1. Press Release: Asia Pacific Conference on HIV/ AIDS and Governance
New Delhi, 2nd December 2004

"Militarisation and WTO (World Trade Organization) are key challenges in the fight against HIV/ AIDS and poverty" said Rep. Satur C Ocampo, Senator and President of Bayan Muna (People First), Philippines. He was addressing Asia Pacific Conference on HIV/ AIDS and Governance. "Place poverty in the top of the agenda in the fight against HIV/ AIDS" he said.

The fight against HIV/ AIDS in Asia Pacific region received a boost today as People Living with HIV/ AIDS, trade unionists, health and human rights activists, law makers, medical professionals, politicians and international agencies came together for this two days conference. The conference that began today is jointly being organized by Asia Pacific People's Alliance to Combat HIV/ AIDS (APPACHA) and ActionAid International- (AAI).

APPACHA is a new initiative that brings people from various walks of life together (like People living with HIV/ AIDS, trade unions, student and youth groups, health activists and others) in the fight against HIV/ AIDS. AAI works in over 40, countries, some of them `flash points' of the HIV/ AIDS epidemic. "Solidarity, synergy and participation are crucial in addressing HIV/ AIDS and its governance issues" said Mr. K.K. Abraham, President of INP + during the inaugural session. "Getting care and treatment is a challenge" he said. "Epidemic is far from control" said Ms. Chitralekha Yadav, Deputy Speaker of the Royal Nepalese Government. "The existing governance structures are not competent enough to tackle the crisis" she said.

Consider the facts:
- Every 24 hours over 8,000 people die worldwide from HIV/AIDS. Majority of them are poor.
- Last year, the epidemic killed over 3 million people - most of them from Africa.
- 39.4 million people are living with HIV/ AIDS worldwide. This is a big jump from the situation in 2002 when over 36.6 million were affected.
- Women are badly hit. The number of women living with HIV has increased across the world. UN agencies report that close to half of 37.2 million positive adults (aged 15 to 49 years) are women. "The steepest increase is in Asia. In East Asia, there was a 56 % increase in the past 2 years. Eastern Europe and Central Asia comes next with 48 %" said a recent report by UNAIDS.
- In Sub Saharan Africa, the worst AIDS affected region in the world, nearly 60 % adults living with HIV/ AIDS are women- that is 13.3 million, nearly the population of India's capital city, New Delhi.

"Go beyond the numbers and statistics" said John Samuel, International Director, ActionAid International. "Put people first to make the system accountable" he said. The conference is
expected to raise hard questions about the lack of accountability and transparency. Time to do a soul searching- not just for the government, but also for other civil society actors" said Prof. B. Ekbal, former Vice Chancellor of University of Kerala and convener of People's Health Movement- India. "Epidemic and its politics are too complex to be left to any single entity" he said.

"Absence of choices is making people more vulnerable" said Ms. Sonam Yangchen Rana, Senior Advisor, Regional HIV and Development Programme, UNDP, New Delhi. "Integrated responses are necessary" she said. "Media needs to fight the fatigue of reporting HIV/ AIDS" said Ms. Nupur Basu from India, a journalist associated with New Delhi Television. "We are yet to unleash the power of the media" she said. "Patents shouldn't come in the way of accessing essential medicines" said Vivek Divan of Lawyer's Collective, India. The changes in the patent laws, under the directions of WTO, will increase the drug prices several times and thus making it unaffordable for the poor people.

Impact of the HIV/ AIDS epidemic on workers and labour force was reiterated by most of the speakers on this opening day of the conference. The conference is expected to amplify the voices of People Living with HIV/ AIDS and communities they live in. A regional action plan for better governance, strengthening of the primary health care system and access to treatment and care for people living with HIV/AIDS is an expected outcome.

For media enquiries: +91-(0)98450 91319 (Dr. Unnikrishnan PV) +91-98180 65092 (Ms.Kiran Shaheen)
ActionAid International- India; C 88; South Extention Part 2; New Delhi 110 049
--from AIDS_ASIA, 2Dec04
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2. Over 338,900 HIV infections estimated in Myanmar
Xinhua News, Wednesday, December 1, 2004

Yangon - A total of 338,911 people in Myanmar were estimated to have been infected with HIV as of this year, according to a latest figures disclosed by the Ministry of Health. The survey was jointly conducted with United Nations agencies and non-governmental organizations, the sources at the ministry said.

