Press Releases

GlobalPost: US Reveals Nearly $1.5 Billion in Unspent AIDS Money

Tue, 17 Apr 2012 14:20:00 -0400

WASHINGTON – The Obama administration has set extraordinarily high goals in its fight against AIDS around the world. Secretary of State Hillary Rodham Clinton said late last year that an “AIDS-free generation” is possible. And President Obama promised last December that the number of US-supported AIDS patients on treatment would rise to 6 million by the end of next year, up from the current 4 million.

So why did the administration submit a fiscal year 2013 budget that called for a $550 million reduction — an 11 percent cut — in its global AIDS program?

GlobalPost put that question to the Obama administration several weeks ago and US officials responded, saying that the government didn’t need more money because there has been nearly $1.5 billion stuck in the pipeline for 18 months or more.

In an interview with GlobalPost, Ambassador Eric Goosby, global AIDS coordinator, explained that $1.46 billion designated to fight AIDS hasn’t been used because of inefficient bureaucracies; major reductions in the cost of AIDS treatment; delays due to long negotiations on realigning programs with recipient country priorities; and a slowdown in a few countries because the AIDS problem was much smaller than originally estimated.

“What we’re doing is defining what money is available, and what’s left are our resources that we will put back into AIDS-free generation type activities — things that will not require continued year funding, could be a one-time funding effort,” Goosby said.

Prompted by the GlobalPost inquiry, Goosby’s office said this week it will immediately start a consultation period with Congress, its partners across the US government and AIDS advocates to address a key question: What should they do with $1.46 billion?

While this could create an unexpected windfall for some programs, it also means that several countries that have not spent the funds will lose tens or hundreds of millions of dollars. The key loser appears to be Kenya, which has had a half-billion dollars — roughly one-third the total amount in the pipeline — that has been accumulating in the US Treasury unspent for more than 18 months after Congress appropriated the money.

In the eight years of US funding of AIDS globally, Congress has appropriated $37.9 billion, amounting to the largest government program ever to fight a single disease, an initiative started by President George W. Bush known as the President’s Emergency Plan for AIDS Relief, or PEPFAR. It has won wide bipartisan support from the start because of its success in saving millions of lives of Africans with AIDS and helped shore up dysfunctional health systems in some of the poorest parts of the world.

But from the start it has been a challenge to spend the money in many countries because many places could not absorb it quickly enough.

Of the $37.9 billion authorized to fight AIDS, $28.9 billion was spent by March 2012, leaving $9 billion in the pipeline, according to figures provided by the US Office of the Global AIDS Coordinator. And of that $9 billion, roughly $7.6 billion is earmarked for programs or is within the acceptable range of 12 to 18 months worth of money in reserve for overseas development programs, State Department officials said.

But the $1.46 billion has been sitting too long — US officials called it a “bad pipeline” — and the officials said in several interviews over the past few weeks that they now will start a process of removing the unspent funds from country ledgers. Senior officials said this week that they have drawn up internal broad guidelines on how they would spend the money and now will move toward identifying specific programs to fund.

To put this in perspective, $1.46 billion is roughly three times the annual amount the US government spent on AIDS globally a decade ago.

Goosby said his office has been aware of a growing pipeline of unspent money for the last two years, and he ordered investigations into why the money was building up in certain countries, notably Kenya, Ethiopia, Mozambique and Tanzania. His office has not spoken publicly about the backlog until now in part because of internal concerns that Congress could cut future budgets because such a large amount was being delayed in the pipeline.

State Department officials told GlobalPost, though, that many foreign assistance programs build up a pipeline of 12 to 18 months of funding. The difference with the PEPFAR backlog is its sheer size; then again, PEPFAR accounts for roughly 20 percent of the US foreign assistance budget.

In the PEPFAR pipeline, some country backlogs are substantial. Kenya alone has roughly one-third the entire amount, with $502 million in unspent funds. Tanzania ($149 million), Ethiopia ($138 million), Mozambique ($130 million) and Zambia ($91 million) are next on the list, which names 22 countries and two regions. Other significant amounts: Uganda ($57 million); Namibia ($57 million); Haiti, ($44 million); Malawi ($35 million); Lesotho ($28 million); Dominican Republic ($26 million); and Swaziland ($21 million).

Kenya has had trouble spending the money because of inefficiencies in its two ministries of health, which were set up as part of a negotiated settlement following post-election violence in 2008, according to several US officials in Washington and Nairobi. Ethiopia’s AIDS prevalence rate, which was estimated at 7.3 percent in 2001, before PEPFAR, was at 1.5 percent in 2011, because of highly inaccurate statistical modeling that inflated the figure for years.

Goosby acknowledged the large amount of unspent money was the major reason why the administration asked for a reduction in funds for the next fiscal year. He said his office asked for what it would need to meet goals under US-supported programs, and because of the cut it also saw an opportunity to seek a 57 percent increase for the Global Fund to Fight AIDS, Tuberculosis and Malaria, to $1.65 billion next year.

Some activists said at the time of the budget announcement in February that the administration “raided” its own AIDS program to put money in the Global Fund. But Goosby said that was an inaccurate analysis.

Several AIDS activists interviewed said they were surprised to hear about the pipeline. Stephen Lewis, a former United Nations special envoy for HIV/AIDS in Africa and now co-founder and co-director of AIDS-Free World, an international advocacy organization, said he was disappointed that the US administration hadn’t been more forthright about the unspent money a long time ago.

“I don’t understand how $1.5 billion accumulates, and suddenly you are in a panic to disburse it,” he said. “I’m glad there is money available for critical purposes, but I would have thought this could be planned for in an orderly way.”

US officials counter that they will spend the money only after consultations and that it is better to put the money where it can be used now rather than letting it sit.

“We see a large need out there, and we have very ambitious goals,” said Tom Walsh, a PEPFAR spokesman. “We will make sure that we are spending the money we have effectively.”

Read the GlobalPost article here.

The Washington Post: “Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome It”

Sat, 07 Apr 2012 13:56:00 -0400

Just a few months ago, in Addis Ababa, Ethiopia, a leading firebrand of the global AIDS movement, Stephen Lewis, said at a conference that the money given to Africa by the U.S. global AIDS initiative called PEPFAR and by the Global Fund to Fight AIDS, Tuberculosis and Malaria amounted to “partial reparations” to the continent. Africa, he noted, was giving the world thousands of health-care workers whom it had educated, saving the West billions of dollars annually.

In his remarkable speech, Lewis, co-director of AIDS-Free World, said the payback was for multiple reasons: “From slavery to today’s extractive industries of minerals and oil, Africa is financing the world. The modern world’s economy was built on Africa’s human and natural resources, and it depends on them to this day. . . . We owe Africa what we give to Africa. And a hell of a lot more to boot.”

As Craig Timberg and Daniel Halperin suggest in their new book, “Tinderbox,”there may be another reason that the West should do more to fight the AIDS epidemic: Colonialists’ aggressive trade practices may have opened new travel routes in central Africa that helped spread a disease from a dense forest to the world beyond.

Timberg, a Washington Post journalist, and Halperin, an epidemiologist and medical anthropologist at the University of North Carolina at Chapel Hill, write that researchers found a strain of the SIV virus among chimpanzees in the bush of the Congo River basin.The virus, which closely resembles a strain of the HIV-1 group M, the deadliest AIDS strain, traveled from chimps to humans through a cut or wound. Genetic testing has traced the origins to the Kinshasa area, most likely arriving there in the blood of a worker in the bush-meat trade. That worker spread the virus to others through sex.

“Colonialists had had the effect of transforming the region into a tinderbox capable of creating the AIDS epidemic,” the authors write. “Then it fanned the flames.”

The theory outlined in “Tinderbox” could support the case for Africa reparations, or at least for more generous giving to fight AIDS. And indeed, the fight against AIDS is particularly vulnerable now: Several European donors have cut their funding for the Global Fund in part because of the economic crisis, and the Global Fund has canceled new giving until 2014. (The Obama administration has pledged to increase its Global Fund donation to $4 billion over three years; activists are arguing for $6 billion.)

Timberg and Halperin devote just the first sixth of the book to their exploration of the roots of the epidemic. The remainder is AIDS 101, focusing in particular on the past two decades. Readers unfamiliar with the epidemic will find it valuable. For those who know something about AIDS, the discoveries are few here — with perhaps one exception.

That concerns the role of Halperin, who met Timberg in 2005 when Halperin worked for the U.S. Agency for International Development in the tiny African kingdom of Swaziland. Timberg, who refers to himself in the first person and to Halperin in the third person (slightly awkward, given that they are both authors of the book), writes that Halperin often “veered quickly into the realm of the impolite.”

Halperin “insisted that the two most important factors in understanding and reducing the spread of AIDS through African societies were sexual behavior and male circumcision.” Other experts saw numerous other reasons for the spread of AIDS, and Halperin “made a career of telling people that most of what they think they know about HIV is wrong.”

Reporter, meet source, and source, meet an audience of your dreams: Washington power brokers. Reporters who cover global health need many Halperins to translate the science and lift a curtain on the messy politics of aid. Timberg writes that he and Halperin were an “odd couple,” but I think not. They needed each other, and “Tinderbox” does a good job of highlighting Halperin’s important role in fighting the epidemic.

Halperin was one of a handful of researchers who forcefully argued for an expansion of male circumcision where it was not common. Male circumcision is a powerful preventive because it removes a part of the foreskin of the penis that can be easily infected by the virus.

U.S.-funded clinical trials supported their position in 2007, leading to PEPFAR’s increased funding of male circumcision over the past four years. It has been an uneven effort: The U.S. government helped pay for the circumcision of 1 million African males from 2008 through 2011 , and President Obama has called for a goal of circumcising 4.7 million African men by the end of 2013.

Lewis and Halperin probably see the goal as laudable, but the time taken to reach it is lamentable. “Tinderbox” will help readers understand why the two men feel so strongly about this, and why the period ahead is so critical in fighting the epidemic. Millions of lives depend on the effort.

SW Radio Africa: Stephen Lewis on Disapora Diaries

Tue, 13 Mar 2012 00:00:00 -0400

The following interviewed with Stephen Lewis was aired on the Diaspora Diaries program on SW Radio Africa on March 13, 2012. Listen to the complete interview here.

Alex Bell: Welcome to Diaspora Diaries on SW Radio Africa, Zimbabwe’s independent voice. I’m Alex Bell and on tonight’s show I’ll be talking to the co-director of the international advocacy group AIDS-Free World, who has called the UN out over its silence on Zimbabwe.

Stephen Lewis, who’s work with the UN has spanned more than two decades has called on the international body to end its silence on the campaign of political rape used by Robert Mugabe and ZANU PF. Speaking on International Women’s Day last week at the UN Human Rights’ Council, Mr Lewis questioned what hold Mugabe has over the UN that Zimbabwe was left off a ‘name and shame’ list of serious sexual violence during elections in different countries.

In December 2009 AIDS-Free World released a shocking report detailing the systematic and widespread attack on MDC members and supporters in the 2008 election period in Zimbabwe. The group said their report contains enough evidence to warrant the prosecution of Mugabe and other top ZANU PF officials for their complicity in the attacks saying they are guilty of crimes against humanity. Their report titled “Electing to rape: Sexual terror in Mugabe’s Zimbabwe” detailed the testimonies of 70 survivors of the rape campaign. This is just one account from one of these women:

“My husband was truly active in his MDC party. He was a youth co-coordinator for MDC. So sometimes he had some grudges with ZANU PF youth leaders and other people who were involved in politics. The first attack it was on my wedding day, when we were having afterwards a party at home. There comes some other two guys and my husband was busy braaing with other guys, then they come, and wanted to beat my husband. Then saying ‘we told you about this MDC thing and you think you are very clever’. So that’s when my brothers and other people come and they attacked the guys, they beat them and they tell them ‘we are ZANU PF guys and they sent us to come and beat this one’. Then the second attack. He was attacked by the time he was coming from his work, he used to teach at a local school in Mabelreign. So they started beating him along the way from school and they told him ‘we are ZANU PF guys and we are after you, we will win you this one day, you should stop that MDC thing’. It was a strong knock and I knew that something wrong is going to happen, or even my husband just know that something was just going to happen, something and we didn’t open the door, they break the door, then they enter the house.

The three other men they hold my husband and the other two, they raped me one by one and I had no alternative just because they tie a cloth on my mouth so that I couldn’t shout and they raped me. Then they told me I will never ever see my husband again. I think my husband is dead. I started crying, shouting for help, then the other teachers they came to my house and I told them the whole story. Then they took me to their house up to the next morning, then we went to report to the Chief. Then from there, they didn’t do anything.

After the rapes I started having some colds, fever until I was tested and I was positive. Most of my time I am thinking of what happened to me, as a result I’ve got something in my hand that I won’t forget that event because I’ve got a result, I’ve got a baby. So each time I just look at the baby I just think of what happened to me and I don’t even know what I will tell the baby when she grows up. I suppose she’ll want to know who is the father and I don’t even know up till now what to tell her. There are so many people who are tortured and raped and most of the people they are scared to tell where they are still living in Zimbabwe, just like myself, if I was staying in Zimbabwe, I wasn’t going to tell this thing.”

Well that was one of the Zimbabwean women who was a survivor of the brutal rape campaign launched by Robert Mugabe’s ZANU PF in the 2008 election period. Now the women, whose identities are being kept strictly confidential for security reasons, spoke to AIDS-Free World of extreme acts of brutality; some women were forced to watch the rape of their daughters and the brutal murder of their husbands and other family members before or after they themselves were raped, often by groups of men. Several other women were held as ‘sex slaves’ at ZANU PF base camps for up to two weeks. All the perpetrators of the attacks identified themselves to their victims as ZANU PF members. We have another testimony from another survivor of this brutal attack

“They just came and then they started beating me because they beat me first. They said ‘you people you want to sell our country to whites, you want to’, they are just talking strong like that. And then I was raped, they left me at home and then I was raped. Why they raped me because we support MDC because we need a change in Zimbabwe; we are tired of suffering; we are suffering in Zimbabwe, we are tired. All I want is for them to be arrested and then they must face the judges but all we want is justice because even to go to the police or what, they can’t do anything because they can’t arrest them because they are the same you know?”

Well that was another of the survivors of the brutal ZANU PF-led attack on MDC supporters which included the unbelievably brutal and systematic rape of women in the 2008 election period. Now these testimonies have been contained in the report by AIDS-Free World — ‘Electing to rape: Sexual terror in Mugabe’s Zimbabwe’. You can read that full report if you go to our web site: www.swradioafrica.com

Now these details are severe and shocking but despite this, the attacks in Zimbabwe appear to have been ignored by the world’s supposedly highest peace authority, the UN, which has sparked anger from AIDS-Free World who are trying to launch a case on the contents of the report in South Africa. Now the group’s Mr. (Stephen) Lewis last week told the UN Human Rights Council that it was ‘unforgivable’ that Zimbabwe has been left off the UN ‘Name and Shame’ list which is seen as a document that will change the course of history for women. Well I’m very pleased to welcome Mr. Lewis as a guest on tonight’s show and I thank you very much for joining me on Diaspora Diaries. Well Mr. Lewis you had some strong words for the UN last week and it’s all related to the ‘Name and Shame’ list released in January. First of all for some context, what is this list?

Stephen Lewis: In December of 2010 the Security Council said to the Secretary General — “we’re passing a resolution which requires you to provide for us a report on situations of sexual violence in conflict and begin to name the names, not just of the countries where the sexual violence is occurring, but of the perpetrators, whether they be militia groups or even individual assailants.” And there was a lot of skepticism about whether the UN would go that far but then in January of this year the Secretary General released a report which surprised everyone because it did name country after country where conflict was taking place and itemized the episodes of sexual violence, including a great of detail about individual perpetrators and about whether or not the groups that were behind the raping. Because this was all about rape, whether the groups that were behind the raping were associated with governments or were independent rebel groups, they were variously defined.

And then as recently as a couple of weeks ago now at the end of February, the Security Council actually debated the report and gave the report its blessing and indicated that they wanted further detail in the future. Then AIDS-Free World, the organization with which I’m associated, began to read the report and I was completely taken aback by the fact that right in the centre of the report, what they did was to argue logically, that conflict has many definitions: It doesn’t just have to be violent militia, internal civil war, it can also be politically orchestrated conflict and rapes which occur in those circumstances should also be included in this report and the countries should be named and shamed – that’s what naming and shaming means.

And then they listed Kenya and Egypt and Syria and Guinea and notably missing was Zimbabwe and it’s just totally fascinating that president Mugabe, with a history of using rape against women who support the opposition party that somehow Zimbabwe was exempt. So I went to the Human Rights Council to make the case that if you’re going to extend the principle of naming and shaming countries engaged in sexual violence and rape who are using it within an election context, then you have to extend it to Zimbabwe.

AB: Now you’ve mentioned some of the countries that were listed, especially in this category of election violence. Are they comparable then to the situation that we’ve seen in Zimbabwe?

SL: Our own feeling is that Zimbabwe exceeds them all because the pattern of sexual violence didn’t begin in 2008, it began in 1980 when Mugabe was Prime Minister, and certainly in 1987 when he became President this has been a strategy of his political apparatus. So if you look at it over the years, the numbers of people, women in particular who have suffered physical violence, sexual violence and rape certainly hugely exceeds Kenya — there’s no comparison — and yet Kenya was named. And it also would exceed Guinea and Egypt and probably even Syria. Syria is devastating at the moment of course but cumulatively I think that president Mugabe leaves a much more malign legacy.

AB: What does this say then about the UN and its relationship with Robert Mugabe, because this seems like a startling oversight?

SL: It is a startling oversight, it takes one’s breath away and I’m not entirely sure what’s going on. It could be that people still hark back to the days when Robert Mugabe was a freedom fighter and one of the front-line states opposing apartheid and nobody will deny that the roles of the countries like Zimbabwe and Tanzania for opposition to South African apartheid. But those days are long gone and President Mugabe’s career has deteriorated into a malevolent authoritarianism and in fact some would call it a kind of berserk tenure, demonic in its behavior. And again on top of that, there is this caution to go after former Commonwealth countries, I don’t know what that’s all about. But mostly I think it’s South Africa. Mostly I think it’s the refusal of President Mbeki and President Zuma to move in on Zimbabwe. I think President Zuma has been showing signs that he’s losing patience and that now Mugabe is calling for another election in 2012 and he’s past his 86^th birthday, that Zuma may be feeling that it’s time to bring Zimbabwe to heel but it’s had a lot of protection from the other African countries, particularly southern Africa and for that there’s no excuse. There’s no excuse in the world for African countries to have put up with President Mugabe.

If I can just make the necessary point — one of the reasons I raised this — I shouldn’t say “I”, AIDS-Free World raised this at the Human Rights Council and with a group of diplomats afterwards, is because it’s undoubtedly continuing according to reports and the raping will be as ferocious as ever when the election is called later this year and somehow the international community has to be alerted to the importance of stopping it.

AB: Well this was my next question because the document, this “Name and Shame” document, it’s being lauded as something that could change the course of history for women in the world, so why is it so important then that Zimbabwe’s included and this is raised in the international circles?

SL: Precisely because this document, for the first time, has the sort of legitimacy, the imprimatur, the authenticity of the Security Council; it’s a document where the most powerful nations in the world gathered together are saying to the rest of the world – “this behaviour is intolerable and we are going to confront it and we’re going to name it and we’re going to shame it and we’re going to tell the world how your misbehaviour is so brutal and callous and compromising the lives of women wherever it’s applied. “We’ve got to bring an end to the raping, it’s as simple as that and if Zimbabwe were included, and that’s the power of the report, I think that organizations like AIDS-Free World, are now fully at liberty to argue that president Mugabe be named and shamed by the Security Council and the United Nations. Just because Zimbabwe doesn’t appear in the report on this occasion doesn’t mean that it will be exempt in future occasions. I think people didn’t realize that the political and election related part of the report should encompass Zimbabwe and now that we can make that case, I think it will be easier to go after the president of Zimbabwe.

AB: Were people shocked or surprised when you raised the argument about Zimbabwe being left off?

SL: Yes, yes because these were Human Rights Council people, they are familiar with the sort of the Human Rights doctrine and therefore they were familiar with the resolution, it’s called Resolution 1960 that was passed back in 2010, they were familiar with the report and it’s so interesting that it hadn’t really fully occurred to people that Zimbabwe should be included. I mean just think of it — my co-director of AIDS-Free World and I, we’ve spent a week in Nairobi after the post-election violence in Kenya which was pretty severe, we spoke to endless numbers of women’s organizations and women activists who chronicled for us the sexual violence that had occurred but nothing that happened in Kenya, nothing, approximates what went on in Zimbabwe in 2008 in terms of the raping of women and will go on again in 2012, you can be absolutely sure if there’s another election called this year unless the international community intervenes. Diplomats suddenly realized that the oversight of not including Zimbabwe should be corrected. Corrected in the way we talk about it now and including it in the future.

