THE ELECTRONIC BULLETIN OF THE SWISS PLATFORM FOR HIV/AIDS AND INTERNATIONAL COOPERATION November 2009

Tanzania: After the death of the parents – who died of Aids related disease – the uncles had distributed Ahadi and her two brothers to distant relatives and destroyed the parental home. The even took the corrugated iron sheets to prevent the children from returning to where they had lived with their parents.

Yet, the children secretly returned to the place of their former home and tried to somehow survive. A neighbour told the community about the children. So, an officer came by to look around, but he told that he had not seen anybody. A representative of a humanitarian organisation reported of “a little something” under the banana trees where the children would supposedly live.

Marcellina, the terre des hommes schweiz coordinator, had heard about it and wanted to meet the children where they lived. The children showed her the tiny shelter under the banana trees. Marcellina got very curious and acknowledged the children’s deed: „How did you manage to build this tiny hut?“ At first, the children were shy, but when they realised that there was someone showing sympathy and esteem to what they had achieved, they started to tell how they had looked for some poles, built a kind of scaffolding and filled in the walls with twigs and leaves; they also told how they slept shifts as the hut was too small for all three of them. While they were telling everything, their faces started to light up with joy. Despite of hardly owning anything, the children had considerable inner resources, in particular an extraordinary will to live, creativity and persistence, to live together where their parents had lived.

The question: „How did you manage to get this far?“ is a typical question of a solution-focused approach. The clients – the children – are thus enabled to tell how they had managed so far and thus they become aware of their resources and abilities.

The solution-focused approach is a specific coaching model developed by Steve de Shazer and Insoo Kim Berg. It starts from the assumption that every person has strengths and abilities on which to build upon when looking for solutions. The solution-focused approach is more a basic attitude than a mere method: Every person is acknowledged as an expert on his or her own life. The role of the counsellors is to support the clients in recognising and valuing its own resources and capacities and to build upon them.

This story is one of the examples that the moderators and participants shared on the occasion of the terre des hommes schweiz training course on solution-focused approaches in South Africa. Experiences of the pilot course with youth from six Sub-Saharan countries have clearly shown how this approach empowers the young people and triggers off positive changes on various levels.

On December 1, the solution-focused approach in the context of HIV and Aids will be the topic of discussion at the Annual Meeting of aidsfocus.ch in Berne. And this approach will also be integrated in the review of the Toolkit on Memory Work. If all goes well, aidsfocus.ch and terre des hommes schweiz will present a poster on the solution-focused approach and memory work at the World Aids Conference in Vienna in July 2010.

But let me first invite you to the aidsfocus.ch-Annual Meeting and the film “Memory Books. Damit du mich nie vergisst” on December 1, 2009 in Berne. The filmmaker Christa Graf will be present and share experiences. We welcome all interested people and friends of aidsfocus.ch to this event.

Johannesburg, 22 October 2009 - The recent news that for the first time an HIV vaccine had shown some protective effect generated widespread excitement, until it emerged that the results were based on the most promising of three different analyses of the trial findings.

The trial team in Bangkok, Thailand's capital, announced on 24 September that a combination of two vaccines had reduced the rate of HIV infection by 31 percent in about 8,200 volunteers, compared to around the same number who were given a placebo.

A few weeks later, researchers who had seen full data from the trial told Science magazine that an analysis based only on participants who had received all six doses of the vaccine at the right times did not show a statistically significant protective effect.

It was hoped that the release of more details from the trial to coincide with the AIDS Vaccine 2009 conference taking place in Paris this week would settle the question of whether the vaccine results were really as significant as the initial announcement had suggested or a mere fluke. Instead, full results of the study, published online yesterday in the New England Journal of Medicine (NEJM) raised more questions than they answered.

The 31 percent efficacy in the initial announcement was based on a "modified intention-to-treat" analysis that included all the 16,402 trial participants, except for seven who were found to have contracted HIV before receiving any vaccinations.