Myanmar has been implementing a three-year joint program (2003- 05) to fight HIV/AIDS. The program, involving the three parties, has been developed to strengthen the enabling environment and supporting capacity for prevention and cure of the disease in the country.

Stressing the role of women in HIV/AIDS prevention and control, the authorities warned that it is not only the risk of HIV infection in women and girls is far higher than that of men but also the impact of the disease is more obvious among women and girls compared to men. In combating HIV/AIDS, Myanmar has introduced two programs of promoting 100 percent condom use and preventing mother-to-child HIV transmission, having expanded the programs to over 50 townships and 22 townships respectively from 44 and 12 in 2002.

According to the National AIDS Program (NAP), Myanmar has also carried out a survey of sexual behavior of people aged between 15 and 49 with the assistance of UNAIDS and UN Children's Fund, and the finding would be used to tailor HIV/AIDS awareness and prevention program to make them more effective.

Meanwhile, the NAP has also been drafting guidelines for voluntary testing for HIV and voluntary counseling for those contracting the virus and the draft is due to complete this year. According to earlier government survey, 68 percent of AIDS cases in the country resulted from heterosexual contract, while 30 percent was caused by injecting drug use and the remaining percent was due to mother-to-child transmission.

Figures of the country's National Drug Center in Yangon also show that about one percent of the blood donors have HIV infections. HIV/AIDS stands as one of the three priority communicable diseases in Myanmar. The others are malaria and tuberculosis.
--from HIV Information Myanmar, 2Dec04
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3. Prison drug use, unsafe sex fueling Asia AIDS epidemic
Wall Street Journal, Wednesday, December 1, 2004

JAKARTA - Unprotected sex and rampant drug use in Asia's overcrowded and run-down prisons is fueling the AIDS epidemic in the region, and governments have been slow to recognize the threat, activists say. Prisons "are HIV factories," said Elizabeth Pisani of Family Health International, an AIDS prevention group in Jakarta. "We are introducing a population that we know to be infected with the virus into an environment where people shoot up drugs and have anal sex." When HIV-positive prisoners are released, there is a high likelihood they will spread the infection, she said.

Rights activists have long called for better conditions in Asian jails, where they allege inmates are routinely beaten, and deadly diseases like tuberculosis and typhoid go unchecked. Medical care in many prisons is substandard or nonexistent and widespread corruption means just about anything - from drugs to sex - can be bought. Few governments in Asia's developing economies keep officials figures on HIV infections among inmates. But private groups say they are rising at an alarming rate.

In Indonesia, prisons that had reported almost no HIV cases among inmates in 1999 had almost 25% of their populations infected in 2003, the National AIDS Commission said. In Thailand, one quarter of inmates at Klong Prem Central Prison on the outskirts of Bangkok have tested positive for HIV , activists say. AIDS disease has also become a leading killer in Cambodian jails. Rising HIV rates in Asian prisons reflect a global trend that has also hit Africa, South America and Russia, the United Nations says. South African prisons have seen death rates surge 500% in recent years largely because of AIDS.

"It probably is much worse than what we expect because prisons represent the lowest common denominator of society," said Anindya Chatterjee, a senior adviser with UNAIDS in Geneva. "These inmates are the underclass and most vulnerable to HIV . We've seen this in Russia. We've seen this in China and we'll definitely see it in Indonesia." Some prisons in Indonesia have started distributing information to new inmates on the dangers of unprotected sex and intravenous drug use and plan to introduce methadone - a heroin substitute prescribed to addicts - in Jakarta and Bali prisons starting this month. But prison officials say they have no money to test inmates for HIV or pay for treatments.