AB: Were we to look at the state of this report then and the facts that the contents are hopefully going to be used within international courts, does the leaving out of Zimbabwe in this list impact if it’s to have this heard before courts?

SL: Well what we intend to do is to launch a case now with the National Prosecuting Authority in South Africa which can employ what is called Universal Jurisdiction where you can indict and try people from outside your own country if they have committed crimes against humanity which we believe we proved unassailably in 2008 and we are able to do that now because there was another case involving torture in Zimbabwe which is being taken to the High Court in South Africa and it will be heard at the end of this month and now we feel we are in a position to launch our own court case through the National Prosecuting Authority. So I think that what we are really seeing here is the beginning of a campaign to bring Zimbabwe to account, the beginning of a campaign to overcome the culture of impunity which has allowed president Mugabe doing some of the worst things to women that have been done anywhere in the world, we’ll probably finally be able to confront president Mugabe, both in law and (inaudible)

AB: A final comment then; you’ve mentioned a couple of times already that if the international community does not intervene, 2012 and a possible election in 2012 could have the same results for the women of Zimbabwe.

SL: I think that’s true; I don’t think it could happen, I think indisputably it will happen. Mugabe is a crazed politician, I’m sorry to use adjectives which are incriminating but I think they are accurate. I think anyone who follows the behaviour of president Mugabe, the language he uses, the weapons he employs, will understand that his wish to hold on to power or to hold onto power long enough to transfer it to somebody else of his choosing, that wish is just insatiable. He’s determined and the ploy that has been used most effectively in the past is the raping of the women of the MDC, the raping of the women of the opposition so that ZANU PF, the war veterans and the youth corps become the rapists and there is not a single question in our mind that president Mugabe will use that again and that women will suffer horrifically again and that’s why we’re trying to stir the momentum through the next several months so that the world is alerted to the possible carnage that is coming if the raping is repeated.

Listen to the interview here

Read the SW Radio Africa transcript here

The Times: Birth Control, HIV Link

Fri, 02 Mar 2012 15:20:00 -0500

Women using hormonal birth control, especially progesterone injections, are twice as likely to be infected with, or transmit, HIV, the results of a study published in the Lancet Infectious Diseases journal show.

But a co-author of the study, Professor Helen Rees, of Wits University's Reproductive Health and HIV Institute, said that not all studies show a link between hormonal birth control and increased risk of HIV transmission.

The connection between the use of the hormone progesterone and HIV infection "is a grey area, and the world’s scientists are unsure of how to interpret it” she said.

“It is an outstanding question and nobody knows how to answer to it.”

The study followed 3790 couples where one partner was HIV positive.

The conclusion of the study was that women must be told "about potentially increased risk of HIV-1 acquisition and transmission with hormonal contraception, especially injectable methods", and about the importance of condoms.

In response, the World Health Organisation held a meeting in Geneva of 75 international experts who decided that the evidence was inconclusive.

In a recent press release, the organisation said "Women at high risk of HIV can safely use hormonal contraceptives".

Former Aids adviser to Unicef, and current co-director of AIDS-Free World Paula Donovan said that the press release was not true because the scientists had agreed that the data were inconclusive.

"The organisation has purposely kept women in the dark about the risk of injectable contraception," Donovan said. “Women have the right to make fully informed sexual and reproductive health decisions."

Rees, who attended the organisation's meeting, said a "room full of experts" agreed that the data were "troubling" and "inconclusive", and more research was needed.

She said doctors did not want to stop women using a contraceptive that worked where women were not easily able to access alternatives and more research might show it to be safe.

But Donovan said that the organisation is violating the rights of the 12million women using the contraceptive injection in sub-Saharan Africa by withholding the information.

"They knew about Depo-Provera (progesterone) users three fold rates of chlamydia and gonorrhoea, two of the sexually transmitted infections that place people at high risk of HIV," she said.

It is believed progesterone thins the vaginal wall, possibly making it more susceptible to infiltration by the HI virus, and suppresses the immune system.

Professor Rees, cautioned that experts don't know what effect of immune suppression has on HIV transmission.

Donovan said that every woman who receives an injection of hormonal contraceptive must also be given a three-month supply of male or female condoms and these should be paid for by the companies that profit from selling the progesterone injection.

The Department of Health's Eddie Mhlanga said its message remained: "Condoms must be used in conjunction with other birth control methods."

Pfizer, in there response to the article said "that it would be premature for non-definitive results to lead to changes in clinical practice. However, it is very important for physicians to strongly communicate to patients that hormonal contraceptives, including Depo-Provera, are not designed to protect against the transmission of disease. In this study, up to 30% of women engaged in unprotected sex despite the clear and immediate risk of HIV transmission. In cases where one partner is known to be HIV-positive, as was the case here, Pfizer believes that consistent and correct use of an effective barrier method must be considered absolutely mandatory."

Read the Times article here.

The Huffington Post: Planned Parenthood Whitewashing Life-and-Death Info on HIV Protection

Fri, 02 Mar 2012 12:24:00 -0500

How many factual errors can you make in a single press statement? Yesterday on the Huffington Post, the Planned Parenthood Federation of America (PPFA) heralded "another victory for women's health" following recent meetings at the World Health Organization (WHO). The world health body convened experts to discuss concerns about hormonal contraceptives and HIV, and to answer to the question: Do women who use hormonal contraceptives face higher risks of HIV acquisition and transmission? PPFA claims that the answer was "a resounding no." That's not true.

The real answer from WHO's experts was: WE DON'T KNOW. They could not draw conclusions from the available research: some studies found higher rates of HIV among women who use hormonal contraceptives, and others did not. Because the findings are inconclusive, and because global experts remain concerned — especially about injectable contraceptives, the most popular method used in sub-Saharan Africa — WHO strongly advises that women who use injectable contraceptives such as Depo Provera (the best-selling injectable by far) should also use condoms. (See the WHO Technical Statement.)

PPFA claims that the experts reviewed one study. Wrong. The experts reviewed all the best scientific research available. They found the data difficult to interpret, and declared that more research is essential.

PPFA claims that the WHO meeting focused on HIV-positive women's risks of transmitting the virus to their sex partners. Wrong again. Most of the data available, and most of the data reviewed at WHO's expert meeting, focused on women who are not HIV-positive, and on the question of whether injectable contraceptives put them at increased risk of acquiring HIV.

PPFA calls it a victory for women that WHO did not have enough data to change its rating of 1 on a scale that weighs data from 1 to 4, with 4 meaning "do not use this method." That simply means that at this point, WHO is equally uncertain about whether injectable hormonal contraceptives are entirely safe, or shouldn't be used. They issued a recommendation that stresses their uncertainty: "A WHO expert group reviewed all the available evidence and agreed that the data were not sufficiently conclusive to change current guidance. However, because of the inconclusive nature of the body of evidence on possible increased risk of HIV acquisition, women using progestogen-only injectable contraception should be strongly advised to also use condoms and other preventive measures."

PPFA's statement refers repeatedly to one study, but does not cite it or explain its findings. The Partners in Prevention study was conducted in Africa, and enrolled 3790 heterosexual HIV-discordant couples (meaning just one person in each couple was HIV-positive). At the end of the study, researchers found that there had been twice as many new HIV infections among women who had used injectable hormonal contraceptives as among those who hadn't, as well as twice as many new HIV infections among the male partners of injectable contraceptive users (Heffron R, et al, for the Partners in Prevention HSV/HIV Transmission Study Team. Lancet Infect Dis. 2012; 12: 19-26).

PPFA says that the study appeared in the Lancet this past November. In fact, it was October. PPFA says that "the findings contradicted the majority of previous research on the same topic," and PPFA refers to it as "this flawed study." Wrong again — very wrong. The findings added more data to the available body of evidence. These findings — and all findings on this topic to date — are derived from "observational data:" that is, while investigating other HIV-related issues, researchers observed that the hormonal contraceptive users in their study had higher rates of HIV acquisition and transmission. The researchers themselves note that such observational data has "limitations:" their study wasn't designed to answer questions about whether or not there is a causal link between using injectable hormonal contraceptives and higher risks of acquiring or transmitting HIV. Limitations are not flaws. The Partners in Prevention study's authors, as well as all the experts convened by WHO, agree that this data raises serious concerns, and that it is essential to carry out further research designed specifically to answer these questions.

AIDS-Free World understands the anxiety felt in the U.S. today, as the hard-won rights of women to choose and use safe, effective, affordable contraceptives are under attack by retrograde male political candidates. We share PPFA's fear. But sexual and reproductive rights are not advanced when the facts women need are withheld or misrepresented. Voluntary contraception is only voluntary when women understand the choices they have, and the risks as well as the benefits. Women's rights to informed consent are sacrosanct.

WHO made its own grave error by issuing a misleading press release after its expert meeting. The headlines declared that hormonal contraceptives can "safely" be used by women living with and at risk of HIV, but omitted the critical clarification — IF they also use a condom each and every time they have sex. When WHO was questioned about why their press release conflicted with the "Technical Statement" issued by their expert group (and only available on WHO's website), a spokesperson explained: "The press release was truly meant to be a very short statement that would lead people to read the Technical Statement. The Technical Statement received much more scrutiny from all those who participated. So really we should go with the Technical Statement."

AIDS-Free World is calling on WHO to retract the misleading press release it issued worldwide, and to replace it with the facts. We are also calling on WHO to make a recommendation that may actually save lives: When a woman receives a hormonal contraceptive injection to protect against pregnancy for three months, she must also be given a three-month supply of condoms. She must be clearly informed that unless she uses the condoms, she may be at increased risk of HIV.

We understand WHO's anxiety: What if women at high risk of HIV hear that experts are concerned about injectable hormones, and choose to stop using them until researchers have come to definitive conclusions? What if, as a result of that choice, many more women in countries with high rates of maternal mortality become pregnant? That may nor may not happen, but it is not WHO's choice to make. Both WHO and PPFA have an obligation to improve women's choices, and to inform women about their options. No global experts or family planning organizations have the right to censor the life-and-death information women need in order to weigh their own risks. Neither WHO nor PPFA has a right to make sexual and reproductive health decisions for women.

PPFA states that women need research, not restrictions. That much is true. But it, too, is only part of the story, and not the most important part. Women need information: complete, uncensored, and factually correct.

Read the Huffington Post article here.

IRIN PlusNews: WHO Clarifies Guidance on Hormonal Contraception and HIV

Fri, 17 Feb 2012 00:00:00 -0500

JOHANNESBURG — Four months after a study suggested women on hormonal contraception may be at an increased HIV risk, the World Health Organization (WHO) has reaffirmed the birth control method's safety, but strongly recommends that women on progesterone-only injections, like Depo-Provera, also use condoms to prevent HIV infection.

In October 2011 the British medical journal, The Lancet, published the findings of a study howing that women who relied on hormonal shots to prevent pregnancy doubled their HIV risk. They also found that women on this type of birth control and living with HIV doubled the chances that they could transmit HIV to their partners.

Although the women in the study did not identify their birth control methods, most were probably using the progesterone-only, depot medroxprogeterone acetate shot. More commonly known by the brand name, Depo-Provera, this drug is the backbone of most African family-planning programmes.

The study prompted WHO meetings in late January and February 2012, during which experts and civil society representatives reviewed research on hormonal contraception and HIV risk. However, because no clinical trial has ever looked specifically at this potential link, including the October 2011 study, evidence remains largely inconclusive.

In the absence of a proven link between hormonal contraception and HIV infection, the WHO issued a statement on 16 February standing by current guidelines that allow women living with or at high risk of HIV to use hormonal contraception. However, the body has recommended that current guidelines be amended to advise women using progesterone-only injections be strongly advised to use condoms concurrently to prevent HIV infection.

The need for future research into the matter was discussed at side meetings, said Dr Jared Baeten of the US University of Washington, one of the authors of the 2011 study. Although no decision was taken, he added that conducting such a trial would pose serious challenges. About 12 million women in sub-Saharan Africa are estimated to be on injectable contraception.

Women need options and integration

"I think the [WHO] statement really reflects what was an extremely thoughtful deliberation and detailed evaluation of the evidence," Baeten told IRIN/PlusNews.

"They made a clear statement by issuing a strong clarification and I think that what's important in the context of delivering family planning service is that we strongly remind women at high risk of HIV that contraception does protect against HIV and that condoms are the HIV preventative measure."

Baeten has worked in high HIV prevalence countries such as South Africa, Kenya and Uganda - all of which depend on family planning services to help fight high maternal mortality rates — and said he was also happy that the need to integrate family planning and HIV services, voiced by policy-makers and researchers at the meeting, was recognized.

This would mean that health facilities providing care and treatment for HIV and other sexually transmitted infections would offer clients family planning and reproductive health services — and an extended array of contraceptive choices.

"What this statement should stimulate is making sure that women have access to a variety of contraceptive choices, and this could include intrauterine contraceptive devices (IUCD) or lower-dose, long-acting hormonal contraception," Baeten added. "The point is that Depro shouldn't be the default."

IUCDs are available in both hormonal and non-hormonal forms. A device is inserted into a woman's uterus, where it affects the ability of the sperm to fertilize an egg, and the egg's ability to implant itself in the uterus. The devices are cost-effective and work for almost all women, according to research by the Maternal, Adolescent and Child Health division at the University of the Witwatersrand in South Africa.

Dissent in the ranks

There has been some criticism of the WHO. Paula Donovan, former East and southern Africa AIDS advisor for the UN Children’s Fund (UNICEF), now heads the international HIV advocacy organization, AIDS-Free World, with former UN Special Envoy on AIDS in Africa, Stephen Lewis.

Days before the WHO released its statement, Donovan issued a statement of her own slamming the body for not moving sooner on consultations when it had convened emergency meetings on past issues like swine flu. She faulted the WHO for not involving more people living with HIV in discussions, and because the body did not issue clear or cautionary messaging to the public following the 2011 study.

According to Donovan, only one HIV-positive African woman was present at the WHO meeting, and confidentiality agreements prevented her from sharing what was discussed with networks of activists and people living with HIV.

Donovan has also criticised the WHO statement, saying that it goes too far by conclusively stating that women living with or at high risk of HIV can continue to use hormonal contraception when the evidence is inconclusive.

"WHO and UNAIDS have violated human rights by withholding information," Donovan said in her statement. "They have failed to inform women that using hormonal contraception may carry some risk. Women have the right to make fully informed sexual and reproductive health decisions."

She added that she would have liked to see the WHO go further in its recommendations, advising that all hormonal contraceptive users be given a three-month supply of condoms with every injection.

"No reasonable person can believe that condom use will increase because the WHO issued a statement declaring that hormonal contraceptives are safe - but condoms should also be used to protect against HIV," she told IRIN/PlusNews. "Statements don't prevent HIV. We would have hoped that [the] announcement would have been accompanied by a plan of action."

Read the IRIN article here.

The Guardian: Disabled People Finally Given a Voice on HIV and AIDS

Thu, 15 Dec 2011 10:46:00 -0500

Access to HIV information, testing and treatment for people with disabilities was raised for the first time as a central theme at the International Conference on Aids and STIs in Africa (Icasa), held last week in Addis Abba, Ethiopia.

A "disability zone" gave delegates rare space to discuss the risks and barriers that arise from misconceptions around disability and sexuality, the heightened vulnerabilities of people with disabilities to infection through sexual violence, and models for inclusive HIV-programming.

"People with disabilities are the world's largest minority group but a substantial number within the Aids community are yet to recognise them as vulnerable," said Emelia Timpo, a senior adviser for UNAids.

A 2004 World Bank study showed that almost all known risk factors for HIV and Aids are increased for people with disabilities.

Professor Nora Groce, chairwoman of the Leonard Cheshire Disability and Inclusive Development Centre at University College London, who conducted the original research is now in the final stages of a full review of existing research on the matter.

"Rarely do more than five or six papers appear per year to add new knowledge and help us design better support services for persons with disabilities," she said. "Given the millions of dollars spent on Aids research, this very slow increase in data accumulation is striking – especially with so many lives at risk."

The data that does exist echoes anecdotal evidence from NGOs and health providers that HIV infection rates tend to be higher among people with disabilities.

Handicap International has just conducted two surveys, in Senegal and Mali, which showed that HIV prevalence among people with disabilities was almost double than that of the non-disabled adult population. Another survey from South Africa reported HIV prevalence of 14% among people with disabilities compared with 10% among those without.

Even when the issue is raised with those who have a mandate to target vulnerable groups, Muriel Mac-Seing, HIV and Aids technical adviser for Handicap International, says she sees a pattern of surprise and embarrassment that people with disabilities have been rendered "unintentionally invisible".

Paula Donovan, co-director of Aids Free World, believes that the lack of focus, data and research on Aids and disability is a matter of wilful ignorance. "If you get data that shows that access to basic testing services is unavailable to people with disabilities, then there is responsibility to allocate some priority funding," she said. "But you don't have to do something about a problem if no one has measured it yet."

Mac-Seing questions why we need to wait for "hard evidence" to recognise that if people with disabilities are struggling to engage with awareness campaigns or access health centres, then the right of 1 billion people to access HIV information, treatment and care is at stake.

The promotion of this message at last week's conference ties in well with the conclusion of the five-year regional strategy plan set out by the African Campaign on Disability and HIV& Aids in 2007 to advance awareness.

As the regional plan wraps up, Mac-Seing says that the energy has naturally progressed towards national ownership of inclusive HIV-programming.

At Icasa, a framework for the inclusion of disability in national strategic plans on HIV and Aids was launched, providing a tool-kit to guide both the development and the review of national plans through a "disability lens".

As planning begins for the Aids 2012 conference in Washington in July 2012, organisers say it will be "a watershed moment to eliminate stigma, criminalisation, and discrimination, which fuel the HIV pandemic".

But in order to achieve that, even at the conference level, said Donovan, disability must be mainstreamed into strategies and budgets. At the same time, people with disabilities must be allowed to join the power-brokers and decision-makers within the Aids community.

Read The Guardian article here.

The Nation: UN Women Limps Toward Its First Anniversary

Fri, 02 Dec 2011 00:00:00 -0500

UN Women is in trouble. The newest agency in the United Nations system, widely hailed as the best hope for significant action globally on women’s rights, is falling short of both money and power as it limps toward its first anniversary in January.

Despite years of statements, campaigns and even Security Council resolutions, the situation of women around the world remains difficult for many millions of them and mortally dangerous for hundreds of thousands who die in civil conflict, gender violence, curable diseases and preventable complications of pregnancy.

Women in many countries lack access to legal systems and may in fact be forced to live under discriminatory laws that deprive them of property ownership, rights over their children, an education or freedom to travel. Hundreds of millions have no access to family planning or are prohibited from seeking contraception when the size of their families becomes a burden too heavy, physically and psychologically, to bear. At least 10 million girls are estimated to be living in forced childhood marriages in South Asia and Sub-Saharan Africa, not a few of them younger than 10, when they should be going to school.

When four underfunded and largely powerless programs for women were abolished or folded into UN Women in 2010, the assumption among its advocates was that, finally, a new agency with much higher rank in the UN system—and a seat in the secretary-general’s cabinet—would put some meaning into decades of pious declarations, rousing international conferences that often produced little more than paper plans of action and hypocritical promises of “gender mainstreaming” in UN work globally. Early signs are that these challenges will take a very long time to be met—if they ever are.

The two crippling factors getting in the way of this important new agency are largely beyond its control: miserly financial contributions from nations on which UN Women’s operating expenses were designed to depend, and some petty turf games inside the UN system. These internal jealousies are compounded by the tepid support bordering on neglect among some of the organization’s highest officials, according to people who have followed very closely the struggles of UN Women in its inaugural year.

The problem is not in its leadership. Its high-powered executive director, Michelle Bachelet, a former Socialist president of Chile who now holds the rank of under secretary-general in the UN, has worked hard to put the agency on the international map, assisted by two very able and experienced deputies who know how the UN works, John Hendra of Canada and Lakshmi Puri of India.

The financial picture, however, is truly bleak, undermining UN Women’s work and forcing Bachelet, with her strong record of action on social issues in Chile, to devote much of her time at UN Women to fundraising. “UN Women has benefited from Bachelet's international standing, though she spent too much time at the outset looking for additional resources,” said Anwarul Chowdhury, a diplomat from Bangladesh and former UN under secretary-general representing the least developed countries, who was an early advocate for the creation of the agency. He believes this preoccupation with fund shortages has dimmed the image of an agency that needed to establish a high profile right from the start.

When UN Women was created by the General Assembly in July 2010 after years of haggling over its status and powers, it was named officially, clumsily and cautiously the United Nations Entity for Gender Equality and the Empowerment of Women—“entity” being a safer word than agency or department among the opponents of the move. The plan was that there would be money from the UN Secretariat budget for setting up offices and providing salaries. That allocation would be augmented many times over by $500 million in voluntary contributions annually from the UN’s 193 member nations, added to donations from corporations, organizations and individuals. Those contributions would fund active programs around the world, filling the gaps left by UN Women’s predecessors.