A second analysis included those seven, while a third "per-protocol" analysis involving 12,452 participants - the one cited in Science magazine - found that the vaccine was only 26 percent effective. This was not enough to be statistically significant, meaning that the difference between the vaccine and the placebo arms of the trial was so small that it could have been a coincidence.

Different interpretations

Dr Jerome Kim of the US Military HIV Research Programme, who helped lead the trial, yesterday told reporters at the vaccine conference in Paris that the modified intention-to-treat analysis was the most accurate, but others disagreed.

A statistician quoted in a New York Times report placed more emphasis on the analysis that included the seven HIV-positive participants, while another did not believe that any of the analyses provided sufficient evidence the vaccine worked.

In an editorial accompanying the article, NEJM editor Raphael Dolin said that "although the merits of each type of analysis can be debated, all three yielded a possible, albeit modest, effect of the vaccine in preventing HIV infection."

The study authors also argued that, taken together, the three different analyses of the results were "consistent with a modest protective effect of vaccine", but could not explain why other findings from the trial indicated that the vaccine's efficacy appeared to decrease over time, or why it was less effective among participants at high risk of infection.

They were also unsure whether it was one of the two vaccines that produced a potentially protective effect, or the combination of the two. Dolin noted that the findings raised "a number of questions that have important implications for future directions in vaccine research", and recommended that the duration of the vaccine's effect be addressed by following up the trial participants, as well as by future trials.

According to a report by a South African news service, Health-e, Colonel Nelson Michael of the US Military HIV Research Programme, another lead investigator of the Thai trial, told a press conference in Paris that a further study of the vaccine may be conducted in South Africa, which has a much higher HIV prevalence than Thailand. The vaccine would have to be modified to contain the strain of HIV most common in sub-Saharan Africa. (PlusNews)

http://www.plusnews.org

Berne | The annual meeting of aidsfocus.ch, the Swiss platform on HIV/AIDS and international cooperation, is an important forum for the sharing of information and experiences. Besides the annual report and accounts, there will be a window open for sharing of information and experiences.

Agenda

Part 1: Formal part

1. Minutes of the annual meeting 2008 2. Annual report 2008/9 3. Accounts 2008 4. Activities planned for 2010: World Aids Conference 2010 in Vienna 5. Theme of the aidsfocus.ch conference in spring 2010 6. Election/ confirmation of members of the Steering Committee 7. Varia

Part 2: Sharing of experiences und discussion

Solution focused approaches in working with youth in the context of HIV, AIDS and violence in Southern and Eastern Africa.

With an input by Irene Bush (terre des hommes), a short film and discussion.

The solution focused approach (SFA) is a coaching model developed by Steve de Shazer und Insoo Kim Berg. It is based on the assumption that every person has strengths and resources, and solutions will be based on his/her strengths and resources. The counsellor helps people identify the things that they wish to have change in their life and also to attend to those things that are currently happening that they wish to continue happening, The solution focused attitude is based on the assumption, that every person is the expert of his/her life and therefore finds the best solution.

The outcome of the pilot course of terre des hommes schweiz with 24 youth from 6 different countries of Sub-Saharan Africa, most of them affected by HIV and AIDS, showed many positive changes on different levels. The training in SFA provided the youth have a methodology and attitude that supports them in their work with Community Based Organisations and makes their intervention more effective.

Part 3: Apéro

You are kindly invited to join for a small apéro in the lobby of the Kornhausforum – a great opportunity for sharing and networking.

Aidsfocus.ch welcomes to the Annual Meeting all people interested in HIV, AIDS and international cooperation. But only partners of aidsfocus.ch will be able to vote.

The annual report, accounts/budget as well as additional materials will be sent to you beginning of November 2009.

Information and registration: Helena Zweifel, info@aidsfocus.ch, or tel. 061 383 18 12

Venue: Kornhausforum, Bern, 1.45 - 5 p.m.