"We know this is a big problem but we've got no money," said Wahid Hussein, an official at the Cipinang Narcotics Prison. "When we see an inmate sick with AIDS, we can't do anything for them." Indonesia, the world's most populous Muslim nation, has refused to follow the lead of European countries and offer free condoms or clean needles for injecting drug users. Officials say doing so would promote gay sex and drug taking. Thailand has begun to offer condoms in some prisons, but it is not providing inmates with clean needles. "OK, so they can't hand out needles - it's too extreme for them to accept," said Somchai Krachangsaeng of advocacy group the AIDS Access Foundation. "But maybe they can tell the prisoners the dangers of using drugs."
--from UNESCAP, 1Dec04
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4. Women ever more vulnerable to HIV/AIDS
The Jakarta Post, Wednesday, November 24, 2004

Jakarta - The Joint United Nations Program on HIV/AIDS (UNAIDS) warned Indonesia on Tuesday that the virus was spreading rapidly among women and girls in the country. The chair of the UN Theme Group on HIV/AIDS, Alan Boulton, said during the launch of AIDS Epidemic Update 2004 here that compared with five years ago, women and girls represented an increasing proportion of people living with HIV/AIDS.

"Research suggests that the main patterns for HIV transmission relate to the commercial sex industry and injecting drug use," said Boulton. The research found that condom use here ranged from irregular to rare. This means that men who are married or in steady relationships who engage in sex outside of the relationship not only are at risk of contracting HIV, but also of passing it on to their wives and partners. According to a senior consultant at the National AIDS Commission, Nafsiah Mboi, from July to September 2004, of 5,701 cases of HIV/AIDS reported in Indonesia some 21 percent involved women.

The number of people living with HIV/AIDS in the country is between 90,000 and 135,000, according to UNAIDS. In its latest epidemic report, UNAIDS said the fight against AIDS was at a critical stage in Asia after a sharp rise in infections driven by the booming sex industry had left more than eight million people in the region living with HIV. Over one million people in Asia were infected with the virus over the past two years alone. The report said HIV rates also were rising sharply in Indonesia and other Asian countries like Nepal, Vietnam and China due to dramatic infection increases among injecting drug users.

"One in two injecting drug users in Jakarta now test positive for HIV, while in cities such as Pontianak (in West Kalimantan) more than 70 percent of drug injectors are being found to be HIV-positive," the report said. Coordinating Minister for People's Welfare Alwi Shihab said in a meeting that followed the launch of the report that many women living with HIV in Indonesia were unaware they had been infected with the virus. "Biologically and socially, women and girls are weaker than men and boys. Many of them are infected not because of their own lifestyle, but from their partners or someone else. A lot of them are ordinary, loyal wives," said the minister.

Boulton said the existing AIDS responses did not help women. "Services that can protect women against HIV must be expanded." Another speaker at the meeting, State Minister for Women's Empowerment Meutia Farida Hatta Swasono, said the promotion of the Abstinence, Be faithful or use a Condom (ABC) principle was not enough to reduce infection rates.

"Premarital sex among girls has become more prevalent and they are doing it without any knowledge or access to HIV infection prevention," said the minister. Meutia also said many young girls were forced into marriage in to support their families. "In many cases, they (the women and the girls) are not in a position to make decisions or protect themselves," she said.
--from AIDS_ASIA, 2Dec04
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5. HIV/AIDS in Viet Nam: Better management of financial resources needed
Community of concerned partners [1] Statement to the consulative group meeting, December 2004
World AIDS Day, 1st December

Today is World AIDS Day. We remember the millions who have already died of AIDS – who are someone’s mother, father, husband, wife – someone’s child. Nearly 40 million people around the world are now living with HIV/AIDS. [2] And East Asia is seeing some of the fastest growing epidemics in the world. According to the UNAIDS/WHO epidemic update: “In East Asia, the 50% increase in HIV infections from 2002-2004 is largely attributable to growing epidemics in China, Indonesia and Viet Nam.”

The growing HIV epidemic in Viet Nam
The Ministry of Health has revised the figures on HIV infection levels in Viet Nam. An estimated 215,000 people were living with HIV by the end of 2003. This is a one-third increase from the previous MOH estimate, and shows that the HIV epidemic is spreading in Viet Nam. One in 75 households now has a family member living with HIV. A million Vietnamese have a direct or extended family member who is infected. And these are young people, with 62% of reported HIV cases aged 20-29 years. This implies serious economic consequences for the nation, with an epidemic among the most economically productive age group.