As late as August of this year, Puri, who handles the management and budget side of the agency, was still hopeful, in an interview with the Inter Press news service, of raising $300 million in 2011, $400 million in 2012 and that goal of $500 million in 2013.

Here’s the reality: at the end of October this year, the total funds pledged to the agency amounted to $131.4 million—and only $58.2 million of that had actually been received. The largest payments came from Canada, Australia, Britain and the United States—in that order. The US contribution, despite loud and clear messages of support for the agency from Secretary of State Hillary Clinton, was just under $6 million, with a promise of more later.

Last year the US government gave more than $132 million to Unicef, the UN Children’s Fund. Add to that the $435 million raised among private donors to the nongovernmental US Fund for Unicef—$70 million of it for Haiti alone following the January 2010 earthquake.

Bachelet’s own country, Chile, now under a conservative government, has managed to find only $ 23,000 for UN Women.

The list of donors says a lot about how much or how little the nations of the world want a powerful women’s agency to succeed. No important developing nations—except India, with $1 million already paid—are among the major donors. China could find only $60,000. Iraq, with its resurgent oil wealth, pledged $100, and had not paid up by the end of October. (For the full list of donors, see www.unwomen.org.)

“The lack of funding is a symptom of what’s going on,” said Paula Donovan, co-director with the Canadian diplomat Stephen Lewis of AIDS-Free World, a nongovernmental organization that also fights for LGBT rights and was at the forefront of promoting a strong UN unit for women. “I think the problem is the lack of support for a new agency from within the United Nations.”

“Just one example is that UN Women is not yet one of the official co-sponsoring agencies of UNAIDS,” Donovan said in an interview. “That’s preposterous.” UN Women is trapped by a bureaucratic paperwork process for membership in UNAIDS even though the epidemic has become a woman’s disease in parts of Africa and Asia and the new agency would seem to be a welcome partner.

“This has nothing to do with addressing and focusing on a subset of the population that desperately needs to be represented around the table when the UN’s talking about the global response to AIDS,” Donovan said, noting that Secretary-General Ban Ki-moon has not used his power to shoehorn the new agency into UNAIDS, cutting through the sclerotic procedures.

Donovan added that the exclusion from UNAIDS is part of a broader picture of “internal rivalries, jealousy and fear” that UN Women under Bachelet will gain too much popularity or influence within the UN system, since women are meant to factor in every area of development. There is concern that funding for other agencies might suffer. The rivalry is particularly strong with the UN Development Program, Donovan said.

Within UN Women itself there are organizational turf lines, caused by the amalgamation of the four separate and occasionally mutually hostile programs for women in the UN system: the Division for the Advancement of Women, the International Research and Training Institute for the Advancement of Women, the Office of the Special Advisor on Gender Issues and Advancement of Women, and the United Nations Development Fund for Women (UNIFEM). None of these bodies had the organizational stature or budget that UN Women was promised.

From the beginning, it was decided that staff from these four would be absorbed into UN Women. There would have been disruptive labor challenges had that not happened. UNIFEM—which operated under the auspices of the UN Development Program—was the biggest winner in the merger. Much of its staff, all of its programs and its largely powerless and underfunded offices in the field simply moved over to UN Women, as even a cursory look at the new agency’s Web site confirms.

This situation has been a damper on UN Women’s ability to be a truly new and more powerful part of the system, said Chowdhury of Bangladesh, a country that has defied substantial odds to promote girls and women, particularly in education and reproductive health.

“So far, UN Women’s efforts to carve out its own independent image had to depend on the staff of its component offices that merged in the new entity,” he said. “The separate streams seem to exist even now as undercurrents.”

Chowdhury, who has also been active in peace projects and in promoting the protection of women in conflict areas, suggests that among fresh campaigns that UN Women could undertake would be to demand more action on a resolution passed by the Security Council in 2000 (and subsequent other resolutions on the subject that followed) calling for not only the protection of women in conflict and post-conflict but also their direct involvement in peacemaking.

Moreover, Chowdhury added: “Despite a wide-ranging sense that a fifth UN world conference on women is long overdue and should be convened latest by 2015, twenty years after the landmark Beijing conference, UN Women has given the idea a cold shoulder instead of seizing the opportunity for leadership that we expect of it to give the women's agenda the standing it deserves.”

While there is little doubt that a big conference to review and advance progress on women's rights would attract a lot of attention, not all of that attention would be positive, as anti-feminist forces would work to use the occasion to roll back earlier gains. Practically speaking, UN Women does not yet have the staff strength, the huge amount of money or a partner nation to host such a conference, which is an event on an enormous scale requiring years of preparation. At a time of global financial crises, there would be little international support. A similar set of obstacles has apparently led to a decision in the United Nations Population Fund to shy away from a twentieth-anniversary event on the 1994 Conference on Population and Development, held in Cairo, when nations essentially signed on to a pledge to give women control of their reproductive lives.

UN Women did produce a substantial report in July, Progress of the World’s Women: In Pursuit of Justice, which drew attention to the hundreds of millions of women around the world who suffer under discriminatory laws and illegal harmful practices, an issue that Obama administration has put on the agenda of the UN Human Rights Council. But UN Women still lacks the authority to intervene with governments in any meaningful way beyond asking them to fix their sexist laws. At the UN only the Security Council can compel nations to act, with the threat of enforceable sanctions.

Leaders of numerous nongovernmental organizations and foundations working with the UN lament the slow start to UN Women, saying that while the upper echelons of the UN administration understand the problem they appear to be unwilling to challenge either UN agencies or member nations, some of which were very much opposed to the agency’s creation.

Bachelet has other options; she may return to Chile and reassemble her political team to run for the presidency again in 2013,as the Chilean constitution permits, after a term’s break. A physician by training and the daughter of an air force officer who died in prison under the rule of Augusto Pinochet, she survived tragedy to build a reputation after Pinochet’s fall that made her the most popular politician in the country. Should she decide to leave UN Women, it might never recover from the loss.

This week in Busan, Korea, Bachelet issued a pointed call to action on gender at an international conference on development aid. When Secretary of State Clinton spoke later, she remarked: “I was standing listening to Michelle, who is her usual effective and strong way was making the case, but I could sense in her voice the same frustration that I feel from time to time, which is, How much longer to we have to make this case?”

Paula Donovan also emphasizes the importance of a strong UN women’s agency in all the UN’s work. “The heads of agencies of the UN, and really the secretary-general and the UN secretariat should have made this the big cause,” she said. “All the heads of agencies should have been pounding the pavement, going with Michelle Bachelet to some of those fundraising meetings, saying that in order for UNICEF to do its job well UN Women will have to be up and funded. For UNDP, the same thing. But that’s not happening. No one inside the UN is taking the big view of what’s best for women.”

Read The Nation article here.

BMJ: Global Fund Suspends New Projects Until 2014 Because of Lack of Funding

Tue, 29 Nov 2011 00:00:00 -0500

The Global Fund to Fight AIDS, Tuberculosis and Malaria has for the first time in its 10 year history cancelled the pending funding round and suspended new grants because of a lack of funding from donors.

The fund is the world’s largest international funder of programmes to treat tuberculosis and malaria and the second largest for HIV and AIDS, after the US President’s Emergency Plan for AIDS Relief.

At the fund’s 25th board meeting in Accra, Ghana, on 20 November, the board voted to cancel all plans for new grant making. Projects that are currently supported by the fund have guaranteed funding for their full lifetimes, but there will be no money for new initiatives until 2014.

The fund’s director of external relations, Christoph Benn, told the BMJ that it had already dispersed some $8.5bn (£5.5bn; €6.4bn) and had approved an additional $1.5bn for 2011-13. However, the recent “critical global economic situation” meant that the board anticipated that it might not be able to achieve the 20% extra funding it estimates is needed to scale up services in the near future, although it has appealed to donors to “provide additional funds to enable countries to meet their millennium development goal targets.”

The fund will instead provide a “transitional funding mechanism” whereby countries known to be facing disruption of their programmes for HIV, tuberculosis, and malaria before 2013 will be offered a chance to apply for funding to cover their most essential needs. However, it says that such funding will be “restricted to the continuation of essential prevention, treatment, and/or care services currently financed” by the fund.

For HIV, this funding can cover drugs for people already receiving treatment but does not provide money for treating new cases of HIV.

Mike Mandelbaum, chief executive of the UK charity TB Alert, told the BMJ that the reduction in funding will have “a catastrophic effect and directly lead to many avoidable deaths.”

He added, “The Global Fund is a very effective funding mechanism and is a huge success. Last year the number of people who died from tuberculosis fell to 1.4 million from 1.7 million the previous year. This progress costs money, and the fund has become a key donor across the world. In Africa, for example, it funds 85% of TB programmes.

“It would be a human catastrophe to take a backward step now. Instead the international donor community should follow the example of the United Kingdom in increasing support to high quality aid programmes.”

In a press statement the UK Coalition to Stop TB said, “The ramifications of this decision will be tragic for millions of people around the world who depend on the Global Fund for lifesaving treatments.

“Without TB drugs and healthcare workers, millions of people with TB and multidrug resistant TB, especially those coinfected with HIV, have little hope of survival. Furthermore, this decision will make it impossible to achieve the millennium development goals on health, and failure to support the Global Fund will drive us further away from controlling the three killer diseases.”

Awa Marie Coll-Seck, executive director of the Roll Back Malaria Partnership, told the BMJ: “The Global Fund currently represents nearly two thirds of international malaria funding. If we don’t have sufficient resources to continue the fund’s work, we will lose the tremendous gains we have made in malaria control in recent years and put millions of lives at risk.”

Tido von Schoen-Angerer, director of Médecins Sans Frontières’s access to medicines campaign, said, “There’s a shocking incongruence between both the new HIV science and political promises, on one hand, and the funding reality that is now hitting the ground, on the other. Donors are really pulling the rug out from under people living with HIV and AIDS at precisely the time when we need to move full steam ahead and get lifesaving treatment to more people.”

Stephen Lewis, director of AIDS-Free World, described the move as “the most serious, catastrophic setback in the fund’s decade of existence.” In a speech to the Yale School of Public Health on 28 November he said that the donors’ failure to live up to their commitments amounted to murder and that their leaders should be tried for “crimes against humanity.”

Earlier this year the Global Fund committed itself to reforms in response to specific incidents of countries’ misuse of funds and corruption.

A spokesperson for the UK Department for International Development told the BMJ: “The international development secretary has been clear that while the Global Fund performed well in the UK’s multilateral aid review, reform is needed. Future UK funding levels will depend on the fund implementing the recommendations in the recent high level panel report and on the success of its consolidated transformation plan.”

Source: BMJ 2011; 343:d7755.

The Globe and Mail: Economic Crisis Hits Health Aid That Has Helped Millions as Donors Cut Back

Wed, 23 Nov 2011 00:00:00 -0500

The global economic crisis has claimed a new victim: a $22-billion (U.S.) health fund that has saved millions of lives in Africa and other low-income regions during the past decade.

Wealthy donors in Europe and elsewhere are drastically cutting back on contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria. As a result, in an unprecedented step, the fund has announced that it is cancelling its next round of grants, despite strong protests from health activists.

The impact could be huge. More than 70 per cent of life-saving AIDS medicine in the developing world, and about 85 per cent of TB programs in Africa, are financed by the Global Fund. The cancellation of its next round of grants will have a direct impact on tens of thousands of impoverished people living with HIV who depend on foreign financing for their medicine, analysts say.

The cuts by donor governments are not just because of the economic slowdown and the financial crisis in Europe, but also because of concerns over corruption in several recipient countries. Some donors, including Germany and Sweden, have frozen their donations because of the misuse of health grants in four recipient nations.

The Global Fund has fallen into “the most dire financial situation it has ever seen since its creation,” according to a statement on Wednesday by Médecins Sans Frontières (Doctors Without Borders).

There is a “shocking incongruence” between the financial cuts and the latest scientific evidence suggesting that an expansion of HIV treatment could be a crucial step toward eliminating the AIDS epidemic, MSF said.

“Donors are really pulling the rug out from under people living with HIV/AIDS at precisely the time when we need to move full-steam ahead and get life-saving treatment to more people,” the group said.

Stephen Lewis, the former United Nations special envoy on AIDS in Africa, warned that the funding cancellation will cost thousands of lives. “It’s incredible that so many countries should default on their commitments at exactly the moment when we know what to do to defeat the pandemic,” he said. “I don’t know how the financial architects of this disaster sleep at night.”

A leading advocacy group, Health Global Access Project, said the donor countries are “betraying” poor people and pushing the Global Fund “to the edge of a cliff.”

The cuts were announced just two days after the UN released dramatic new data on AIDS, showing how the increase in financing from donors such as the Global Fund over the past few years has helped prevent the death of 700,000 people and reduce the number of new infections by 30 to 50 per cent.

In addition to the cancellation of the next round of grants, there is mounting evidence that some donors are failing to fulfill their existing pledges, leading to turmoil among many recipients.

The most famous AIDS activist group in South Africa, Treatment Action Campaign, says it will be forced to close its doors and dismiss its 230 workers by the end of January unless it receives a much-delayed grant that was originally supposed to arrive in July. “We face a real crisis,” the group said.

Read the Globe and Mail article here.

Jamaica Observer: Free Representation for Persons Facing Discrimination

Wed, 23 Nov 2011 00:00:00 -0500

NASSAU, Bahamas — Gay men, sex workers and HIV-positive persons will be among Caribbean nationals who will qualify for free legal representation under the newly established Caribbean Social Justice Coalition, if they believe they are being discriminated against.

Already the foundation of the international apparel company Levi Strauss Company has stepped forward to become the first funder of the coalition, which has been registered as a legal entity and launched here at the 2011 Caribbean HIV Conference which concluded Monday at Atlantis Paradise Island.

Dr. Ernest Massiah, director of the UNAIDS regional support team for the Caribbean, said the coalition was born out of a need for the region to provide a mechanism for people who are subject to arbitrary discrimination, especially those who are poor and cannot afford legal representation.

Explaining how the coalition will work, Massiah said a team of lawyers has already been identified and will have their travel expenses paid to get to and from the islands where the cases are being heard.

"Should they win a case, part of the award will go to the lawyer, part to the individual and part to the coalition so that the coalition won't have to be overly dependent on external funding," he said. He added that UNAIDS will also put resources in this coalition and other funders are also interested in funding it.

"The idea of how it will function is still being worked out but the basic principle is it must become self-sustaining," said Massiah, who stressed that it would not only involve discrimination of HIV-infected persons but will provide a mechanism for anyone who seeks redress for injustice.

Miguel Bustos, senior programmes manager for the Americas at Levi Strauss, said that company has been involved in social justice ever since its inception and was one of the first to step forward in the 1980s when people first began dying from HIV in San Francisco. "We used to fund prevention and treatment but we decided we need to get to the root cause and fund advocacy," he said. The company, he added, was delighted at this new initiative and was happy to be the first funder.

"We are pleased to fund the work to support men who sleep with men, sex workers, drug users and anybody else searching for human rights," he said.

Maurice Tomlinson, a Jamaican lawyer on the team, said he opted to leave his private practice in intellectual property rights and take up this cause after he heard of some disturbing human rights violations.

He said the killing of 16-year-old Oshane Gordon on October 18, by men who hacked him to death in his house, because he was suspected of having questionable relations with another man, is one such cause that resulted in his involvement with the coalition.

"It is hard to hear those stories and go back to your life without being compelled to do something," he said. As such, he said, he wanted to dedicate his work with the coalition to the Gordon's memory.

Tomlinson said he is hoping to influence other colleagues to join in this work as it is tragic that a region which has seen so much oppression can continue to oppress others.

"I can't understand why Jamaicans have a problem with privacy rights, and who people choose to love. That was one of the rights denied us as people brought here as slaves to populate a region, yet we can't validate the love of two consenting adults," he argued.

Dr Edward Greene, United Nations special envoy for HIV/AIDS for the Caribbean, said the initiative is even bigger than HIV/AIDS.

"It gives us as advocates something to grasp at and support because its success means we could succeed in our mission to eliminate discrimination of people living with AIDS," he said. He added that social justice is something strived for in order to eliminate stigma of people living with HIV.

Miriam Edward, head of the Caribbean Association of Sex Workers, said this coalition should help sex workers who cannot afford legal representation. "We face a lot of challenges on the street where men would beat us and take back their money and then report us to the police and we are the ones who get locked up," said the Guyanese national.

Read the Jamaica Observer article here.

The Daily Beast: The Eye of the Storm

Fri, 04 Nov 2011 11:57:00 -0400

The past decade has seen natural disasters on an unprecedented scale: “Hundred-year” floods are hitting Western Europe and India every two or three years; hurricane and tornadoes of extraordinary strength are ravaging every continent; agriculture systems from Somalia to Texas are collapsing under the assault of unrelenting drought. But what is lesser known is how the effects of these environmental catastrophes—whether sudden or slow-moving—are disproportionately borne by women. Disaster is seldom gender-neutral.

The gap is easiest to see in the most acute disasters. In the 2004 Southeast Asia tsunami, death rates for women across the region averaged three to four times that of men. That’s in part because girls and women, per tradition, were less likely to have been taught how to swim. Also, many lacked the upper body strength necessary to climb to safety or cling to a tree; and, most tragically, in a fast-moving storm surge, mothers who stopped to find and gather up children or other dependents lost valuable time, which in some cases meant the difference between life and death.

The tragic list goes on: in the 1995 Kobe Japan earthquake, one and a half times more women died than men; in the 1991 floods in Bangladesh, five times as many women as men died. In these societies, women often live longer, but they often live in substandard conditions compared with men, making them most vulnerable to havoc wreaked by nature.

Even when the disaster does not roll in with jaw-droppingly swift power, women typically fall victim far more often than men. For instance, climate change is already producing shifts in the habitats of malarial mosquitoes throughout Africa, pushing the disease into new places. For millions of women, especially pregnant or HIV-positive women, this is a new threat knocking at the door: malaria is one of the leading causes of maternal mortality.

As climate change wreaks havoc in agriculture, we are witnessing a burgeoning crisis regarding food, both in its availability and price. In most cultures, including, arguably, our own, women eat the least; men and boys are privileged in household and family food allocation. In a feature article for The Washington Post in 2008, reporter Kevin Sullivan observed that, “In poor nations, such as Burkina Faso in the heart of West Africa, mealtime conspires against women. They grow the food, fetch the water, shop at the market, and cook the meals. But when it comes time to eat, men and children eat first, and women eat last and least.” This is certainly happening in Somalia in the path of the devastating famine: The United Nations has warned that women fleeing for refugee camps across the border are being raped, abducted, and forced into marriage. In the new world order of climate change, the world’s women will get hungrier, and more brutalized, still.

When acute disasters or chronic environmental change produce social and economic disruption, and particularly if civic order collapses entirely, violence against women and girls, especially sexual violence and sex trafficking, increase dramatically. As the U.S. State Department noted in its 2010 Human Trafficking Report, “From cyclones and floods in Southern Africa to the earthquake in Haiti, the last year has seen a multitude of natural disasters leading to increased physical and economic insecurity. These disasters disproportionately affected the most vulnerable sectors of society—migrants, job seekers, and poor families—making them easy targets for exploitation and enslavement.”

To mitigate the gendered impacts of environmental change, we need, first, to start with awareness—knowing the problem, and acknowledging it. Most official and policy analysis of disasters and environmental change is stunningly gender-blind. But a small cadre of feminist researchers and activists are poised to turn this tide. The international Gender & Disasters Network and the Gender and Climate Change Network provide clearinghouses for research and offer focal points for activists and scholars working toward policy change. Persistent efforts, combining the forces of academia and community organizing, are shifting official policies, albeit at a glacial pace. The Intergovernmental Panel on Climate Change is only recently—yet stingily—taking note of the gender component, while most of the U.N. agencies dealing with social or environmental issues make obligatory, if fleeting, note of the gendered dimensions of disasters.

One of the brightest spots on the official policy map is Mozambique, where Environment Minister Alcinda Abreu in 2009 and 2010 commissioned a worldwide first national strategy plan for gender and environment. Let us hope the rest of the world is not far behind.

Read The Daily Beast story here

Television Jamaica: Jamaica Pressured to Remove its Sodomy Laws

Fri, 28 Oct 2011 11:57:00 -0400

This story from Prime Time News on Television Jamaica covers the press conference announcing AIDS-Free World's petition to the Inter-America Commission on Human Rights challenging Jamaica's anti-gay law. View the press release about the IACHR petition here.

