments.

To address the emergency, Dr Teixeira revealed that WHO was committed to 
getting three million people on ARVs by the end of 2005.

He said WHO will lead the effort alongside UNAIDS and other partners, using 
skills and experience in co-ordinating global response to diseases.

The world health body therefore intends to, among other things, provide 
Emergency Response Teams at the request of governments.  Highly burdened 
countries will be given preference.

The organisation will establish AIDS Drugs and Diagnostic Facility, and 
publish simplified treatment guidelines by December 1.

According to Dr Teixeira, the 3 million target by the end 2005 was urgent 
because more than 20 million people have died of AIDS and at least 42 
million more are infected.

The hardest hit region, he said, was sub-Saharan Africa, with one out of 
ten adults (more than 28.5 million people) currently living with HIV/AIDS, 
out of a total population of 291 million.

The UNAIDS Executive Director, Dr Peter Piot added that increased access to 
comprehensive HIV care and support, including antiretroviral medicines and 
treatment for HIV-related opportunistic infections, was a global priority.

He also expressed concern that treatment and care were not reaching the 
vast majority of people in need.  In his opinion, priority should be in 
care, which he said is a vital and powerful investment that directly 
benefits people living with HIV/AIDS because it reduces the social and 
economic impact, as it boosts prevention efforts.

He expressed appreciation that there was a steady fall in the prices of 
ARVs since the end of 2000.

At the beginning of that year, the price of Highly Active Antiretroviral 
Therapy (HAART, also referred to as triple therapy) for one patient for a 
year was US$10,000-12,000, but had dropped to US$500-800 per person per 
year, towards the end of the year.

By May this year, the least expensive branded ARV combination recommended 
by WHO for lower income countries was approximately US$ 75 person per year, 
while the least expensive generic combination, also recommended by WHO, was 
just under US$ 300 per person per year.

Dr Piot, however, noted that in low and middle-income countries, even where 
ARV generic drugs were being manufactured and offered domestically, still 
only a fraction of those in need were receiving treatment.

By the end of 2002, for example, of the global 800,000 people on ARVs, 
500,000 were in high-income countries. Yet in sub-Saharan Africa, where an 
estimated 2.3 million people died of AIDS in 2002, only 50,000 were on 
treatment.

Similarly in Asia and the Pacific, where an estimated 485,000 people died 
of AIDS in the same period, only 43,000 people were receiving ARV treatment.

He noted therefore, that even with greatly reduced drug prices in 
low-income countries with high AIDS prevalence, there was still need for a 
significant external financial support to provide antiretrovirals to all 
those in need.

Reported by Joseph K'Amolo

  Catholic Church In Kenya Launches Book On HIV/AIDS

NAIROBI (AANA) September 27 - The Catholic Church in Kenya has launched a 
book in response to HIV/AIDS.

Presiding over the occasion, the Archbishop of Nairobi, Raphael Ndingi 
Mwana a' Nzeki, urged "everyone" to engaged in the war on the pandemic for 
it to be won.

The book, titled, Inventory of the Catholic Church's Response Against 
HIV/AIDS in Kenya, is an account of how the Church has been tackling the 
problem.  It is the product of a survey carried by the Catholic Church, and 
an ICASA Task Force meeting since may.

Archbishop Ndingi said the task force sought to offer delegates attending 
the just ended 13th ICASA a realistic picture of how the Church in the host 
country was responding to HIV/AIDS.

The primate urged rich nations to help poor nations in combating the 
pandemic. "AIDS is not witchcraft, it is real and is killing many of our 
people, rich or poor, young and old," he added.

"This is a world catastrophe no one is immune to. We should all go all-out 
to eradicate the disease. Parents should talk to their children in the best 
language they understand. They should never feel scandalised. It is killing 
us," he continued.

The information contained in the booklet, which details the HIV/AIDS 
situation in Kenya, is intended to guide the Catholic Church in responding 
to the pandemic.

The project was funded by the Catholic Relief Services (CRS), Development 
and Peace, Cordaid, Cafod, Caritas Italian, Tracaire and African Jesuit 
AIDS Network.

The survey was carried by Koinonia Advisory Research and Development 
Services and Jesuit Hekima Centre, both based in Nairobi.

The launching was preceded by holy mass in memory of all who have succumbed 
to the killer disease.

Reported by Zacharia Chiliswa

Businesses Community Takes Up Challenge Against AIDS

NAIROBI (AANA) September 27 - Although the business community wishes to 
join governments in fighting HIV/AIDS pandemic, the challenge is that 
governments need to put in place policies and frameworks on which the two 
could partner, said Patricia Mugambi, Corporate Public Relations Officer of 
the Global Business Coalition.

Speaking here on Thursday during the 13th ICASA, Ms Mugambi said that the 
business world could not replace governments, no matter the urgency and the 
need to intervene on HIV/AIDS.

"The business coalition is interested in fighting the scourge on all 
fronts. Those who suffer and die from it are employees, their employees' 
spouses or their employees' children," said Mugambi.

According to Trevor Neilson, Executive Director of the Global Business 
Coalition on HIV/AIDS (GBC), "it is in the direct economic interest of 
every business operating in Africa to make AIDS its business".

More and more major corporations are now implementing prevention, testing 
and treatment programmes for their workers and communities.

"However, if we are to have a sustained impact, African governments and 
international donors must involve business programs and expertise in their 
AIDS emergency strategies," added Trevor.

"No company or individual of conscience and conviction can ignore the 
horrible and tragic AIDS pandemic," Chris Kirubi, Chairman of the Kenya 
HIV/AIDS Business Council, said.

He added that the most immediate way businesses can take action on HIV/AIDS 
was by protecting its most valuable resource - employees. "Investing in 
AIDS is investing for the future of humanity," said Kirubi.

Reeta Roy, Divisional Vice President of Global Citizenship and Policy at 
Abbott Laboratories, noted that building capacity in terms of functioning 
hospitals and clinics, as well as trained doctors and nurses, is critical 
to expanding access.

"As a business community, working with governments and NGOs, we have the 
opportunity to impact the course of this disease in Africa," stated Roy

In partnership with governments and civil society, companies offer unique 
skills and expertise to fight the epidemic.  Mugambi said that companies do 
this by applying their core competencies to improve HIV/AIDS programmes 
around the world.

They support national AIDS campaigns through high level advocacy to change 
public attitudes using their advertising and marketing skills, provide 
HIV/AIDS workplace programmes, testing and treatment and supporting local 
communities.

GBC brings together close to 120 leading national and international 
business organisations responding to HIV/AIDS scourge.

But the future challenge, according to Mugambi, is what to do with 
employees during post employment or death, saying that the business 
coalition is still looking for the best way out.

Reported by Henry Neondo