Increasing national response to the HIV/AIDS epidemic
In response to the increasing effort, the government has called for a strengthened national response to HIV/AIDS. The Prime Minister approved the National Strategy on HIV/AIDS Prevention And Control In Viet Nam Till 2010 With A Vision To 2020 in March 2004. The National Strategy calls for the active involvement of all Ministries, sectors and levels in HIV prevention, and in providing care and support for individual and families coping with HIV/AIDS. The National Strategy emphasizes values of solidarity and compassion, and the social mobilization of all sectors for HIV/AIDS prevention, care and support.

The Party Commission on Culture and Ideology is working to revise the communication guidelines on HIV/AIDS, and the Commission on Science and Education is evaluating the impact of the Party’s Directive on HIV/AIDS. The Viet Nam Women’s Union is providing strong leadership on preventing HIV at community level, and in providing support to families affected by HIV. The Social Affairs Committee of the National Assembly is revising the HIV/AIDS Ordinance, to have a more effective legal and policy response to the epidemic, and to strengthen the rights of people living with HIV/AIDS.

There is also increasing national commitment to the scaling up of treatment for people living with AIDS. The MOH estimates that only about 100 people are on modern ARV treatment through the government sector. Less than 1% of those needing treatment are receiving it; this is one of the lowest rates in East Asia. Many Vietnamese are dying from AIDS, who could be treated, and continue to be productive members of society. The MOH is working to scale up treatment, and the international partners are supporting the MOH to undertake this work as rapidly as possible.

International support, but concerns about the coordination and management of resources
The international side fully supports the Government, National Assembly and Party in this increased effort to prevent the spreading epidemic in Viet Nam, and to provide care and support to people living with HIV, and their families. The UN International financial institutions, bilateral agencies, international NGOs, foundations and others are increasing their technical and financial support for HIV/AIDS programmes in Viet Nam. External financial support is increasing very significantly, and is expected to reach $ 45 – 50 million dollars per year by early 2006.

Such a rapid scale up would naturally challenge any organization, including the MOH. Many donors are concerned about slow approval and implementation rates for AIDS funding. This issue was raised as a major concern at the 2003 CG meeting, and the Government agreed to “fast track” AIDS projects, and to strengthen the management of donor funds for HIV. Donors are also concerned that external funds are concentrated very largely at the MOH. This concentration of funds increases the complexity of the management task for the MOH. And it means that other Ministries and sectors cannot fulfil their assigned duties and responsibilities – because they do not have adequate funding. In line with government policy, stronger efforts at decentralization of AIDS budgets to provincial and local levels also enables a more effective response to this growing epidemic.

This is the second year that donors are expressing a strong concern about the need to improve the coordination and management of external funds for HIV/AIDS. We would now like to move to action on this problem, and to recommend the setting up of a joint working group of international organizations and key Ministries, including the MOH, MOF, MPI, MOLISA and others to identify practical ways to strengthen the management and coordination and use of external funds for HIV/AIDS work, and to monitor the disbursement of funds. Effective action on these issues will help ensure continued donor funding to HIV/AIDS activities in Viet Nam.

Effective leadership needed to address stigma and discrimination
Countries around the world are struggling with the issue of stigma and discrimination against people living with HIV/AIDS. The National Strategy identifies the serious problem of stigma and discrimination in Viet Nam, and calls for action from all sectors, at all levels to address the problem. A number of research studies have documented how widespread discrimination is in the workplace, schools, and the health services. The linkage between HIV and “social evils” continues to exist in many people’s minds, despite the new model of compassion, solidarity and social mobilization in the National Strategy.

Strong leadership is key to addressing stigma and discrimination. The visit of the President to people living with HIV/AIDS in August this year gave strong leadership on the issue. Pham Thi Hue, from Hai Phong, is an example of a courageous woman, speaking out as at person living with HIV, and reminding us all of the realities of living with HIV/AIDS. In spite of the lack of treatment, and continuing stigma and discrimination, people living with HIV/AIDS and their families are beginning to play an important role in the national response as care givers and educators. Along with leadership, the capacity of people living with AIDS to make an effective contribution relies on their ability to easily meet, organize, form organizations, network and communicate. Involving people living with AIDS fully in the national efforts is a critical part of fighting stigma and discrimination.