Television Jamaica: J-FLAG Protest

Thu, 28 Jul 2011 14:28:00 -0400

In this story from Prime Time News on Television Jamaica, AIDS-Free World Legal Advisor Maurice Tomlinson discusses the recent J-FLAG protest in Kingston and the rise in the number of recorded attacks against the gay, lesbian, bisexual, and transsexual community this year. "It’s just been horrendous the amount of abuses that LGBT Jamaicans have been exposed to," Tomlinson said.

View the Television Jamaica news report here

IPS: U.N. Women's Agency Being "Strangled at Birth"

Thu, 30 Jun 2011 00:00:00 -0400

UNITED NATIONS — When the United Nations inaugurated a landmark special agency for women last January, Secretary-General Ban Ki-moon set an initial target of 500 million dollars as the proposed annual budget for the new gender-empowered body.

But nearly six months later, the voluntary funding for U.N. Women (UNW) from the 192 member states has remained painfully slow.

Ambassador Hardeep Singh Puri, India's Permanent Representative to the United Nations, expressed disappointment over the funding shortfall.

Nearly six months after its operationalisation, the actual contributions and pledges received are modest and only around 80 million dollars, he said.

"This is not commensurate with the aspiration and ambition assigned to U.N. Women," he complained.

Addressing the first regular meeting of the 41-member executive board of UNW early this week, he said: "We must not be oblivious of the fact that activities enumerated in the Strategic Plan need resources."

The Strategic Plan envisages financial requirement of nearly 1.2 billion dollars in 2011-13.

"If we have to ensure that U.N. Women stands for action, the donor community has to make generous contributions to U.N. Women," said Ambassador Puri.

Stephen Lewis, a former deputy executive director of the U.N. children's agency UNICEF and co-founder of the international advocacy organisation AIDS-Free World, has been one of the strongest advocates of UNW since long before its creation.

In an interview with IPS, Lewis said total funding raised so far — anywhere between 80 million and 126 million dollars — is "hopelessly, pathetically below what's needed and was expected".

"I gather that UN Women has now lowered its sights to a target of 250 million dollars. That's a travesty ... barely more than the cumulative total of the four small entities that were rolled into UN Women at its formation," he said.

The four women's entities that were folded into UNW were: the U.N. Development Fund for Women (UNIFEM); the Office of the Special Adviser on Gender Issues; the U.N. Division for the Advancement of Women; and the International Research and Training Institute for the Advancement of Women (INSTRAW).

The extended title of the new UNW is: 'the United Nations Entity for Gender Equality and the Empowerment of Women', and it is headed by the former president of Chile Michelle Bachelet.

Lewis said the secretary-general's target was 500 million dollars, which he described as "ridiculously low".

The target set by non-governmental organisations (NGOs) was one billion dollars ("barely enough").

"At the moment, UN Women is being strangled at birth by a coalition of the wealthy," said Lewis, a former Canadian ambassador to the United Nations.

"All the misogynist countries, from Pakistan to Sudan, must surely be laughing behind the scenes. They never wanted UN Women and now the Western donors are doing the dirty work for them," he said.

"It's an ugly business and shows, yet again, that when it comes to women, the U.N. can never get its act together," declared Lewis.

"As always, we and others will give Michelle Bachelet the benefit of the doubt. She's quite superb as an under-secretary-general (USG, the rank she holds in the U.N. totem pole)," he added. "But even Michelle Bachelet cannot change the world for women without the resources to do so."

Antonia Kirkland, legal advisor at the New York-based Equality Now, told IPS that without a significant increase in funding by member states, UN Women risks being as sidelined as the previous four entities it replaced that focused on women's empowerment.

"We must ensure that governments fulfill their legal obligations to protect women's rights".

Kirkland said the UN Women's Executive Board must concretely implement commitments made by its members and must devote adequate resources and projected funds to this entity, whose creation was a result of tireless efforts and advocacy by the international women's movement, and in particular the GEAR campaign.

A coalition of over 300 international non-governmental organisations (NGOs) led a global campaign for Gender Equality Architecture Reform (GEAR) in the U.N. system resulting in the creation of UNW.

The coalition included Women's Environment and Development Organisation (WEDO), Center for Women's Global Leadership, International Planned Parenthood Association, Asia Pacific Women's Watch, African Women's Development and Communication Network and Development Alternatives with Women for a New Era, among others.

Kirkland said member states have already invested precious time and money to establish UN Women. It is now time to urgently implement programmes that will benefit women and girls around the world, and give them the promised opportunity to achieve equality and enjoy their full human rights.

Meanwhile, Ambassador Puri told the executive board that to ensure that UN Women stands for action, "We would support all efforts to ensure that scarce resources are not diverted from programme activities in the field to administrative expenditure at U.N. Headquarters."

He said UN Women will be measured by what and how it delivers in the field, not just by what it symbolises.

The first challenge of resource mobilisation to fulfill its ambitious agenda is critical and would demonstrate the trust the international community bestows on UN Women. This needs a sound plan and a committed senior management, he said.

"I am happy to see that the revisions which have been made in the support budget late last week are the right steps in the right direction," Puri noted.

The Indian envoy described the initial target of 500 million dollars as reasonable as well as modest.

"Although I do want to point out here that the Secretary General last year had actually proposed that UN Women should be created with the initial corpus of one billion dollars," he said.

This was also the demand of the developing countries and civil society.

"This might sound ambitious, but the lower target of 500 million dollars should not make us complacent and limit ourselves," he said.

Instead, "We should be prepared to revisit this target later this year, and consider upward revision, in a realistic and practical manner."

"I would like to inform you that the Government of India is seized of the need to make appropriate contribution to UN Women," he added.

The New York Times: I Had Polio. I Also Have Sex.

Sat, 18 Jun 2011 00:00:00 -0400

Lusaka, Zambia — I spoke at an AIDS conference not long ago, and after the talk, someone asked me how I had contracted H.I.V. “Well,” I replied, “sexually.” Staring at my crutches, which I have used since I got polio as a child, she exclaimed, “But how?”

The assumption that all disabilities — of hands, feet, hearing, sight — somehow also affect the ability and desire to have sex is common. It would be comic if it didn’t have such serious consequences: people with disabilities are rarely exposed to sex education and are almost never considered in need of information about H.I.V. and treatment for it.

As a result, although people with disabilities are just as likely to be sexually active as people without, our H.I.V. infection rate is up to three times higher.

In Africa, children with disabilities are less likely to receive sexual health education, both because they are less likely to be enrolled in school, and because those who attend are sometimes removed from sexual health classes. Due to the widespread belief that we are asexual, we are often left out of family planning programs, despite the fact that many of us want children or are parents already.

The blind can’t read H.I.V. prevention posters; the deaf can’t hear radio campaigns. Vague messages are not understood by those with intellectual disabilities. Places where condoms and education materials are available are often physically inaccessible.

People with disabilities are often among the poorest of the poor, and can’t afford health care services. But even those with access to health care often experience discrimination and loss of privacy in health centers. Consider my hearing-impaired friends, who have to bring a family member to interpret if they want to get tested for H.I.V. In many places, people face being evicted or ostracized if family members learn they have H.I.V. The lack of confidentiality is a big deterrent to testing and treatment.

Worst of all, when drugs and services must be rationed, our lives are sometimes valued less than others. I have heard of cases where people with disabilities are given a lower priority for life-saving antiretrovirals.

Last week world leaders met at the United Nations to discuss efforts to fight H.I.V. Despite pledges for universal access to prevention, treatment and care, some people — children and heterosexuals — always get more attention in these meetings than others — sex workers, drug users, gays and lesbians and people with disabilities.

We must no longer be overlooked because of false assumptions about our sexuality. People with disabilities can and do have sex. I know from my own experience. We need to be a part of the fight against H.I.V., too.

Read the New York Times article here.

Jamaica Observer: Campaigners 'Disappointed' with Lorna Golding's Speech on HIV/AIDS

Fri, 17 Jun 2011 00:00:00 -0400

UNITED NATIONS, New York (CMC) — HIV/AIDS campaigners said they were disappointed by Jamaica's presentation as the spouses of government and state leaders spoke on a UNAIDS programme to eliminate new infections of the disease, now passing its 30-year milestone.

Lorna Golding, wife of Prime Minister Bruce Golding, was among 30 'First Ladies' from the Caribbean, Latin America, Africa and Asia who gathered at the United Nations in New York last week to mobilise support around achieving the Joint United Nations Programme on HIV/AIDS' (UNAIDS) vision of zero new HIV infections among children by 2015. The event was held while their spouses and diplomats met for a UN high-level meeting on AIDS.

Panos Caribbean, the information and communication non-governmental organisation, reported on reaction to the session involving Golding and her counterparts which was focussed on first spouses' role in eliminating new HIV infections in children.

In a brief presentation that invoked the Jamaica national pledge, Golding announced that Jamaica has successfully reduced HIV transmission from mother to child since the inception of its Prevention of Mother-to-Child Transmission programme in 2004, Panos said.

"The number of HIV-positive pregnant women receiving antiretroviral medication has increased significantly from 47 per cent in 2004 to 83 per cent in 2009. This has led to a dramatic reduction in mother-to-child transmission of HIV from 25 per cent in 2002 to below five per cent since," she said.

HIV/AIDS campaigners representing civil society who attended the session told Panos Caribbean they felt Golding's presentation was disappointing and lacked clarity in what her plans were for eliminating vertical transmission of HIV.

"I'm disappointed that there were no specific commitments made by the First Spouse on this very critical issue. She only quoted from our national prayer that 'under God' Jamaica will play her part in advancing the welfare of the whole human race. I'm surprised she didn't seize the opportunity to seek specific assistance from the international community to support prevention of vertical transmission in Jamaica," legal advisor, Marginalised Groups AIDS-Free World, Maurice Tomlinson, told Panos Caribbean.

"She gave no indication as to what she or the Government plans to do. This makes it palpably clear she and the Government failed to understand the issue of vertical transmission which is not going away but is festering and threatens to explode in our high-sex and multiple/concurrent partners' context," Tomlinson added.

Director of programmes and training at Eve for Life, Joy Crawford, also told Panos Caribbean that Golding's contribution lacked specifics or any clear action plan, strategies or projects that she would undertake.

"In her promise to play her part in upholding the national pledge 'Before God and all mankind' we anticipate she will develop clear advocacy and interventions that will reduce the current societal, familial and moral stigma and discrimination faced by the young pregnant adolescent female especially those identified as HIV positive," Crawford said.

Sophia Martelly, the wife of Haiti's newly inaugurated President Michel Martelly, committed to working to involve more Haitian men in reducing the rate of mother-to-child transmission of HIV. She also pledged to improve sex education for teens and to support programmes that empower women and improve their economic status.

Read the Jamaica Observer article here.

VOA News: UN Agency for Women the Culmination of Years of Effort

Mon, 06 Jun 2011 00:00:00 -0400

"Diplomats erupted in rousing applause," reported a United Nations press release when the resolution passed to create a new body dedicated to women's rights and gender equality. After four years, two General Assembly resolutions and much negotiating, U.N. Women was finally becoming a reality.

The U.N. Entity for Gender Equality and the Empowerment of Women, called U.N. Women for short, brings together the U.N.'s four units dedicated to women's issues into one larger, higher-level entity. Supporters hope the new agency, which became operational January 1, will bring a change in how the U.N. approaches gender issues.

Creating a brand new agency marks a rare change for a bureaucratic system like the U.N. And although the work of creating the new agency is far from done - funding goals haven't been reached and priorities are still being formalized -- the launch of U.N. Women is a victory for those who fought for it inside and outside the U.N.

So what does it actually take to create a new U.N. agency? Just ask those who have been involved since the beginning.

1) Get the Issue on the Agenda

The U.N. embarked on a process of reform in 2005, appointing the Secretary-General's High-level Panel on U.N. System-wide Coherence to look at ways to streamline the U.N. and improve its effectiveness. Advocates for women's rights saw it as an opportunity to advance proposals for strengthening the U.N.'s approach to gender issues.

Timeline: The Creation of U.N. Women

• June 2006: Office of the U.N. Special Envoy for HIV/AIDS in Africa puts out a report supporting the creation of a new agency for women's issues

• November 2006: U.N. high-level panel on reform includes the new agency in its recommendations

• February 2008: The GEAR campaign is unveiled to demand women's agency

• September 2009: The General Assembly adopts a resolution supporting the creation of U.N. Women

• July 2010: The General Assembly votes unanimously to create a new entity

• September 2010: Michelle Bachelet is appointed head of U.N. Women

• November 2010: Executive Board members are elected. Iran is denied a seat but other controversial states win seats

• January 2011: U.N. Women becomes operational and lays out its 100-day plan

• June 2011: U.N. Women's strategic plan is set to be presented

Activists discussed two possibilities -- expanding the largest existing unit, UNIFEM, or creating a new agency that would merge the existing units. But the spirit of consolidation and reform encouraged them to lobby for the option of creating something new, according to Charlotte Bunch, the co-director of the GEAR campaign.

The GEAR campaign is a coalition of NGOs created to support the creation of U.N. Women. It grew out of the work NGOs did early on to lobby for the new agency.

A push for reform also came from within the U.N. itself, from the office of the Special Envoy for HIV/AIDS in Africa. Senior Advisor Paula Donovan put out a report chastising the U.N. for its record on women's rights and pushing for change.

"Other members of the U.N. were offended and agitated as we expected them to be and wanted them to be," said Stephen Lewis, who was the Special Envoy at the time and is now co-director of AIDS-Free World with Donovan. "We had no sympathy for their excuses and their apologies, because in fact women had not been well served over the decades and there was no use pretending otherwise."

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Rights Watch: Sex, HIV and Disability

Fri, 03 Jun 2011 00:00:00 -0400

In an interview on Human Rights Watch's program Rights Watch, AIDS-Free World's Myroslava Tataryn and Winstone Zulu explain why it is important to recognize and act upon the connections between HIV and disability. The program can be listened to here.

AMY COSTELLO: Welcome to Rights Watch, a program about human rights around the world from Human Rights Watch. I’m Amy Costello.

About ten percent of the world’s population live with disabilities, according to the United Nations. That makes people with disabilities the world’s largest minority. And when it comes to one of the world’s great pandemics — people with disabilities are not immune. A 2004 Global Survey on Disability and HIV/AIDS conducted by Yale University and the World Bank, found people with disabilities face the same risks, or even greater risk for contracting HIV, as people without disabilities.

Even so, people with disabilities say they often feel invisible when it comes to discussions about sex — the primary means of HIV infection.

MYROSLAVA TATARYN: I think that historically, people with disabilities have been seen as asexual.

AMY COSTELLO: Myroslava Tataryn is an advisor on disability and AIDS for AIDS Free World, an international advocacy group. She also has a disability.

MYROSLAVA TATARYN: You don't usually see images of people with disabilities showing affection or love or expressing their sexuality.

AMY COSTELLO: Tataryn says just like anyone else, people with disabilities are definitely interested in sex.

MYROSLAVA TATARYN: On a personal level, often that's what people talk about the most or want to talk about, because we all want to have good, positive loving relationships.

AMY COSTELLO: But instead of feeling like they’re part of the conversation, people like Winstone Zulu are often sidelined and stigmatized. Zulu contracted polio when he was a child in Zambia. Now he uses crutches or a wheelchair to get around. Zulu’s also been HIV positive for more than twenty years. He says, sure he faces stigma when people find out he’s HIV positive. But that’s nothing compared to the way people underestimate him...and his manhood...just because he has a bum leg.

WINSTONE ZULU: People think, if your leg is not working it's a reflection of a general weakness for the whole of you. Perhaps this is the reason why they think that everything, including everything in your pants, are disabled. So you can't have sex.

AMY COSTELLO: But of course, people with disabilities have sex. That’s how Zulu contracted HIV. Now he travels the world speaking about HIV, tuberculosis and disability...and the intersections among these conditions. During one of Zulu’s speaking engagements, someone in the audience asked him a question about his HIV.

WINSTONE ZULU: One of the women said, "How did you get it?" And I said, "Sexually." She looked at me, like up and down, and said, "But how?" you know, just like that! Like it's the most complicated thing in the world to have sex.

AMY COSTELLO: There can be dire consequences when we assume that people with disabilities don’t have sex, or aren’t even capable of having it. In the era of AIDS, talking about sex, sexually transmitted diseases, and how to practice safe sex, has never been more important. The Yale study found that adolescents and adults with disabilities are just as likely to be sexually active as anyone else.

Despite this, Tataryn says young people with disabilities are still seen as A-sexual. As a result, they are kept out of life-altering — and potentially live-saving — discussions.

MYROSLAVA TATARYN: Because there's this perception of asexuality amongst children with disabilities and this historical desire to protect disabled children, then often there's anecdotal evidence that children are taken out of sexual health classes because they don't need to worry about that. And we want to protect them from that stuff. Or they'll never have the opportunity to have sex anyway, so we don't need to trouble them.

AMY COSTELLO: But just ensuring that children with disabilities have equal access to sex ed in schools may not be enough. Tataryn says in many places in the developing world — you may not even find disabled children in schools anyway.

MYROSLAVA TATARYN: The levels of education among children with disabilities are lower. So if the primary source of sexual health education is at school, and those children aren't attending school, then right away there's going to be a gap.

AMY COSTELLO: Naturally, many of the girls and boys who are shut out of discussions about sexual health grow up to become mothers and fathers themselves. In Zambia, where Winston Zulu is from, he says people with disabilities are routinely denied access to family planning clinics and services.

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Americas Quarterly: J-FLAG Issues Statement on International Day Against Homophobia

Tue, 17 May 2011 00:00:00 -0400

Kingston — The first national survey of attitudes and perceptions of Jamaicans towards homosexuality, conducted by a research team headed by Professor Ian Boxill, has found that negative views of homosexuality tended to be greatest among males, non-university educated persons, those who listened mostly to dancehall and reggae music and those in lower socio-economic groups.

As J-FLAG celebrates International Day Against Homophobia (IDAHO), the findings of the study underscores the reality of homophobia faced by many gay, lesbian, bi-sexual and transgender Jamaicans. The study showed 59% of respondents chose negative words to describe their feelings towards homosexuals. 51% acknowledged learning about homosexuality at 14 years old and younger, with family & friends (32.9%) and media (31.3%) being the main sources of exposure.

Strongest objections to homosexuality were raised on religious grounds and the need to ‘protect Jamaican society from changing its cultural practices for the worse’, with 85% saying that they did not think that homosexuality among consenting adults should be legal, pointing to a widely held misconception that it is illegal to be homosexual. Additionally, the survey showed that 81.8% of respondents attend church and 82% deemed male homosexuality to be morally wrong as opposed to 3.6% who did not see it as a moral issue.

Of significance is the fact that 30% agreed that someone can be homosexual and also be a Christian, but 56% believe that it is not possible to be a homosexual and be religious at the same time. However, a significant minority (43%) did not share this view, suggesting some conflict on the issue of homosexuality and religiosity again highlighting the need for dialogue to begin to allay concerns that are unfounded and rooted in fear and ignorance.

UNAIDS Executive Director, Mr. Michel Sidibé, in his message for IDAHO called on the world to “replace violence and discrimination with acceptance and tolerance,” emphasizing the need for greater tolerance towards gay, lesbian, bi-sexual and transgender (LGBT) persons. Echoing the call for increased tolerance, Dane Lewis, Executive Director of J-FLAG noted that “the rise in the number of reports to J-FLAG in the last three months has been significant pointing to the reality that LGBT Jamaicans continue to be victims of human rights violations in varying degrees.

Despite the strong negative perceptions and attitudes towards homosexuality, which cut across all social classes, gender and social groups, the research offered some hope of greater tolerance, revealing that 49% of respondents believe that homosexuals experience genuine love and affection, like heterosexuals, in their intimate relationships. A significant minority, 20%, of respondents chose positive words such as tolerance and acceptance when asked to describe their feelings towards homosexuals in spite of the prevailing climate of homophobia. Interestingly many respondents readily pointed out that persons who are homosexual make an important contribution to the society. Most of the respondents did in fact believe that homosexuals were and can be productive members of society.

The research team conducted the research using a nationally representative sample of 1007 adults from 231 communities between October and November 2010. The survey was also supported by a qualitative study based on five focus groups conducted across the island between October 2010 and January 2011.

The research was commissioned by the Jamaica Forum for Lesbians, All-sexuals and Gays (J-FLAG) with the support of AIDS-Free World and Open Society Institute.

Read the Americas Quarterly story here.

IRIN/PlusNews: Straight Talk from Stephen Lewis

Mon, 11 Apr 2011 00:00:00 -0400

Laura Lopez Gonzalez, a reporter for IRIN/PlusNews, interviewed Stephen Lewis in Johannesburg during a March 2011 meeting of activists who gathered to discuss a new, civil society-driven framework for global health. Ms. Gonzalez is one of 11 journalists who were awarded fellowships in 2011 by the International Women's Media Foundation. The fellows will jointly produce between 30 and 40 investigative reports on HIV and AIDS in South Africa, through a MAC AIDS-funded project that seeks to "increase global coverage of women's issues and to support women in the media."