Global Solidarity
The Community of Concerned Partners stands united with the government and people of Viet Nam to work to prevent HIV, to provide care and support for people living with AIDS. This is a challenge for the whole world. And together in global solidarity, we can fight stigma and discrimination, and ensure the rights and dignity of people living with HIV and their families. This is the best guarantee that our efforts to halt the epidemic will succeed.

Note: [1] Community of Concerned Partners (CCP): is a coalition of stakeholders in Viet Nam concerned with the growing threat HIV/AIDS poses to the people of Viet Nam and to the nation’s development.It consists of local and international NGOs, foundations, bilateral and multilateral donors, UN agencies and others. The goal of the CCP is to engage with the Government and people of Viet Nam to support swift and decisive action to halt the spread of HIV.
[2] UNAIDS and WHO, (2002), AIDS Epidemic Update 2004, Geneva
--from JV Net, 2Dec04
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6. [INTL] UN report sounds grim new warning over AIDS
Turkish Press, Tuesday, November 23, 2004

BRUSSELS - The UN warned that the world is facing a "unique development challenge," as new data showed nearly 40 million people now have HIV and over 3 million will die of AIDS this year, the highest tolls in the 23-year history of the killer disease.

The World Health Organisation (WHO) and UNAIDS named Asia and Eastern Europe as the regions where the AIDS virus is spreading the most swiftly and noted the pandemic was advancing alarmingly among women. Without urgent action "the world is unlikely to gain the upper hand over AIDS," the two United Nations agencies warned bluntly.

"These latest developments firmly establish AIDS as a unique development challenge," said UNAIDS chief Peter Piot, who presented a new report at a Brussels press conference. The time of quick fixes and emergency responses is over. We have to balance the emergency nature of the crisis with the need for sustainable solutions," he added.

In an annual report, "AIDS Epidemic Update," published ahead of World AIDS Day on December 1, the two agencies estimated that 3.1 million people will have died from AIDS in 2004, the most in any one year and 200,000 more than the mortality in 2003. Around 39.4 million people have the human immunodeficiency virus (HIV) which causes the disease, an increase of 1.6 million over the previous year and another record. In 2004, 4.9 million people, the most in any single year, will have become infected by HIV, compared with 4.8 million new cases in 2003, they estimated.

"The number of people living with HIV has been rising in every region," the report said. "(...) A massive effort is needed to achieve a response on that which matches the global AIDS epidemic." It sounded the alarm for East Asia and countries of the former Soviet Union, but said the situation in sub-Saharan Africa, the world's worst-hit region, where more than 25 million people have the AIDS virus, was varied. It made these points:

- East Asia: 1.1 million people have HIV, an increase of 56 percent over the past two years that is mainly attributable to an explosive rise in China, where all 31 provinces are now affected. The disease is being spread in diverse ways, but mainly through sex workers and shared syringes used by injecting drug users. "If China is to shape the course of its epidemic, it needs to move swiftly and with great resolve," the report warned.

- South Asia and Southeast Asia: HIV infections have spiralled upwards, from 6.4 million in 2002 to 7.1 million in 2004, of which 5.1 million live in India -- the highest in the world except for South Africa.

- Eastern europe and Central Asia: Some 1.4 million people have the AIDS virus, compared with a million two years ago. The causes: a resurgence of infections in Ukraine and a relentless rise in Russia, where it is entering the population mainstream through sexual intercourse, after being largely limited to injecting drug users.

- Sub-Saharan Africa: Remains by far the worst-affected region in the world, although the situation varies greatly across the continent. In South Africa, where 5.3 million people are infected, "there is no sign yet of a decline in the epidemic," and HIV prevalence among pregnant women, which in 2003 was already 27.9 percent, is continuing to rise. However, rates have remained stable in much of West and Central Africa and Uganda has seen modest declines.

- Women: Women are increasingly at risk from the spreading pandemic. In 2004, 47 percent of new infections occurred among females, a figure that ranges from 21 percent in Oceania to 57 percent in Africa. Poor education, domination by men and physical susceptibility to the virus are blamed.