JOHANNESBURG — A former politician, diplomat and aid worker, few people have witnessed the fight against HIV from as many international vantage points as former UN Special Envoy for AIDS in Africa, Stephen Lewis. Now co-director of the international advocacy organization, AIDS-Free World, Lewis spoke to IRIN/PlusNews about the direction of the international response to HIV.

Question: Reduced funding, a lower donor profile, and arguments against AIDS exceptionalism — has the fight against HIV lost momentum?

Answer: The fight against HIV is at a very difficult moment, there's no question and for two reasons. First, the decline in funding could be truly catastrophic by or before the end of this year. Western governments, which are reducing their contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the United States, which is flat-lining the US President's Emergency Plan for AIDS Relief, do it all on the ostensible rationale of the financial crisis but that's just utter nonsense. There's never a financial crisis when you have to bail out the banks or provide a stimulus package... there's only a financial crisis when you’re dealing with global public health and putting people at risk.

We have 10 million people who require HIV treatment urgently and there is no guarantee we'll be able to roll out the drugs fast enough to keep people alive. There are already many projects in Africa that cannot enroll new patients. This is preposterous. It's happening in Malawi, it's happening in Uganda, it's happening in Zambia, and there are drug stock-outs. It's becoming increasingly clear that the hazard of cutbacks financially is putting more and more lives at risk.

The other factor: there is a determination to expand the portfolio of health interventions in a way that is prejudicial to the work on HIV and AIDS. HIV is possibly the worst pandemic in human history — 30 million people dead, 33 million people infected... 15 million orphans — how in God's name is [this] not exceptional?

That doesn't mean that other things should be prejudiced by AIDS... no one who works on HIV and AIDS would deny funding for maternal and child health or for non-communicable diseases... You have a moral obligation to enlarge the pie to encompass all the requirements of health and what [funders] are doing in a kind of Pavlovian, unthinking way is to fail to analyze the overall needs.

Q: What is the hardest truth about the fight against HIV that we are not facing?

A: The recognition that there are HIV prevention interventions that would work if only the world would galvanize around them.

Prevention of mother-to-child transmission — it should be called vertical transmission — that should have been the easiest. Instead, for the past 10 years, we have been stagnated by the lack of urgency in the response. Countries like India and Ethiopia continue to use single-dose Nevirapine. Everyone now knows that single-dose Nevirapine has the possibility of inducing drug resistance in the mother and the child, and therefore puts their lives at risk. [Agencies and governments] still put single-dose Nevirapine into the percentages of success when they say, extravagantly, that we have 53 percent of the women who are HIV positive and pregnant on drugs, they include single-dose Nevirapine, which covers roughly a third of those women. That's completely irresponsible, that's not an intervention. It's incredible that there hasn't been a single-minded crusade to get everyone off single-dose Nevirapine.

Look how long it took us to implement male circumcision. We knew in the 1990s that male circumcision was a way of reducing HIV infection for men. We waited until we had a plethora of studies and didn't get going until 2005. Paula [Donovan, AIDS-Free World co-director], in the year 2000, suggested circumcision [should] coincide with immunization for babies. If that had been done, we would soon be receiving the benefits of that but everybody laughed it off.

It isn't one item, it's just item after item after item in which the international community is failing. If I can make an obvious observation, recently UNAIDS and WHO [World Health Organization] put out a joint press statement saying, "We're worried about the funding. We're very, very worried we're not going to have the funding, people are going to be put at risk, there will be great calamities."

UNAIDS in its epidemic update report last year said that we'd turned the corner, had all this success, we can see that the virus is in retreat. Well, you can't on the one hand tell the donors that everything is moving along nicely, and then expect them to take you seriously when there's not enough money. There's just not enough thinking about what is said and what is done.

Q: HIV activism has moved from Act-Up in the United States in the 1980s to South Africa's Treatment Action Campaign in the 1990s — both groups have had to scale back due to funding problems. What does that mean for the future of HIV activism?

A: I think HIV activism has been stalled momentarily, and I emphasize "momentarily," because of the crises around funding and the retreat from the serious responsibility around the pandemic on the part of many, western, governments in particular. [Activists'] voices aren't being listened to as they used to. TAC is sort of the spiritual leader of [HIV activism] and if TAC feels compromised, in any way, it's a great pity because they are — for all of us — the beacon of activism.

Q: How much time do you think countries have until they have to fund the bulk of their HIV responses?

A: There is no way of avoiding the international responsibility, this is an international pandemic and no country escapes it... There will always have to be a significant component of international aid, these countries are so poor; the majority of people in most of the beleaguered countries are living on less than US$1 a day, how can they be expected to handle the costs of treatment, prevention, care and support? It's just not realistic. It is necessary for them to put more and more money into the fight against AIDS and necessary for them to achieve the 15 percent national budget allocation for health [set out in the Abuja Declaration] but there will always have to be an international component.

Q: If donors do not want to give, what can the HIV/AIDS community do?

A: We just keep fighting. I think of the Global Fund getting $11.7 billion when really what they needed at minimum was $17 billion, and for the best trajectory of getting to those extra 10 million people, they really needed $20 billion, so they're way down. What is even more worrying of course, is that for obvious reasons, Japan will probably not fulfill its financial commitments [to the Fund]; the right-wing in the Unites States will, to some extent, cut the American contribution; and Germany and Sweden still have not committed to their funding. In Japan’s case this is understandable; in everyone else’s case this is reprehensible.

One grits one’s teeth and one doggedly continues to hammer away at the injustice, the inequality, at the misogyny because women suffer most, at the insensitivity and irresponsibility because race is involved. The [withdrawal from the fight against HIV] violates all the basic moral principles of the struggle for social justice so you make the arguments as strongly as you can and you document them. You do the research and show the shortfalls and the consequences in human terms, and one day the pendulum swings. The pendulum has swung in the wrong direction but one day it will swing back and more money will become available.

The Globe and Mail: House Approves Generic-Drug Bill Meant to Help Poor Countries

Wed, 09 Mar 2011 00:00:00 -0500

A long-running attempt to make it easier to produce and distribute copies of patented medicines for sale at cut-rate prices to the world’s poorest countries has been approved by the House of Commons.

A private-member’s bill known as C-393, which has gained the support of some Canadian celebrities including the musician K’naan and writer Margaret Atwood, is now headed to the Conservative-dominated Senate.

K’naan, a Canadian born in Somalia, told reporters on Wednesday that he took time away from recording news songs to make a public stand in favour of the bill.

“If I look at the kind of fortunes that I (have), it compels me to do something, it compels me to look back and see what it is that I can change...” said the Juno-award-winning musician.

“What is the most important (thing) is when a nation can look at another nation, or another group of people that are bleeding, and say that ‘that is my blood as well’ - that they can see outside of their particular experience and say ‘I am going to do something,’ because that is the human experience.”

The bill was first introduced in 2009 by former New Democrat MP Judy Wasylycia-Leis and was handed off to one of her colleagues when she retired. NDP Leader Jack Layton, who has been in hospital recovering from hip surgery, appeared in the House specially for the vote which passed with the help of the Bloc Quebecois, all but two Liberals, and a handful of Conservatives.

James Orbinski, the founder of Dignitas International, a medical humanitarian organization, pleaded with Senators to expedite it into law.

“It will save millions of lives, not in some distant future but literally within the next year or two,” said Dr. Orbinksi. The generic-drug maker Apotex has said that, if the legislation is successful, it will begin the production of a pediatric medicine to treat children in developing countries with HIV.

The Access to Medicines Regime was introduced by a former Liberal government as part of a pledge to help Africa’s poor. But the licences that it grants are severely limited and, in it’s seven-year-history, it has been used to send just two batches of a single drug to one developing country. Bill C-393 would eliminate many of the restrictions that the generic companies say have rendered the regime unworkable.

Those who oppose the legislation argue that it violates intellectual property rights and will dampen the enthusiasm of brand-name pharmaceutical companies to invest in medical research.

Brett Skinner, the president of the Fraser Institute who specializes in health policy research, said most developing countries do not register patents so Bill C-393 won’t change anything.

“Patents are not a barrier to access. And, when generic companies had access to these markets under previous provisions, they just simply did not ship their drugs to these (impoverished) countries,” said Mr. Skinner. There is a fear, he said, is that the cheap generic copies of these medicines will instead be sold to secondary markets like Hungary.

But Richard Elliott, the executive director of the Canadian HIV/AIDS Legal Network which has been a leading proponent of the bill, said patents do exist in some developing countries. And, in any case, it is against the law for Canadian generic manufacturers to copy and produce patented drugs here for sale abroad.

Stephen Lewis, the former United Nations special envoy for HIV/AIDS in Africa, said children and women who are infected with HIV are among those who have the most to gain from the passage of Bill C-393.

He pointed out that Prime Minister Stephen Harper, as chair of last year’s G-8 summit, launched an international maternal and child health initiative. “I can’t imagine anything,” he said, “that synchronizes more directly, that integrates more directly into his involvement in maternal and child care than would this legislation.”

Read the Globe and Mail article here.

TrustLaw: UN Women Pressured to Do More with Less Money

Fri, 04 Mar 2011 00:00:00 -0500

LONDON — It took Crescentia four long years to persuade her mum to let her go back to school rather than supporting the family full-time. In the summer holidays — like hundreds of teenage girls in northern Ghana — she headed south to work as a construction porter. But there, her sister's husband drugged and raped her, making her pregnant.

Five years on, with assistance from the Nadowli Assembly Women Advocacy Group, Crescentia is a student again, doing exams. Now in her twenties, she wants to become a nurse so she can make a better life for herself and her child.

The Ghanaian organisation that helped her get back on track is a partner of international development charity Voluntary Service Overseas (VSO), which says the United Nations' new agency for women must make a real difference to the lives of women and girls like Crescentia who suffer violence and other abuses of their rights, including property, inheritance and land rights, particularly in Africa, Latin America, the Middle East and North Africa.

"One of the major barriers to development is the low status of women, and the discrimination they face," said Kathy Peach, head of external affairs at VSO UK. "The feedback we get from our volunteers and partners is that the U.N. is not really delivering for women at the grassroots."

The U.N. Entity for Gender Equality and the Empowerment of Women (UN Women), operational since January but officially launched in late February, is tasked with helping states speed up progress on meeting goals for women's rights — a tough challenge after years of neglect by many governments, activists say.

VSO's Peach thinks the agency, headed by former Chilean President Michelle Bachelet, should get to work quickly on assisting women who have suffered domestic, sexual and other types of violence to get access to justice.

In a recent survey commissioned by VSO UK and Oxfam, covering 100 civil society organisations in 75 countries, 72 percent said ending violence against women must be the top priority for UN Women. Peach believes the agency should leverage the U.N.'s influence with governments to press them into criminalising violence against women and using the law to hold perpetrators to account.

Paula Donovan, co-director of the HIV/AIDS advocacy organisation AIDS-Free World, spots a promising opportunity to help HIV-positive mothers who visit clinics for treatment to stop their unborn babies contracting the virus. While much progress has been made in preventing HIV transmission from mother to child, it's shocking that many women who receive these drugs aren't assessed or given medication for their own infection at the same time, says the former U.N. official who has long lobbied for the creation of a women's agency with real guts.

"UN Women could say enough of treating women like incubators; they deserve proper attention," she told TrustLaw from New York. HIV/AIDS would be a good focus area for the agency to demonstrate results because infection rates and numbers of patients being treated are relatively easy to quantify, she added.

No Results, No Money?

UN Women is certain to face pressure to show it is having a deeper and wider impact than the four previously distinct parts of the U.N. system it brings together, including the U.N. Development Fund for Women (UNIFEM).

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CBC News: Video: Monitoring Global Aid Funding

Wed, 26 Jan 2011 00:00:00 -0500

View the CBC News video here.

Prime Minister Stephen Harper is co-chair of a UN commission formed to ensure delivery of roughly $40 billion pledged to a mother-and-child health fund. The ambitious program comes on the heels of an audit of a global aid fund that found millions of dollars may have been misused.

Stephen Lewis, a former UN envoy for HIV and AIDS in Africa, spoke to CBC News on Wednesday from New York about the issues of maternal health, accountability and transparency.

Women's eNews: U.N. Women Superagency Opens, But Just Barely

Thu, 13 Jan 2011 00:00:00 -0500

UNITED NATIONS — The new United Nations gender agency, known as U.N. Women, quietly opened on Jan. 3 without any publicity or announcements.

The superagency's midtown Manhattan headquarters remain unoccupied, said U.N. Women spokesperson Gretchen Luchsinger. Employees from the four U.N. gender agencies and offices that this new entity is uniting continue to work out of their own, scattered offices around the U.N. Secretariat building.

"Maybe because of the U.N. bureaucracy we have experienced a slow process to seeing U.N. Women become operational," said Margot Baruch, spokesperson for the Gender Equality Architecture Reform, a civil society coalition with offices in New Brunswick, N.J., that campaigned for U.N. Women's creation.

U.N. Women activity is likely to remain low-key until the public ceremonial launch on Feb. 24 — pushed back from Jan. 20 — at the U.N. Secretariat, according to Baruch. The evening event will coincide with the start of the annual month-long session of the Commission on the Status of Women, which typically brings in thousands of women's rights activists from around the world.

Concerns raised in the fall about the agency's financing — a minimum annual $500 million budget is deemed necessary to scale up programming and see any impact — have continued into the new year.

Budget Discussions Pending

U.N. Women's budget is going to be part of the first regular session of U.N. Women's executive board, running Jan. 24-26, said Luchsinger in an email interview.

On its new Web site, U.N. Women says it so far has received nearly $77 million in country pledges, which will become a part of the budget that aims to scale up to $500 million by the end of 2011.

Seven high-level staff positions are still open. Two assistant secretary-general jobs are slated to be filled by the end of February, according to a budget presentation by the new agency's executive board on Tuesday. The same group said all seven members of the senior management team will be in place by the end of April.

Luchsinger said U.N. Women couldn't provide numbers on the entire staff size, including high-level positions, until after the budget is approved.

"U.N. Women is going through a process of transition and assessment to understand what else is needed and will be filling positions accordingly," she said.

UNIFEM country programs continue to operate as they were, according to Luchsinger, but now under the U.N. Women name.

Bachelet Leads Superagency

The U.N. General Assembly voted to create U.N. Women in July 2010. Two months later, Secretary-General Ban Ki-moon appointed former Chilean president Michelle Bachelet as its executive director and as an under-secretary general in a widely celebrated move.

Paula Donovan, co-director of the New York City-based nongovernmental group AIDS-Free World, described Bachelet as a "realist." Donovan and her co-director Stephen Lewis — both of whom helped launch debate on the need for the superagency in 2005 — recently met with Bachelet in New York.

"She understands the expectations are extraordinarily high and there are so many people who have been waiting so long for real progress on these issues," Donovan said. "She will do absolutely everything she can to fulfill her vision of a strong U.N. Women agency, but she wants to make it clear to people that it is a process and she can't do it alone. She can't suddenly change the U.N. system."

A shadow fell on the new agency in November, when Saudi Arabia — which has made significant reforms but also restricts women's freedom of movement by, for example, prohibiting them from driving and requiring a male guardian to give permission to travel, work or study — was among the countries elected to its executive country board, a body of 41 charged with overseeing general policy.

Read the Women's eNews article here.

IPS: U.N. Chief Leaves Women Out of Year-End Summing Up

Wed, 05 Jan 2011 00:00:00 -0500

UNITED NATIONS — When Secretary-General Ban Ki-moon wrote a year-end op-ed piece for an Australian newspaper last week, he talked about the future of a world body facing a new generation of threats: climate change, poverty, nuclear disarmament and human rights.

But, wittingly or unwittingly, he left out one of the biggest political success stories of the world body: the creation of a separate body, UN Women, to promote gender empowerment worldwide.

The new U.N. agency, armed with a projected 500-million-dollar annual budget and headed by Under-Secretary-General Michelle Bachelet, began functioning at the beginning of the New Year.

But there has been no fanfare or political celebration inside the world body — even as the secretary-general is being accused of bypassing the importance of the landmark event.

"It would have been a tremendous opportunity to draw attention to UN Women ... after all, the creation of an entirely new agency devoted to half the world's population is something to be noted and celebrated," said Paula Donovan, a co-director of AIDS-Free World, one of the early active campaigners for the new agency.

"But there's not a word on UN Women," she complained in a letter to Bachelet, jointly authored with Stephen Lewis, a former deputy executive director of the U.N. children's agency UNICEF.

"And that's only the half of it. The other half provokes disbelief," says the letter.

The agency was inaugurated Tuesday, the first working day at the U.N. since Monday was a New Year holiday.

In a paragraph that summarises the Millennium Development Goals (MDGs), the secretary‑general lists seven of the eight goals. "The only one left out is, astonishingly, the goal on gender equality and the empowerment of women. How is that possible?" the letter notes.

The creation of UN Women was hailed as a phenomenal success judging by the decades-old negotiations.

Asked to respond to the criticism, deputy U.N. spokesman Farhan Haq told IPS: "The secretary‑general has made clear his commitment to women's issues, and he pushed strongly for the establishment of UN Women."

His commitment to UN Women can be seen through his efforts to win approval for that entity and his search for a strong leader for UN Women, which he found in Michelle Bachelet, said Haq.

"He has spoken extensively on women's issues, and its absence from one op-ed does not imply any lessening of his commitment on this crucial issue," he declared.

In the op-ed piece, which was published in the Sydney Morning Herald Dec. 31, Ban says the United Nations today leads what seems at times like a double life.

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News from Africa: Homosexuality: AU Asked to Tone Down Leaders’ language

Thu, 23 Dec 2010 00:00:00 -0500

In an open letter they wrote to the Chairperson of the African Union, Dr. Jean Ping, two AIDS-Free World officials said, “we are writing to express our grave concern about the recent escalation of homophobia throughout the African continent. A vocal minority spouting hatred, paranoia, and intolerance is dominating public discourse.”

In response, said the letter, increasing numbers of parliaments are attempting to criminalize homosexuality, and increasing numbers of African leaders are publicly endorsing this criminalization.

Currently, over two-thirds of countries in the African Union have legislation that criminalizes homosexuality.

And the AIDS-Free World said it is disturbed by the silence of AU leaders in the face of this discrimination, and we urgently call upon the African Union to hold a special session to address the issue.

“We do not believe it is the intention of the African Union to condone this homophobia and discrimination, given the strong commitments to human rights and equality enshrined in the African Charter on Human and Peoples’ Rights.”

The Charter states unequivocally that “All peoples shall be equal; they shall enjoy the same respect and have the same rights.”

“We also do not believe that it is the intention of the African Union to take a devastating step backwards in the fight against AIDS. Yet that is precisely what will happen if this growing homophobia is not addressed strongly and swiftly,” they said.

The two told Dr Ping that when homosexuality is demonized — whether through hate speech, discriminatory legislation, or criminalization — lesbians and gays are driven underground into unsafe and often terrifying situations, their prospects of receiving counseling and testing to establish their HIV status diminish drastically, and it becomes virtually impossible to reach them with the information, education, and condoms that can prevent the spread of HIV.

Numerous studies have shown that rates of HIV amongst men who have sex with men are already higher than rates in the general population.

Recent news stories paint a wrenching picture of the tide of anti-gay sentiment rising throughout the continent:

In Uganda, hatred stemming from fear and paranoia is causing individual citizens to attack homosexuals verbally and physically.

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PlusNews: Disability, HIV Find Common Ground

Tue, 21 Dec 2010 00:00:00 -0500

People living with disabilities are known to be just as, if not more, at risk of contracting HIV as non-disabled people, but there is little specific data or programming that reflects this reality on a global scale.

That is slowly starting to change, say HIV/AIDS and disability civil society leaders, as well as UN agency health officials, as connections between the divergent groups are growing stronger and the urgent need to address this gap is being made increasingly clear after years of internal stalled progress.

"There's just a real dearth of data," said Paula Donovan, co-director of AIDS Free World, an international HIV/AIDS advocacy organization based in New York. "If a country said, 'We don't have data on disability and HIV/AIDS', then that in itself is data, but we don't see that, even. The actual activity, the expression of will, is sporadic."

More than 600 million people — 10 percent of the global population — live with disabilities, and 80 percent of them live in developing countries. This population often struggles to gain access to sex education and health services, including HIV prevention and education materials.

Yet people with disabilities engage in the same sexual behaviours that the general population does, according to a landmark 2004 Yale University/World Bank report entitled HIV/AIDS and Individuals with Disability. Additionally, women with disabilities are more vulnerable to sexual exploitation and rape than non-disabled women.

Eighty-seven percent of disability advocates, programmes and institutions from 57 countries consider HIV/AIDS "of immediate concern" to the disabled populations they serve, the report showed.