- Treatment: Distribution of the anti-retroviral drugs which can hold HIV at bay is widening, but slowly. Around 440,000 people in poorer countries now have access to this medication, yet they account for only 10 percent of those currently in need. "If this low level of coverage continues, five to six million people will die of AIDS in the next two years," the report said. On the positive side, WHO and UNAIDS judged there had been "a sea-change" in funding for the war on AIDS.

"Global funding has increased from roughly 2.1 billion dollars in 2001 to an estimated 6.1 billion in 2004, and access to key prevention and care services has improved markedly," they said. But cash is not enough, they warned. "The big challenge for all of us is to ensure that this money reaches the people who need it," Piot told reporters. "We have the funding, now we have to act," he said.

More than 23 million people have died from AIDS since the disease, caused by destruction of the immune system by a virus, came to light in 1981.
--from UNESCAP, 24NOV04
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7. [INTL] UN health agency reinstates two de-listed AIDS antiretroviral drugs
November 30 2004 10:00AM

New York - The United Nations health agency is reinstating two generic AIDS antiretroviral drugs it de-listed earlier this year after the Indian manufacturer carried out new studies to confirm that the medicines, widely used in developing countries, are as effective as their brand-name counterparts.

"This is good news for patients and another important step forward in our progress towards the 3 by 5 target," World Health Organization (WHO) Director-General Lee Jong-wook said today, referring to the agency's initiative to get 3 million people living with HIV/AIDS in developing and middle-income countries on antiretroviral treatment (ART) by the end of 2005.

The two medicines - Lamivudine 150mg tablet from Cipla Ltd, Kurkumbh and Lamivudine 150mg plus Zidovudine 300mg tablet from Cipla Ltd, Vikhroli - were removed from the international list of medicines available to developing countries because the manufacturer had not ensured they were equivalent to the original medicines they were supposed to copy.

The manufacturer carried out new bioequivalence studies, and further WHO scientific assessment and inspections have validated the compliance of these new studies. In such tests, volunteers take the generic medicines and their blood is tested after a certain time to determine whether the concentration of the generics in their blood is similar to that of the brand-name medicines in other volunteers.

"This shows that generic manufacturers are reacting responsibly to recent de-listings," said Vladimir Lepakhin, WHO Assistant Director-General for Health Technology and Pharmaceuticals. "The prequalification process does work. As well as a list of validated products, it is also a much-needed capacity building effort to promote
quality and safety of medicines in developing countries." A number of new antiretrovirals - including fixed-dose combinations - are currently in the pipeline for WHO assessment.
--from HIV Information Myanmar, 2Dec04
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8. [INTL] Everybody must fight AIDS, Mandela says
Reuters NewMedia, Thursday, November 25, 2004
Jeremy Lovell

LONDON - Former South African President Nelson Mandela, surrounded by rock stars, launched a book of photographs of a major anti-AIDS concert on Thursday with a call to ordinary people to take a lead in the fight against HIV/AIDS. "We all have a responsibility to act. Each of us must do more. We are all leaders now and good leaders must lead," he told a news conference at the book launch in London. The 46664 concert in Cape Town last year took its name from Mandela's prison number during his nearly 27 years in apartheid jails. Some 30 artists from Bob Geldof to Bono took part and the concert was beamed to an audience of up to two billion people. The frail 86-year-old said it was not enough to rely on governments and the international drug companies -- which were not doing enough -- to stop the disease that infects 37.2 million people worldwide.

Joined by Annie Lennox, Brian May, Roger Taylor, Peter Gabriel and Yusuf Islam -- all performers at the Cape Town concert "Mandela declared that "46664 is to raise awareness and inspire acts to fight HIV/AIDS. It shows we all care. Only by working together can we stop the spread of HIV/AIDS. Every HIV infection can be prevented and every AIDS infection
can be treated. Together we can make the dream a reality," he added.

John Samuel, chief executive of the Nelson Mandela Foundation, said he hoped that 46664 would have raised $15 million by the end\ of 2005 from the concert, a DVD, the book of photos and two further concerts next year. Samuel said it was particularly important to put women at the forefront of the campaign to eradicate the killer disease.

"We won't change the world overnight, but we are taking one step at a time," Samuel said, urging Britain, which takes over leadership of the G8 group of leading industrialised countries in
January and the EU presidency in July, to fight for action.
--from AEGIS, 28Nov04
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