But indications that speak to the impact HIV/AIDS has on the disabled community on a global scale largely stop there.

Initiatives

UNAIDS is now picking up the pieces, nearly seven years later, and is planning to investigate ongoing initiatives that link AIDS and disability, and what kind of engagement there has been with persons living with disabilities.

It is a start that will eventually lead to in-depth analysis of these connections, said Emilio Timpo, senior adviser to UNAIDS, and on programming specific to disabled persons.

Other UN agencies, like UNICEF, have also begun to focus more on the connections between HIV/AIDS and disability at the country level, said Ken Legins, HIV/AIDS chief at the UN Children's Fund (UNICEF).

UNICEF's Burkina Faso office recently conducted a study on HIV among people with disabilities aged 15-64, which revealed they were much more likely to be illiterate and out of school, and with limited access to information about HIV. They tended to have low incomes and their subjection to sexual abuse made them more likely to be forced into risky sex behaviours.

"The challenge is that the HIV community itself is not well connected with people who are advocates for disability at the country level," Legins told IRIN/PlusNews. "When discussing HIV, disability gets left out because the group of people who work on these issues are often not a part of the discussion and we need to make sure that they are."

Disability and HIV/AIDS were prominently featured in the main programme for the first time in an International AIDS Conference this past July, in Vienna, marking a sharp turn from the previous conference in Mexico City in 2008, said Donovan of AIDS Free World. The conference venue was not accommodating to disabled people and disability was sidelined to a satellite event, she said.

Communications gaps

UNAIDS recently co-sponsored a panel discussion on HIV/AIDS and disability in New York, sandwiched between World AIDS Day and the International Day of Persons with Disabilities — commemorative events that are usually kept separate, UNAIDS's Timpo said.

Disability will receive an even higher profile at the International AIDS Society conference in Washington D.C. in 2012, predicted Steve Estey, chair of the International Committee of the Council of Canadians with Disabilities.

The acceleration of inclusion has been "quite astonishing" since 2006, noted Estey, when "we were nowhere".

At the panel discussion in New York, though, questions circled around the communication gaps that have existed between the two communities for years, and why it has taken UN agencies so long to take action.

Eric Sawyer, civil society adviser to UNAIDS, said it was partly a function of working to scale-up basic services first.

"The UN system has been struggling just to get prevention messaging and treatment access available and accessible around the world," Sawyer said. "Once you are able to ensure people have that access, then you are able to increase the level of services. But of course we are working to ensure that the disabled have equal access and that is increasingly finding a place in people's consciousness."

Read the PlusNews article here.

The Guardian: UN Accused of Risking Women and Children's Health

Fri, 17 Dec 2010 00:00:00 -0500

If World Aids Day on December 1st felt like a bit of a love-in over achievements to date against the disease, a Canada-based organisation has brought us earthwards with a bump. Aids-Free World, founded by the redoubtable Stephen Lewis and not known for pulling its punches, says in a statement that the UN's determination to be seen to be cutting the numbers of infants infected with HIV at birth is putting the health of mothers and babies at risk. UNAIDS absolutely refutes the charge.

Aids-Free World says that women are being given sub-standard treatment to prevent their HIV infection being transmitted to their baby. In some, but not all, countries, they are still being offered single-dose nevirapine, which in the early days of attempts to safeguard babies, was all that was available.

"That quick fix is no longer recommended by the World Health Organisation because it falls so short of acceptable standards of care, but worse, because it puts mothers and babies at risk.

"About a third of women who are given a single dose of nevirapine during childbirth will develop resistance to that class of drugs. Later, when their HIV disease progresses and they need treatment to stay alive, the antiretroviral regimens (ARVs) used in most developing countries may not work. Over 50 percent of the babies exposed to single-dose nevirapine will also develop drug-resistant HIV".

The charge against the UN is that it is counting this sort of flawed treatment - which would no longer be permitted in rich countries - as part of the statistics of success (53% of pregnant women with HIV are given drugs to prevent transmission to their babies, says this month's UNAIDS report).

"Of the four countries in sub-Saharan Africa applauded for achieving the UN's 80 percent goal, three — Namibia, South Africa and Swaziland — reached the target in part by prescribing single-dose nevirapine; in Namibia, 48 per cent of women enrolled in the programme received it. In Ethiopian and India, single-dose nevirapine was prescribed to all the women treated, and yet both countries earned a tick on the UN ledger that marks progress toward "virtual elimination of mother-to-child transmission".

Paul De Lay, deputy executive director of UNAIDS, clearly feels the attack is unfair. The figures they presented, he says, were the data available — in the report it was broken down by type of drug given.

"Whether that is a success or not depends how you view it. Does nevirapine prevented transmission? Yes it does. Does single dose nevirapine save infants' lives — officially three to four years ago it was the gold standard treatment? Yes it does," he says.

It's a rapidly evolving field, De Lay says. "Should we be accused of not using the most effective drugs? That's ridiculous," he says. It takes time to implement new scientific wisdom — but in fact, in HIV/Aids, things have moved incredibly fast. The guidelines came out only at the end of 2009, he points out. "It took the US two years to implement the initial long-term AZT drug regimen recommended at that time in the mid 90s."

In five or ten years' time, we are very unlikely to be using the drugs that are considered gold standard now, De Lay adds. Few would dispute that — least of all, one assumes, Aids-Free World. In fact, that's their point, I assume — that the faster we move, the more lives we save.

Read The Guardian article here.

VOA News: Homophobia Sweeping Africa Like a Disease, says Rights Group

Thu, 16 Dec 2010 00:00:00 -0500

The group Aids-Free World says there’s a wave of "homophobia sweeping across Africa." It’s calling on the African Union to take urgent measures to stop "a growing and insidious contagion."

Co-director Paula Donovan says silence on the part of the AU about the issue is similar to silence during the early days of the AIDS epidemic.

"The problem is definitely getting worse. Homophobia seems to be spreading like a contagion from country to country in Africa. And the efforts to criminalize homosexuality…(have) been taken up by increasing numbers of parliaments and promoted by increasing numbers of African leaders, including heads of state and prime ministers."

In the news

A number of anti-homosexual incidents have been reported recently in Africa. Uganda has considered legislation that would impose harsh penalties for homosexual acts. One measure even called for the death penalty in some cases. In Malawi, a male couple was prosecuted when their gay relationship became public. Donovan says other incidents can be found Kenya, Zimbabwe and most recently Ghana.

Bernice Sam, program coordinator for Women in Law and Development (WiLDAF), called for Ghana’s constitution to be amended.

"In Ghana, to our dismay, an advocate for women’s rights spoke publicly about the need for the constitution to be reviewed. She saw a loophole…that would allow gay marriage and that would not allow for the criminalization of homosexuality. And she said publicly on tape that we don’t want gay marriage in Ghana," says Donovan.

Sam is also quoted as criticizing attempts on the continent to recognize the rights of gays, lesbians, bisexuals and transgenders.

Donovan says, "We were shocked to hear the statements coming from her. As I think anyone who is aware of and supportive of WiLDAF’s work would be shocked. You know, you simply can’t categorize the rights of lesbians, gays and other sexual minorities as separate and distinct from the rights of all human beings. To hear this sort of homophobia being promoted by people who purport to be human rights activists is incredibly troubling."

30 years later

In the early years of the HIV/AIDS epidemic, a number of African leaders stated that homosexuality did not exist in their countries, that it was a matter for Western nations. Some 30 years later, it remains an issue.

"I’m not quite sure what happened to trigger this new wave of homophobia across Africa. I think that it probably happens in any human rights debate. That people who are theoretically in favor of human rights can speak in platitudes and then suddenly, when they see a particular subset of the human population about whom they’re fearful and distrustful, then they start to rethink their general support for the human rights of all people," she says.

She says many African leaders have embraced the idea of ending stigma and discrimination against those living with HIV/AIDS, but she adds the sentiment doesn’t go far enough.

"It’s been pointed too narrowly at people who are already HIV positive," she says, "We need to understand that stigma and discrimination is what drives people into high-risk groups. And so, as long as you discriminate against people and drive them into the margins of society, then you’re going to exacerbate your HIV problems."

She adds that "tolerance, openness and refusal to discriminate have to apply to people before they are HIV positive, as well as after."

Listen to the radio interview with Paula Donovan here.

The Independent: Big Pharma and the Business of HIV/AIDS

Wed, 01 Dec 2010 00:00:00 -0500

The cost of treating HIV with antiretrovirals has plummeted during the past decade. Prices for the six most common initial treatments — or first-line drugs — in low- and middle-income countries fell by between one per cent and 36 per cent from 2008 to 2009 alone, according to the World Health Organisation.

The declines are down to a variety of factors, including the production of generics or cheap copies of expensive drugs, and favourable pricing policies by pharmaceutical firms. But if you look beyond the headline figures for first-line treatments in poorer countries, it becomes clear that HIV remains big business for big pharma. HIV antiretroviral sales across the seven major markets of the US, Japan, France, Germany, Spain, Italy and the UK totalled $11.8bn (£7.6bn) last year, according to figures from the research firm Datamonitor.

That represents compounded annual growth of 10 per cent between 2005 and 2009. The US was the biggest market, booking $7.7bn in antiretroviral sales last year. France was the largest of the European markets, with sales of $1.1bn, while Japan was the smallest overall. In terms of patients, the number of people living with HIV across the seven major markets went from 1.4 million in 2001 to 1.8 million in 2009, with further increases expected in the coming decade. The US is forecast to hold on to first place, with Datamonitor expecting it to account for 60 per cent of sales across the seven markets in 2019. Japan is forecast to remain the smallest.

The recent surge in growth was driven by the continued uptake of the Truvada drug, which is produced by California-based Gilead Sciences, and by Atripla, a combination of Truvada and Bristol-Myers Squibb's Sustiva treatment in a single pill. In 2009, Gilead notched up $2.5bn in Truvada sales; Atripla was just behind with $2.4bn in sales. In the US, Truvada boasts a market of share of 32 per cent of all prescriptions in its class of drugs. Atripla's share stands at 28 per cent.

More recently, the companies reported a rise in profits for the third quarter as sales of its core HIV drugs surpassed expectations. Sales of Truvada were up by 8 per cent to $668.7m, while Atripla sales soared by more than 20 per cent to $742.7m.

In the UK, GlaxoSmithKline (GSK) and the US group Pfizer joined forces in November last year to put their HIV business into a joint venture called ViiV Healthcare. With a portfolio of 10 available medicines, ViiV, which is 85 per cent-owned by GSK and 15 per cent by Pfizer, commands a 19 per cent share of the worldwide HIV drugs market. Its full-year figures will be published in February, but GSK's last annual report showed that sales of HIV medicines totalled £1.6bn last year.

Back in the US, Bristol Myers-Squibb's most recent results showed a 9 per cent rise in third-quarter sales for its Sustiva drug. The figures for rival group Merck are also impressive. Its lead HIV drug, Isentress, recorded worldwide sales of $278m in third quarter of 2010, an increase of 41 per cent on 2009.

Stephen Lewis, the former United Nations special envoy for HIV/Aids in Africa and current co-director of Aids-Free World, an international advocacy organisation, says the strength of the HIV drug firms shows that while treatment prices for low-income countries have gone down, companies have sought to offset the declines by continuing to market drugs at high prices in richer markets — a part of the HIV/Aids story that is often overlooked.

Moreover, he said, prices in low-income countries came down primarily because of the growth of "generics producers in places like India, not because of some sudden humanitarian spasm" on the part of the pharmaceutical companies.

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Toronto Star: G8 countries are congenitally addicted to the betrayal of Africa

Wed, 30 Jun 2010 00:00:00 -0400

News that the G8 nations are “explicitly cutting back” on funding for HIV/AIDS comes as no surprise to Stephen Lewis.

Lewis, the former special envoy for HIV/AIDS in Africa, told a Toronto news conference the G8 nations will be at least $7 billion short in their promised funding commitments to Africa. The figure comes from the G8 itself, taken from their Muskoka Accountability Report, an assessment of how the nations are doing on their big-ticket promises.

As host of the G8 and G20, Prime Minister Stephen Harper is using his position to promote child and maternal health. But the “fraudulence” of what Harper is promising is proven in that he has failed to do this in his own country, said Lewis, pointing to high infant mortality rates in First Nations communities.

“If you don’t attend to these issues in your own country you can hardly have serious credibility internationally,” Lewis said Tuesday from Ryerson University, where he was joined by several African and Canadian AIDS activists. “He grabbed maternal and child health because it sounded good.”

What world leaders are failing to grasp is that the health of mothers and babies in the developing world is inextricably tied to the fight against HIV/AIDS. If they don’t address that pandemic, nothing will ever get better, Lewis said.

However, Canada has been a consistent funder to the Global Fund to Fight AIDS, tuberculosis and malaria, which is largely supported by the G8. The Geneva-based organization handles $19.3 billion for more than 572 programs to fight the diseases in 144 countries.

As first reported in the Star, earlier this month in advance of the G8 in Huntsville, Global Fund executive director Dr. Michel Kazatchkine met with Harper to press his case for continued financial support. They need $17 billion over the next three years to continue programs to stop mother-to-child transmission of HIV/AIDS and combat malaria.

While keeping a world view is important, said Denise Lambert of the Canadian Aboriginal AIDS Network, the spread of HIV/AIDS in First Nations communities mirrors that of developing nations. She noted the latest data show 50 per cent of new cases of the human immunodeficiency virus are now in women.

“It is taking a terrible toll on aboriginal peoples,” said Lambert, who knows of many HIV positive women who discovered their status only when tested during pregnancy. “It is really critical we pay attention, not only to the big picture but what is happening in our own backyard.”

Harper is a “Stephen-come-lately” on the issue of maternal health, said Lewis. Holland, the United Kingdom and even the World Bank have worked in this area for several years. “I fear a fistful of promises that will not be delivered,” he said. “Between promise and delivery there lies an eternity.”

But what is ominous now is the sudden international downturn in funds and interest to fight a disease that has so far killed about 15 million Africans, he said.

All over the world, developed nations seem to be retreating from earlier promises. In the United States, the President’s Emergency Plan for AIDS Relief (PEPFAR) is being flat-lined for at least the next two years, Lewis said.

“That this should happen under President (Barack) Obama is inconceivable,” he said. “It only negates the pledge that the president (and Hillary Clinton) made during the (election) campaign.”

And in Uganda, Malawi, Zambia and Mozambique programs being run by Médecins sans frontières and others cannot enroll new patients unless someone dies, he added. “Again, the spectre of death will stalk the land,” he said.

There simply is no voice, no commitment anymore, Lewis said. Italy, Germany, Japan are all delinquent by failing to live up to financial commitments. “Where is the voice internationally on these issues?”

Celebrities such as Bono and Bob Geldof just aren’t enough to shoulder the burden, he said. “Celebrity status only does so much but governments make the policies.”

Siphiwe Hlophe, a grandmother from Swaziland living with HIV/AIDS, has been in Canada since May. She said now is the time to move from promises to deliverables. “We’ve been talking since the initiation of HIV/AIDS — two decades have since passed and the African countries are still struggling,” said Hlophe, one of the first Swaziland women to declare her HIV status publicly. Seventeen of her 24 brothers and sisters have died of AIDS-related causes.

“We come to the G8 and the G20. How many countries have delivered their promises?

Read the Toronto Star article here.

Deutsche Presse-Agentur: Anti-AIDS groups say G8 falls short on promises to Africa

Tue, 22 Jun 2010 00:00:00 -0400

New York — Organizations devoted to combatting HIV/AIDS in Africa said Tuesday that the G8 has fallen short by more than 30 per cent on its commitment to provide an additional 25 billion dollars this year to fighting the epidemic.

The Group of Eight nations committed to the amount when it met in Gleneagles, Scotland, in 2005. The G8 is scheduled to meet this weekend in Muskoka, near Toronto, and has issued a report on HIV/AIDS, recognizing its failure to fulfil the promise.

AIDS-Free World, a Canadian advocacy group headed by former Canadian UN ambassador Stephen Lewis, said the G8 Muskoka Accountability Report released this week admitted that the bloc will fall short by at least 7 billion dollars of the total of 25 billion dollars this year, or about 30 per cent.

Lewis said studies by two other anti-AIDS organizations show that the G8's shortfall on fighting the disease may be higher.

The ONE Campaign, co-founded by singer Bono, said the G8 has fallen short by at least 8.9 billion dollars, or 40 per cent, using a slightly different form of calculation than the Muskoka report.

"Bono and company do their best to flatter the contributions of the G8, but even they are forced to say that the increases from 2005 to 2010 have fallen far short of what was promised," Lewis said.

The Africa Progress Report 2010, published by a panel of international experts and chaired by former UN secretary general Kofi Annan, said the G8 will have fallen short by at least 9.8 billion dollars once the group has done its final calculation.

"This background is merely to underscore the betrayal of Africa to which the G8 is congenitally addicted," Lewis said. "It should come as no surprise then to learn that now, the G8 is explicitly cutting back on funding for HIV/AIDS."

Lewis said the US President's Emergency Plan for AIDS Relief, or PEPFAR, is being "flat-lined, for at least the next two years."

He said Washington now believes that the AIDS campaigns have had too much money and that additional funds should go to other health initiatives like maternal and child health.

"If the G8 and G20 are to do more than dissemble, they have to match their actions to their commitments," Lewis said. "This time, they must put up the money that's required for Africa along with a timetable for delivery, and then they must keep their promises by sticking to that timetable."

AIDS-Free World said the international community now knows how to treat large numbers of people living with AIDS and that "hope is finally alive." It said 5 million people are now receiving treatment and 9 million others are waiting for it.

The advocacy group said Doctors Without Borders and other non- governmental organizations are providing medical treatment in Uganda, Malawi, Zambia and Mozambique. Those groups cannot accept new patients unless someone dies.

It said the cut-backs in PEPFAR funds have had disastrous effects in places where HIV-positive pregnant women were turned away and people are so sick that they were carried in wheelbarrows to hospitals.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, supported by donors like the Bill and Melinda Gates Foundation, is seeking to replenish this shortfall with 20 billion dollars for a three-year period. But it is facing a gap of 7 billion dollars this year.

Here & Now: AIDS Activist Calls For Focus On Health Of HIV-Positive Mothers To Help Kids

Mon, 21 Jun 2010 00:00:00 -0400

The leading cause of HIV infection in children is transmission from mother to child, or what’s known as vertical transmission. In 2001, governments around the world pledged to reduce transmission by half. But our guest, Paula Donovan, of the advocacy group AIDS-Free World, argues that rates haven’t dropped significantly in the developing world, and that has to do with the fact that too little attention is paid to the health of the mother. Her organization is calling for more attention to the health of the mother, whose survival is critical for the health of the child.

Listen to the program here.

The Diane Rehm Show: Setback in the Fight Against AIDS

Tue, 18 May 2010 00:00:00 -0400

On May 18th, 2010, Stephen Lewis, Dr. Anthony Fauci and Dr. Peter Mugyenyi were guests on the Diane Rehm Show. The program discussed the impact of the United States’ decision to flat-line money for ARVs.

Listen to the program here.

AP: Group: Mugabe loyalists raped women during vote

Thu, 10 Dec 2009 00:00:00 -0500

Supporters of Zimbabwe's President Robert Mugabe used rape to terrorize the political opposition during last year's contested elections, international human rights activists said Thursday.

AIDS-Free World, led by former UNAIDS envoy Stephen Lewis, released a 64-page report that documents 380 rapes it said were committed by Mugabe loyalists.

Some 70 women linked to Zimbabwe's opposition detailed to the group how they were raped, kept as sex slaves and even forced to watch their daughters being raped. Ten became pregnant following the attacks and many believe they were infected with HIV, the virus that causes AIDS.

"These women were raped because they were politically defiant," said Betsy Apple, the organization's legal director. "It was meant to punish them and their communities."

Efforts to get comment from Mugabe's ZANU-PF party on the report were not successful Thursday.

Groups monitoring the March 2008 elections reported scores of deaths and thousands of cases of illegal arrests, assaults and rapes by militias operating in cities and out of countryside camps. Election officials declared a runoff was necessary after the vote but opposition leader Morgan Tsvangirai dropped out, citing attacks against his supporters.

Mugabe was later declared the winner, but he formed a unity government in February with Tsvangirai as prime minister. Many though fear the coalition will collapse because of a lack of cooperation from Zimbabwe's longtime ruler.

"The politically orchestrated and systematic campaign of sexual violence unleashed against women who supported the opposition carves yet another chapter in the annals of Robert Mugabe's legacy of depravity," Lewis said.

The rapes documented by Lewis' organization began in 2007 but increased dramatically in 2008 with 64 percent occurring between the March election and the June runoff when tensions in Zimbabwe were at their height.

All of the women said their rapists were clearly identifiable as ZANU-PF supporters. Many arrived at the women's homes late at night wearing party T-shirts or singing party songs. Sometimes they were in mobs of up to 200 men who terrorized locals.

"When the 10th man finished raping me they said they were going to rape my daughter ... My daughter was 5 years old," one woman from the capital, Harare, told interviewers.

"During the rape my daughter was crying and trying to resist but they kept pushing her down. I was confused and in shock and had no strength to say or do anything or even move," the woman said.

The majority were abducted and taken to camps where they were gang-raped by five or more men. Ten of the women were pregnant at the time they were attacked. More than half of the women said they were beaten with fists, sticks, electric cords or metal rods before or after they were raped. Six women said they had to be taken to hospital in wheelbarrows or carts.

Just over half of the women reported their rapes to police and few of the perpetrators have been prosecuted, enjoying protection by police who have long been aligned to Mugabe. Few of the women have had access to medical treatment or counseling.

Activists are calling on Zimbabwe's neighbors and the international community to help ensure perpetrators are brought to justice. The group fears that the victims' stories will be lost as the world throws support behind the unity government and attempts to rebuild Zimbabwe's collapsed economy.

"This report is both a reminder of the past and a threat of what the future might bring," Apple said.

The Globe and Mail: Group Claims Evidence of Mugabe-Led Rape Campaign, Urges Prosecution

Thu, 10 Dec 2009 00:00:00 -0500

JOHANNESBURG — Armed with 70 sworn affidavits from rape victims, an advocacy group says it has enough evidence to warrant the prosecution of Zimbabwe President Robert Mugabe and his ruling party for crimes against humanity.

The group, co-headed by former United Nations ambassador Stephen Lewis, says the sworn testimony is powerful evidence that Mr. Mugabe and his party were responsible for a systematic campaign of rape against opposition supporters in last year's election.

In a report to be released today, the group documents the cases of 70 Zimbabwean women, all opposition supporters, who were collectively raped at least 380 times by 241 different members of the ruling party and its affiliated organizations. Their sworn affidavits were gathered by teams of lawyers who conducted more than 300 hours of interviews with the victims.

The leaders of Mr. Mugabe's party are reportedly preparing their militias for another campaign of systematic rape in the next presidential election, the report says. To stop them from doing it again, they must be prosecuted under international laws on crimes against humanity, it says.

"Continued impunity will be a green light for the next rape campaign," it says. "The infrastructure necessary for executing another campaign of rape during the next election period already exists in Zimbabwe, and there are credible claims it is being reinvigorated now."

The advocacy group, AIDS-Free World, says its investigators and lawyers found clear evidence that the rapes last year were systematic, widespread and organized, affecting thousands of victims across Zimbabwe.

It says the affidavits from the 70 women "all share a common narrative: politically motivated attacks, the orchestrated use of rape as a tool of terror and intimidation, and the deliberate effort to harm, humiliate and degrade women within their communities as a way to subjugate those communities."

In each of the 70 rape cases, the victims were supporters of the Movement for Democratic Change, the main opposition party in last year's election. Most were organizers or activists in the party. And in each case, the report said, the perpetrators were clearly identifiable as members of the youth militia of the ruling party, ZANU-PF, or its affiliated organization of war veterans.

In 33 cases, for example, the rapists were wearing ZANU-PF shirts. In 17 cases, the attackers were singing the party's songs or chanting its slogans. And in 67 of the 70 cases, the rapists made political statements that made clear that they were ZANU-PF members, or that they were attacking the women because of their MDC involvement, the report says.

In almost every case, the women said the attacks began when their homes were surrounded by mobs of ZANU-PF supporters who looted and destroyed their property. Most of the women were abducted and taken to militia bases or bush locations, where they were raped. Others were raped in their homes.

"Each woman, on average, was raped five times, although these numbers may be underestimates because many women fell unconscious during the violent rapes and therefore lost count of the number of rapists and rapes at some point," the report says.

Many of the women said their attackers were obeying orders from leaders among them. One woman said her attackers were led by a commander who claimed that Mr. Mugabe himself had ordered the attacks. "If you meet an MDC supporter, do whatever you want to them," the commander said, quoting Mr. Mugabe, according to her testimony.

Zimbabwean police have consistently refused to investigate the rapes, the report says. Since it is virtually impossible for the attackers and organizers of the rape campaign to be prosecuted in Zimbabwe, the report proposes that they could be prosecuted in another African state such as South Africa, which has laws authorizing the prosecution of international crimes such as crimes against humanity when the alleged perpetrators are in South African territory. Zimbabweans often travel to South Africa for work or business.

The Telegraph: Robert Mugabe's Supporters 'Used Rape as a Weapon' in Election

Thu, 10 Dec 2009 00:00:00 -0500

President Robert Mugabe's supporters have been accused of using rape as a political weapon against the opposition during the election in Zimbabwe last year.

A report by an American charity documents 380 politically motivated rapes committed by 241 individuals across all of Zimbabwe's 10 provinces.

Aids-Free World, which is led by the former United Nations envoy on Aids, Stephen Lewis, said that those behind the attacks on supporters of the Movement for Democratic Change had even set up central facilities where several women could be gang-raped simultaneously.

Campaigners painted a harrowing picture based on interviews with 72 survivors and witnesses. The perpetrators allegedly included members of the Zanu-PF youth militia, and so-called "war veterans" loyal to Mr Mugabe.

In some cases women were held at Zanu-PF supporters' bases and were violated in the same room as others, the report said.

"The room was large, with many other women MDC members and Zanu-PF men inside," a woman from Harare told campaigners. "All three of them were rough when they raped me. Around the room there were other men raping other girls. All the men in that room were either raping or waiting to rape women."

At least nine of the women interviewed believe they were infected with HIV when they were raped. A 23-year-old in Masvingo said her attackers told her: "You say [MDC leader Morgan] Tsvangirai is good. We want you to know that Tsvangirai is not good. We want to give you diseases and see if Tsvangirai will take care of your children."

In other cases family members, even young girls, were also targeted. A woman from the capital said: "When the tenth man finished raping me they said they were going to rape my daughter. I cried out but I could not even stand up at this time.

"After they finished with me, they raped my daughter when I was there and I couldn't do anything to stop them. My daughter was five years old."

Mr Mugabe and Zanu-PF have consistently denied responsibility for the violence that took place in Zimbabwe last year. They now share power with the MDC.

Read The Telegraph article here.

The World: Sexual Assault in Mugabe's Zimbabwe

Thu, 10 Dec 2009 00:00:00 -0500

On December 10, 2009, Stephen Lewis appeared on the radio program The World to discuss AIDS-Free World's report on sexual violence in Zimbabwe, "Electing to Rape." A transcript of the program is below. The program can be listened to here.

MARCO WERMAN: In his speech, President Obama also paid tribute to reformers who brave repression from their own governments. He singled-out those in Zimbabwe who cast their ballots in the face of physical violence. A report out today, lays-out in detail the nature of some of that violence. The report alleges that during last year’s elections President Robert Mugabe and supporters orchestrated a campaign of rape against the opposition. The World’s Jeb Sharp reports.

JEB SHARP: The report is called, “Electing to Rape: Sexual Terror in Mugabe’s Zimbabwe.” It documents, in chilling detail, the rape of women affiliated with the opposition, MDC Party, by supporters of Mugabe’s ZANU-PF Party. Stephen Lewis is Co-Director of AIDS-Free World, the organization that produced the report.

STEPHEN LEWIS: The rapes we recorded through affidavits from seventy women occurred in every single province of the country; and the patterns were unmistakable. The rapists all wore ZANU-PF T-shirts; they all sang ZANU-PF songs; they told the women as they were raping them that they were raping them because the women supported the opposition party, MDC. I mean, I must say that I have never heard of an instance where you had extreme sexual violence unleashed against women because they happened to be members of a political party.

SHARP: AIDS-Free world engaged the pro bono services of a major American law firm to take sworn affidavits. The lawyers made six separate trips to the region, interviewing dozens of survivors. The victims range from children to the elderly. According to the report, the 70 women were raped, collectively, 380 times, by 241 different ZANU-PF loyalists—many were gang-raped. Stephen Lewis says the alleged atrocities constitute crimes against humanity because of the orchestrated nature of the violence.

LEWIS: Even the same language was used, by rapists in different parts of the country, while they were raping the women; and so was the torture that was inflected. You know, the women were always beaten on the soles of the feet; always beaten on the buttocks; always with the same instruments. And as we accumulated the affidavits with some considerable horror, we realized he’s using it as a strategy to win an election—that was his total purpose, was to hold on to power—and he was prepared to sacrifice women’s bodies for that purpose.

SHARP: There’s been no response yet from Mugabe, but in the past he’s dismissed allegations that he’s responsible for political violence. As for the scale of the alleged crimes, AIDS-Free World believes these 70 women and their stories could represent thousands more. Zimbabwean author and human rights advocate, Peter Godwin, does too.

PETER GODWIN: I’ve spent months during the violence there, and everything—the cases that they’ve got here—completely chime with all the information that I was getting; with all the people I was talking to. We have this problem with rapes, specifically, in that it’s so stigmatizing, and that people are … It’s terribly underreported that the victims are–in many, many cases—unwilling to come forward. And in Zimbabwe they’re still scared, because often they are living still in the vicinity of the perpetrators.

SHARP: Godwin is writing his own book about human rights abuses in Zimbabwe. He’s impressed with the rigor of this particular report.

GODWIN: Nothing’s been done on rapes, specifically, that’s this detailed. And a lot of the stuff that comes out tends to be journalistic, and some of it sort of impressionistic to some extent. I mean I’m not saying it’s not accurate, but here what we’ve got—you know, high-powered legal teams going over there and taking affidavits that are “water-tight.”

SHARP: The hope is to use the document as the basis for a legal case against Mugabe, and to put pressure on countries like South Africa to withdraw their support for him. The report’s authors say, for now, women are terrified the same thing will happen again in the next round of elections. For The World, I’m Jeb Sharp.

Read "Electing to Rape" here.

British Medical Journal: Campaigners Warn That Discrimination Threatens Progress Against HIV and AIDS

Tue, 01 Dec 2009 00:00:00 -0500

Progress in combating HIV is being undermined by anti-homosexual stigma and repressive legislation in some of the most affected countries, a major human rights charity says.

Human Rights Watch points out that this year’s world AIDS day theme is "universal access and human rights," but in many parts of the world "legislation effectively criminalises populations living with HIV or vulnerable to HIV infection, such as sex workers, drug users, and men who have sex with men."

Such laws "fuel stigma and discrimination, increase barriers to HIV information and treatment," and contribute to the spread of disease, says the charity.

Joe Amon, health director at Human Rights Watch, said, "There is increasing evidence that antiretroviral treatment can be an important part of comprehensive prevention strategies. But if human rights abuses are unaddressed, and punitive laws target people vulnerable to or living with HIV, the potential of treatment and prevention isn’t going to be realised."

Uganda, a country often hailed for its progress in combating HIV, has been particularly criticised for proposed legislation that, campaigners say, "declares war on homosexuality."

The putative new laws would jail for up to three years anyone who fails to report a person they suspect of being lesbian or gay. A person infected with HIV who has consensual homosexual sex would face the death penalty, regardless of risk of HIV transmission and even if their partner is also HIV positive.

Stephen Lewis, head of the charity AIDS Free World and former United Nations special envoy for AIDS in Africa, last week warned in a speech on the eve of the Commonwealth summit in Trinidad: "What is put at terrible risk here [in Uganda]—beyond the threat of the death penalty for HIV positive homosexuals—is the entire apparatus of AIDS treatment, prevention, and care. It’s profoundly ironic that the country that’s seen as emblematic of success in fighting the pandemic is now contemplating such a decisive step backwards."

Professor Lewis said, "The effect of this legislation will inevitably be to demonise homosexuality even further, to intensify stigma, to drive gay men and women underground, to terrify them in their everyday lives, to diminish dramatically the prospect of counselling and testing to establish HIV status, to make it virtually impossible to reach homosexuals with the knowledge and education and condoms that prevent the spread of AIDS."

Dr Amon told the BMJ, "Lewis is right to be concerned about proposed Ugandan legislation that would strengthen penalties against homosexuality. Not only is the bill retrogressive and homophobic, but it coincides with deeply troubling proposed legislation on HIV and AIDS that would promote discredited and counterproductive approaches to the AIDS epidemic." If passed into law these bills "would mark a huge setback" for Uganda’s efforts to tackle the disease, he added.

Dr Amon warned, "HIV prevention has failed in many countries not because we don’t know how to design effective prevention programmes but because governments have been unwilling to implement these programmes and ensure that they reach everyone.

"The potential of HIV treatment in comprehensive prevention programmes will be similarly sabotaged if governments continue to pass punitive laws and trample upon human rights."

Read the BMJ article here

The Globe and Mail: Uganda's Anti-Gay Bill Causes Commonwealth Uproar

Wed, 25 Nov 2009 00:00:00 -0500

The Commonwealth convenes for a summit this week amid growing furor over a proposed law that would impose life imprisonment on homosexuals in Uganda, whose President is chairing the gathering.

The law, proceeding through Uganda's Parliament and supported by some of its top leaders, would imprison anyone who knows of the existence of a gay or lesbian and fails to inform the police within 24 hours. It requires the death penalty for “aggravated homosexuality” – defined as any sexual act between gays or lesbians in which one person has the HIV virus.

The controversy is growing because Ugandan President Yoweri Museveni is the chairman of the Commonwealth Heads of Government Meeting in Trinidad and Tobago, which opens on Friday with Stephen Harper joining the leaders of 52 other countries.

If it is raised at the summit, the issue has the potential to divide Commonwealth leaders, who hold deeply polarized views on homosexuality. A number of Commonwealth countries, including Canada and Britain, have liberal views on the subject, but many African and Caribbean nations are socially conservative and maintain laws on their books that criminalize homosexuality.

Activists are urging the Commonwealth to make it clear that it will suspend Uganda's membership if the law passes.

Human-rights groups, including Amnesty International and Human Rights Watch, have condemned the bill. They say it is a product of a campaign by evangelical churches and anti-gay groups that has led to death threats and physical assaults against Ugandans suspected of being gay.

The governments of the United States and France have criticized the proposed law, with France expressing “deep concern.”

In Ottawa Tuesday, a spokesman for Mr. Harper also criticized the bill, using words that were virtually identical to the official U.S. comment of several weeks ago. “If adopted, a bill further criminalizing homosexuality would constitute a significant step backwards for the protection of human rights in Uganda,” said Dimitri Soudas, a spokesman for the Prime Minister's Office.

“Canada has clearly spoken out against human-rights violations committed against persons on the basis of their sexual orientation and we urge states to take all necessary measures to ensure that sexual orientation and gender identity may under no circumstances be the basis for criminal penalties, in particular executions, arrests, or detention.”

By chairing the summit without opposing the anti-homosexuality law, the Ugandan President “makes a mockery of Commonwealth principles,” Stephen Lewis, the former United Nations envoy on AIDS in Africa, said in a speech in Trinidad Tuesday. “This intended anti-homosexual statute has the taste of fascism.”

“The credibility of the Commonwealth is hanging by a spider's thread,” he said. “The putative legislation declares war on homosexuality. … What is put at risk here – beyond the threat of the death penalty for HIV-positive homosexuals – is the entire apparatus of AIDS treatment, prevention and care.”

The private member's bill was introduced last month by a Ugandan backbencher who described homosexuality as a “creeping evil.” The bill has not been formally endorsed by Mr. Museveni, but his government has allowed it to proceed through Parliament, and some of his top officials have praised it.

Analysts are predicting that the law will be approved by Parliament with only minor revisions. A senior government member, Ethics and Integrity Minister James Nsaba Buturo, said he views the bill “with joy” because it will “provide leadership around the world.”

The law would impose a sentence of life imprisonment on anyone who “penetrates the anus or mouth of another person of the same sex with his penis or any other sexual contraption.” The same penalty would apply if he or she even “touches another person with the intention of committing the act of homosexuality.”

The law requires a three-year prison sentence for anyone who is aware of evidence of homosexuality and fails to report it to the police within 24 hours. It allows for the prosecution of Ugandans who engage in homosexual acts in foreign countries. And it imposes a prison sentence of up to seven years for anyone who defends the rights of gays and lesbians.

These clauses have “a powerful Orwellian flavour” and reflect a “twisted world of sexual paranoia,” Mr. Lewis said in his speech to the Commonwealth People's Forum, a civil-society group. “Can you imagine a father or a mother turning in a son or daughter? Can you imagine a teacher ratting on a student? But that's exactly what this law requires. I've truly never seen its like before.”

Mr. Lewis, co-director of Aids-Free World, an international advocacy organization, noted that many other countries have laws against sodomy. “But nothing is as stark, punitive and redolent of hate as the bill in Uganda. Nothing comes close to such an omnibus violation of the human rights of sexual minorities,” he said.

“What is truly staggering about all of this is that not a peep of skepticism or incredulity has come from President Museveni.”

The proposed law would “demonize homosexuality” and “intensify stigma,” driving gays underground and making it much more difficult to prevent the spread of AIDS, Mr. Lewis said.

Read the Globe and Mail story here.

VOA News: Scientists Urged to Take a Stand on AIDS

Tue, 21 Jul 2009 00:00:00 -0400

The former U.N. special envoy for AIDS in Africa is urging scientists to "take a stand" in the fight against the pandemic.

Stephen Lewis, co-founder of AIDS-Free World, spoke this week at the 5th International AIDS Society on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa.

"I think fundamentally, scientists speak about the AIDS pandemic with enormous authority and knowledge, he says. "And if they can speak in a collective voice about what's going wrong, about what the crucial issues are, about where the world should now respond, then they can have an enormous impact."

Scientists are "somewhat passive when it comes to the political fray" that has often surrounded HIV/AIDS, Lewis says.

"When you have millions of lives at risk, it's terribly important that they take a stand."

They must fight on their "own terrain," he says.

"The scientists know what causes the pandemic. The scientists know how to respond…. The scientists don't have to…answer to the arguments of others," he says.

Backlash against AIDS funding

"A number of people, I think for motives largely of resentment rather than logic, are arguing

Critics, he says, want money for HIV/AIDS diverted to other issues, such as maternal and reproductive health.

"No one denies the needs in these other areas. But it is frankly crazy to attempt to take money away from one sector of health, which is vital, and apply it to another sector, albeit also vital. What you need is more money. What you need is more resources to do everything," he says.

Criminal?

Lewis wants scientists to call on G8 leaders to fulfill the promises they made on HIV/AIDS at the 2005 summit in Gleneagles, Scotland.

"Scientists have to put the pressure on the G8 countries, who appear inexplicitly and frankly criminally to be backing away from their commitment."

Lewis says he expects AIDS funding to continue but adds, "whether or not it will be adequate is anyone's guess. And inadequacy puts people's lives at risk. And that's just not irresponsible, that's criminal."

Questioned about his use of the word "criminal," Lewis says, "I don't know how else to describe the possibility of people losing their lives as a result of the resources, which were promised, not being forthcoming."

At Gleneagles, G8 leaders promised near universal access to all those in need of treatment for HIV/AIDS by 2010.

"In the last G8 conference a couple of weeks ago in Italy, the word "AIDS" didn't event appear in the communiqué and none of the funding that had been committed was included," he says.

In the renewal of the PEPFAR program in 2008 – the US Congress authorized about $50 billion to be spent over five years on AIDS, TB and malaria. Officials say the goal is to provide treatment for three million people, prevent 12 million new infections and care for another 12 million, including aids orphans and vulnerable children.

The former UN special envoy says while stigma and discrimination over HIV/AIDS are easing in many African countries, there's still a great deal of discrimination around the world against homosexuals and intravenous drug users. Lewis calls the discrimination against homosexuals "homophobia."

He also supports new wording to replace the term "mother-to-child transmission." He says that wording makes it appears that it's the mother's fault a child gets infected. He says the term "vertical transmission" is gaining favor.

Read the VOA News article here.

The Canberra Times: Push to Form UN Women's Agency

Mon, 25 May 2009 00:00:00 -0400

The UN is poised to create a powerful new department for women, who say they have been sidelined for decades, and rectify a glaring omission in the world body.

Women's rights advocates are looking for a fully fledged agency with a budget of $1billion on a par with other high-profile United Nations departments, to address crucial areas such as violence against women, property rights and HIV/AIDS.

The co-director of AIDS-Free World, and an advocate of gender equality, Stephen Lewis, said, ''[The UN] has neglected the rights and needs of women everywhere. It's clear to everyone that the marginalisation of women over decades is unacceptable and the best way to correct it is a UN agency like UNICEF for children.''

In sub-Saharan Africa, of the 63 million people with HIV, 60 per cent were women, and the percentage shot up to 75 per cent to 80 per cent in the 15-24 age group, he said.

Although the UN has poured billions into agencies for refugees and for children, women's issues are dealt with by several small departments that lack the resources of a fully fledged agency.

The idea for such a body emerged in 2006, from plans to reform the UN by the former UN secretary-general, Kofi Annan.

A high-level panel endorsed an agency headed by an under-secretary-general, one rank below secretary-general.

Rich nations favour creating an agency by the end of the year, but some members from the G77 group of developing countries, such as Cuba, Libya and Sudan, want to nail down issues such as governance and funding before agreeing to vote on a resolution.

How the agency will operate at country level with other UN bodies is an issue, as is the question of who will lead the new organisation. Mr Lewis is optimistic that the general assembly will pass a resolution to create the agency in September when it holds its annual session.

The aim to get $1billion will depend on the Obama Administration, which has yet to declare its position, and how much cash it will put in.

View the Canberra Times story here.

The Globe and Mail: 900 babies a day are born with AIDS virus in the developing world: report

Thu, 21 May 2009 00:00:00 -0400

Johannesburg, South Africa — Eight years after the world pledged a dramatic reduction in the transfer of HIV from mother to baby, only 8 per cent of pregnant women in the developing world are getting full treatment, and 900 babies a day are being born with the AIDS virus.

The infected infants could easily be protected if their mothers were given a simple program of drug treatment, but a promise by world leaders in 2001 has never been kept, and global institutions are “cooking the books” to conceal the failure, according to a new report by a leading international coalition of HIV activists and experts.

The world's governments promised in 2001 that HIV infections among newborn babies would be reduced by 50 per cent by 2010. Since then, they have triumphantly claimed to be making progress, but this claim is a “conspiracy of misinformation,” the report said.

In reality, among the 1.5 million women with HIV who become pregnant every year in the developing world, only a third are receiving any drug treatment at all, and most of this treatment is so inadequate that it fails to prevent them from transmitting the virus to their babies, the report said.

Only about 8 per cent are getting the full triple-dose drug-combination treatment that is widely used in the West to virtually eliminate mother-to-child transmission.

“That makes the program something of a travesty,” said Canadian AIDS activist Stephen Lewis, co-author of a preface to the report, in a conference call Thursday.

He criticized the United Nations health agencies for their claim that a growing number of pregnant women are getting “access” to treatment, when in fact the vast majority do not have any access to the triple-dose treatment that would effectively protect their babies. “It makes the access a simple mockery,” he said.

The UN agencies have declared they are making “substantial progress” in giving medicine to pregnant women to prevent their babies from getting the AIDS virus. But in fact, only a third of pregnant women with HIV in the developing world are given any treatment, and most of those are given only a single drug, which is effective in less than half of cases.

“We reject the double talk that touts failure as success, and the double standard that values wealthy women over poor,” wrote Mr. Lewis and Paula Donovan, co-directors of the AIDS-Free World advocacy group, in their preface to the report.

The report said the world is tolerating a “shameful example of double standards,” since pregnant women in wealthier countries are given enough medicine to prevent their babies from getting the virus, allowing mother-to-child transmission to be virtually wiped out in the developed world, while it remains a massive problem in poorer countries.

In 61 countries – including India, Nigeria, Ethiopia and Cameroon – at least three-quarters of pregnant women with HIV are not receiving any drug treatment to prevent the virus being transmitted to their babies, it said.

The report, released Thursday, was written by the International Treatment Preparedness Coalition. It was based on detailed research in six countries, including three African countries, along with global data.

In Uganda, it said, less than half of prenatal clinics are able to provide treatment to prevent HIV from being transmitted to the infant, largely due to severe shortages of health workers and drugs.

In Cambodia, almost 90 per cent of HIV-positive mothers and babies are given no drug treatment at all, while HIV testing is so minimal that 84 per cent of pregnant women do not even know whether they have the virus.

In Morocco, only 7.5 per cent of pregnant women with HIV have any access to treatment to prevent their babies getting the virus. And in Zimbabwe, the health system is in such disastrous shambles that the drug treatment program for HIV-infected patients was completed halted for several months over the past year.

The report also found a “shocking lack of consistency and co-ordination” among the governments and agencies that are supposed to be preventing HIV transmission from mothers to children. Only 18 per cent of the world's pregnant women were offered HIV tests in 2007, and there is a severe lack of prevention and counseling services for women, it said.

One of the worst problems is the lack of counseling on infant feeding. Most women with HIV are not properly counseled on how to safely feed their babies, and sometimes the advice has a dangerous bias toward infant formula, instead of breast-feeding, the report said.

VOA News: AIDS Report: Failing Women, Failing Children

Thu, 21 May 2009 00:00:00 -0400

A report Thursday accuses UN agencies, governments and donors of not doing enough to prevent mother-to-child transmission (PMTC) of HIV, the AIDS virus. The report, Failing Women, Failing Children, comes from the International Treatment Preparedness Coalition (ITPC). It's being issued as the World Health Assembly meets this week in Geneva. Gregg Gonsalves, co-founder of the ITPC, says, "One-point-five million women with HIV who become pregnant every year don't have access to many of the vital services for their own health or to prevent mother-to-child transmission. This means that over 900 new cases of HIV are reported in babies in developing countries every day."

The report says these new infections are preventable.

"Our failure to prevaent HIV transmission to babies is truly a failure to prevent disease progression in women living with HIV. If we treat mothers properly, if we treat women properly for their own health, we would have few or no HIV infections in babies," he says.

LEADING ACTIVIST LENDS SUPPORT

Backing the new report is former UN Special Envoy for AIDS in Africa Stephen Lewis, who is now co-director of the organization AIDS-Free World.He says the keys to preventing mother-to-child transmission of HIV are universal access to medicine and gender equality.

He says there's a "shocking double standard between the Global North and the Global South" when it comes to treatment. It's better in rich nations than in most poor nations.

"In the Global North, when you have HIV-positive pregnant women, we use what are called triple combination (drug) therapies. And the transmission to the infant is reduced by…98 or 99 percent," he says.

Not so in developing countries.

"In the South, we use a single dose application of a particular drug. And the reduction in transmission is only about 40 percent. Even when you combine it with another drug, it's about 60 percent. Only 8 percent of all the women in the developing world have access to the triple combination therapy, which would virtually elimination transmission," he says.

Lewis says the keys to preventing mother-to-child transmission of HIV are universal access to medicine and gender equality.

UN AGENCIES CRITICIZED

"What is painful…is to see the way in which the figures are manipulated by the United Nations agencies. There's a certain misleading component to it because they pretend that 33 percent – fully a third of all the women who are HIV positive and pregnant – have access to drug intervention. When in fact all they have access – almost 50 percent of the – is to this single dose response," he says. Lewis calls that response "a mockery."

UNAIDS POSITION ON PMTC

UNAIDS says health systems "need to be strengthened" to prevent mother-to-child transmission of HIV. And it calls for the "timely administration" of a combination of anti-retroviral drugs that is affordable and offers superior resistance to the aids virus.

Read the VOA News article here.

AIDS-Free World Guest-Edits a Special World AIDS Day Edition of Pambazuka News

Tue, 02 Dec 2008 00:00:00 -0500

The invitation to guest-edit a special issue of Pambazuka News wasn't something we pondered at AIDS-Free World; it's something we pounced on. We consider Pambazuka a precious commodity: a consistent source of timely, credible, thought-provoking, expectation-defying news and views. Our subscription has helped keep us informed and made us better at what we do, which is to push and prod for more urgent and more effective global responses to AIDS. And so we snatched at the opportunity to be involved in an issue devoted to HIV/AIDS, and our Political Advisor, Gerry Caplan, began working with the Pambazuka staff to solicit articles and essays about the most confounding of the African pandemic's unsolved problems.

Read the Special World AIDS Day Edition of Pambazuka News here.

An Introduction to power, politics and AIDS in Africa
by Stephen Lewis and Paula Donovan

The topics covered in this issue aren't naturally uplifting. Whether it's the world's persistent blind spot concerning TB and that disease's morbid attraction to HIV; a seemingly universal ignorance about people with disabilities that places 10 per cent of the human population at heightened risk of contracting the virus; or evidence that Zimbabwe's government orchestrated a campaign of sexual violence for political ends, and will likely do so again while the world stands by, the issues underlying HIV/AIDS are not for the faint of heart.

But in the 18 months since we started AIDS-Free World — an advocacy organization with a mission to speak up and speak out, to challenge authority and demand responsible leadership, to subject the status quo in AIDS prevention, treatment and care to unflinching critique, to build not only awareness but impatience and outrage over unnecessary suffering — beyond what has seemed like a mountain of inertia and indifference, we have also glimpsed countless reasons to be hopeful. You will read about some of them in this issue, too. One is the long-awaited recognition by UN member states that the world body has failed women — not least by allowing worldwide gender inequality to give rise to an explosive AIDS pandemic — and a current move to create a new UN agency for women. Another is the small but hopeful indication that beneath a surface of machismo, and with the right prodding, significant numbers of men are actually as anxious to be free of the cycles of violence against women as women are themselves.

We wish Pambazuka News continued success as it explores and exposes the issues that present Africa with its AIDS-related trials and triumphs. AIDS-Free World will also keep poking and prodding, unafraid to analyze, assess, critique and take principled stands. We invite you to visit our website at www.aids-freeworld.org, where starting next month, you'll find our 2-minute daily video commentaries on the AIDS-related news of the day. It was a privilege to contribute to Pambazuka's World AIDS Day issue, and it's an honor for AIDS-Free World to count ourselves among this special news service's informed, inquisitive readership.

Click here to read this issue of Pambazuka News in its entirety.

Retuers: Zimbabwe Militias Accused of Raping Dozens

Fri, 08 Aug 2008 00:00:00 -0400

MEXICO CITY — More than 50 women, some as young as 13 and others as old as 60, have been gang raped and tortured by government-backed militias in Zimbabwe because of their support for the opposition, rights groups and victims say.

"They came to my house singing political songs, they stole everything in my house ... raped me and killed four people in my neighbor's house," said a 53 year-old Zimbabwean widow too fearful of reprisals to give her name.

A supporter of the opposition Movement for Democratic Change, or MDC, she spoke through tears in her native Shona language at an international AIDS conference in Mexico.

She said her daughter and granddaughter were also raped in the attack, after her house was looted by hundreds of youth militia members in a town near the capital Harare in June.

Activists fear the women, who were refused treatment by government doctors, are at risk of contracting AIDS, since over 15 percent of the country is infected.

Women's rights organizations are working with international human rights lawyers to document hundreds of cases of alleged rape by youth militias backed by the ruling ZANU-PF party of President Robert Mugabe.

The MDC says more than 120 of its supporters were killed by pro-Mugabe militia in political violence since disputed elections in March. Mugabe blames the violence on the opposition.

The two sides earlier this week called on their supporters to end violence. ZANU-PF and MDC negotiators, under heavy international pressure to reach a deal to end Zimbabwe's economic and political crisis, began power-sharing talks two weeks ago mediated by South Africa.

Local newspaper reports say they are close to an agreement but that has not been confirmed by officials.

AIDS Fear

Rights workers said there have been 53 cases of rape since mid-April in heavy violence between two rounds of a presidential election. Around 13 of the women have been tested for AIDS but it is too early to say if any have been infected from the rapes, the workers say.

One 60-year old woman said she was raped by 18 militia members who told her they wanted her to have a ZANU-PF baby, others have had pesticides forced into them for failing to reveal the location of opposition leaders, Zimbabwean human rights activist Betty Makoni told a news conference.

A 13-year-old girl told how she was abducted from her home in exchange for a goat and held in a youth militia camp where she was repeatedly raped and beaten, said Makoni, who heads a network of support groups for girls across the country.

"We are in a situation where the pain and the trauma is beyond comprehension, I am here talking for women with wounded genital organs who cannot even sit on a chair to talk," said Makoni, who herself was raped as a child.

Opposition leader Morgan Tsvangirai won the first round of the presidential election on March 29 but fell short of the absolute majority needed for outright victory. He pulled out of the June 27 second round because of attacks on MDC supporters and Mugabe won the widely condemned poll.

"The accounts of politically motivated gang rape, severing of limbs and practices of sexual slavery ... are not individual offenses, these are crimes against humanity," said Noah Novogrodsky, the legal director of U.S.-based advocacy group AIDS-Free World.

"We believe that the members of Mugabe's inner circle who turned the ZANU-PF youth militia into rapists and killers are responsible," said Novagrodsky, adding that a team of lawyers will be collecting evidence against the perpetrators for eventual criminal prosecution.

Women who have been raped are at higher risk of contracting AIDS, a serious danger in Zimbabwe where between 1.6 million and 1.9 million people are infected, according to the United Nations.

"Women have told me 'When you are raped by 18 men you are already dead, so what is the use of keeping quiet, I must break the silence,'" said Makoni.

Read the Reuters story here.

VOA News: Zimbabwe Activist Sees HIV Infection Surge Following Political Violence

Thu, 07 Aug 2008 00:00:00 -0400

A Zimbabwean child rights activist told delegates to the the 17th International AIDS Conference in Mexico City on Thursday that rape as a form of political violence seems likely to boost the rate of HIV infection among women and girls in the Southern African country.

Girl Child Network Director Betty Makoni charged during a session organized by AIDS-Free World of Canada that many women and girls were subjected to rape and torture by militia members allegedly under the control of the ruling ZANU-PF party during a wave of political violence that followed March elections and was mainly directed at the opposition.

AIDS-Free World said it is now documenting such crimes and is naming alleged rapists with the intention of bringing them to justice. Makoni said it will not be difficult to name names, because most of the perpetrators are individuals known to residents of the localities, often remote rural areas, where the alleged sexually based attacks took place.

Makoni said most of the cases were reported to the police, but that government doctors were reluctant to document the crimes, or administer HIV prophylactic treatments.

Makoni told reporter Carole Gombakomba of VOA's Studio 7 for Zimbabwe that her main concern at present is to help rape victims heal physically, but added that given the high HIV prevalence rate in the country, many victims could find their plight even more dire.

Listen to the interview with Betty Makoni here.

IRIN PlusNews: Treatment as prevention: the next frontier

Wed, 06 Aug 2008 00:00:00 -0400

MEXICO CITY — As the search for an effective HIV prevention strategy intensifies, scientists are hoping that antiretroviral (ARV) drugs, normally associated with HIV treatment, may provide part of the answer.

"We are in a desperate race against time in pursuit of prevention that works," former UN Special Envoy for AIDS in Africa Stephen Lewis told journalists at the International AIDS Conference in Mexico City on Tuesday.

Lewis, who is currently co-director of AIDS-Free World, an international advocacy organisation, remarked that during his tenure as UN Special Envoy, he had spent almost five years "begging" governments in Africa to roll out treatment to those who needed it. "If I had been able to say ... 'not only will [ARVs] keep people alive, but they can significantly reduce new infections', this would have been a huge inducement."

A study by Canada's British Columbia Centre for Excellence in HIV/AIDS recently found that providing ARV treatment to HIV-positive people could lower the number of new HIV infections by as much as 60 percent.

The theory is that higher concentrations of the HI virus in the body (viral load), increase the likelihood of transmission. ARV therapy reduces the viral load in the blood, as well as in genital secretions in both men and women, making HIV-infected people potentially less contagious.

Several studies have shown that in discordant heterosexual couples (where one partner is positive and the other negative) the odds of the negative partner becoming infected are very low when the positive person's viral load has dropped significantly as a result of treatment.

The Canadian researchers used a new mathematical model to find out whether providing treatment to more people living with HIV in British Columbia would reduce future cases in the province.

The results showed that offering the life-prolonging medication to 75 percent of HIV-positive people would reduce the annual number of HIV cases in British Columbia by 30 percent; if 100 percent of HIV-positive people received the drugs, the number of new cases would drop by 60 percent.

"We've known for some time that the expansion of coverage of highly active ARV therapy could help to reduce the number of new infections ... we were amazed at the actual number of new infections that can be potentially averted by expanding access to treatment," said Dr Julio Montaner, head of the British Columbia Centre for Excellence in HIV/AIDS.

Montaner, who led the study, called for more research, but warned that treatment alone would not be enough to prevent new HIV infections; a combination of prevention interventions was the only solution.

During his Tuesday plenary presentation, Myron Cohen, a researcher at the University of North Carolina, agreed that there were still a number of unanswered questions about using ARVs for prevention, and that it would be impossible to "treat our way out of the epidemic". Nevertheless, he told delegates that the time had come to "marry" HIV prevention and treatment.

Cohen is leading a clinical trial of 1,750 discordant couples in six countries to determine the effects of starting treatment early on the transmission of HIV to uninfected partners. Results of the trial, which is being conducted by the HIV Prevention Trials Network of the National Institute of Allergy and Infectious Diseases, will probably only be available in five or more years' time.

A pill a day keeps the virus away?

In the meantime, trials looking into the efficacy of pre-exposure prophylaxis (PrEP), in which ARVs are regularly given to HIV-negative people who are at high risk of infection, are either planned or underway in countries in Africa, Asia, Latin America and North America.

According to the AIDS Vaccine Advocacy Coalition (AVAC), more people will be enrolled in PrEP trials than in all of those for vaccines and microbicides combined.

"Although still unproven by human clinical research, PrEP is considered one of the promising clinical interventions against HIV currently in development," said Mitchell Warren, executive director of AVAC, earlier this week.

AVAC released a new report at the conference, calling for increased action by governments, donors, researchers and advocates to prepare for initial results from the first PrEP trials, which are expected as early as 2009.

"We should look ahead to consider all of the possible outcomes of these trials, and make real plans for making PrEP available to those who can benefit from it as quickly and safely as possible if it is proven effective," urged Pedro Goicochea, an investigator for a PrEP study underway in Peru and Ecuador.

Read the IRIN PlusNews article here.

AFP: HIV: High infection tally sparks search for new strategies

Tue, 05 Aug 2008 00:00:00 -0400

MEXICO CITY — With new infections of HIV running at an average of 7,500 a day, the mission to brake the spread of the lethal virus is exploring new, even controversial paths, the world AIDS conference has heard.

HIV prevention is the poor bloody infantry in the war against AIDS, languishing in comparison to the headline-making advance of antiretroviral drugs -- the daily therapy that now keeps millions alive.

Last year, 2.7 million people became infected with HIV, bringing the global tally to 33 million.

Experts describe this as a devastating testimony to a quarter-century of attempts to encourage use of condoms, clean needle exchange for intravenous drug users, treatment to prevent mother-to-baby infection, sexual abstinence and other behavioural changes.

To those craving a technical miracle, such as a vaccine and a virus-thwarting vaginal gel, both lie many years, even decades off.

"We are in a desperate race against time in pursuit of prevention that works," Stephen Lewis, former UN special envoy to AIDS in Africa, said at the International AIDS Conference in the Mexican capital.

In the quest for fresh approaches, Canadian researchers on Tuesday said they uncovered unexpected evidence that antiretroviral drugs themselves had become a prevention tool.

Their theory is that the drugs, by killing HIV, slash virus levels in the blood and semen, which thus reduces — but not fully eliminates — the risk of exposure to an uninfected partner.

Their study, published last month in the Journal of Infectious Diseases, included a mathematical model to project what would happen in the western Canadian province of British Columbia if antiretroviral coverage rose from the current level of 50 percent of those in medical need.

Boosting coverage to 75 percent would lead to a decrease of new infections by more than 30 percent over 25 years, and 100-percent coverage would lead to a fall of 60 percent.

"We've known for some time that the expansion of coverage with HAART [antiretroviral therapy] could help to reduce the number of new infections," lead researcher Julio Montaner of the BC Centre of Excellence in HIV/AIDS told a press conference.

"However, we were amazed at the actual number of new infections that can be potentially averted by expanding access to treatment."

Thanks to a big scaleup in the past two years, three million badly-infected people in developing countries now have access to anti-HIV drugs. This is still less than a third of the people in need, though.

The rising cost of buying antiretrovirals for infected people has raised fears that the bill will eventually become untenable.

But Montaner said that the cost would be offset by savings to healthcare systems, because infections would fall.

Another novel idea being tested is to use antiretroviral drugs as a "pre-exposure" prevention. The idea is that people at risk from infection could take one pill, or a combination of them, before sex to prevent infection.

The strategy is being tested in Peru and Ecuador, and set to be amplified next year.

But it stirs worries in some quarters. Some experts fear that using antiretrovirals in a "start-stop" way will help the wily AIDS virus to mutate, in the same way that improper use of antibiotics helps a germ build resistance.

Once considered a cultural or religious rite, male circumcision has also leapt into the HIV prevention arena, thanks to evidence from trials in eastern and southern Africa that foreskin removal can more than halve the risk of infection for a man.

According to French researcher Bertran Auvert, who conducted the South African study, circumcision could avert up to 3.8 million infections and half a million deaths in sub-Saharan Africa between 2006 and 2016, and up to 5.8 million deaths by 2026.

But movement to encourage circumcision among men in badly-affected countries is proceeding gingerly, as a botched campaign would cause the strategy backfire disastrously.

Read the AFP article here.