The cost of HIV medicines is rising all the time, meaning that many people with HIV will not be able to afford life-saving medicines. There is a way to produce new drugs at affordable prices: The UNITAID patent pool for HIV medicines could change this. Join MSF in pushing drug companies to put their patents in the pool. This way drug companies share their drug patents with the pool, so they still get their royalties ….but at the same time other companies can get hold of these patents to make cheaper drugs. (October 2009)

http://www.msfaccess.org

Nairobi, 2 November 2009 - A 22-year-old ban on people infected with HIV entering the US was officially lifted on 2 November, with the new rules taking effect in 60 days. AIDS activists have hailed the move as a major coup in the fight against stigma. Samuel Kibanga, national coordinator of the National Forum of People living with HIV/AIDS Networks in Uganda, commented: "This shows that America can now see the reality that people living with HIV are just like any other people, deserving of the right to free movement - the travel ban was discrimination of the highest calibre." (PlusNews)

http://www.plusnews.org

Geneva/New York, 31 October 2009 — UNAIDS welcomes President Obama’s announcement of the final rule removing entry restrictions based on HIV status from US policy. The removal of HIV-related travel restrictions in the US overturns a policy that had been in place since 1987. Such restrictions, strongly opposed by UNAIDS, are discriminatory and do not protect public health. “I urge all other countries with such restrictions to take steps to remove them at the earliest,” said United Nations Secretary-General Ban Ki-moon.

http://www.unaids.org

Johannesburg, 22 October 2009 - The recent news that for the first time an HIV vaccine had shown some protective effect generated widespread excitement, until it emerged that the results were based on the most promising of three different analyses of the trial findings. The trial team in Bangkok, Thailand's capital, announced on 24 September that a combination of two vaccines had reduced the rate of HIV infection by 31 percent in about 8,200 volunteers, compared to around the same number who were given a placebo. A few weeks later, researchers who had seen full data from the trial told Science magazine that an analysis based only on participants who had received all six doses of the vaccine at the right times did not show a statistically significant protective effect.(PlusNews)

http://www.plusnews.org

Geneva, 22 October 2009 - The International AIDS Society (IAS) urged Uganda's political and public health leaders to oppose and reject the Anti-Homosexuality Bill presented last week in Uganda's parliament. If enacted, the bill would dramatically expand existing criminal sanctions on same-sex practices between consenting adults, including authorizing the death penalty in certain circumstances, such as same-sex sexual behaviour by "serial offenders" and people living with HIV.

http://www.iasociety.org

Nairobi, 15 October 2009 - "With the current financial crisis it is going to be very difficult to achieve the MDGs through official government aid, so innovative methods of financing the fight against these diseases must be sought," said Philippe Douste-Blazy, chair of UNITAID. According to him, the airline levy gives participating developing nations an opportunity to contribute to treatment in their countries rather than depending on handouts from the developed world. Cote d'Ivoire, Niger, Madagascar and Mauritius are applying the airline levy, while Benin, Burkina Faso and Kenya have said they will introduce it. (PlusNews)

http://www.plusnews.org

Bamako, 14 October 2009 - Up to 60 percent of the children receiving HIV treatment at the Gabriel Touré hospital had lost one or both parents and were often shuttled among caretakers. Only half of the 935 children taking antiretrovirals (ARVs) show up regularly at the hospital for medical care. More than 280 of the hospital's paediatric HIV patients are listed as "missing”. Some children are rejected by their families, kicked out when their HIV status is known. (IRIN)

http://www.irinnews.org

More than 4 million people in low- and middle-income countries were receiving antiretroviral therapy (ART) at the close of 2008, representing a 36% increase in one year and a ten-fold increase over five years, according to a new report by the WHO, UNICEP and UNAIDS. It highlights other gains, including expanded HIV testing and counselling and improved access to services to prevent HIV transmission from mother to child. "This report shows tremendous progress in the global HIV/AIDS response," said WHO Director-General Margaret Chan. "But we need to do more. At least 5 million people living with HIV still do not have access to life-prolonging treatment and care." (2009)

http://www.unaids.org

Strengthening the linkages between sexual and reproductive health and HIV prevention, treatment, care and support is critical to achieving the Millennium Development Goals. This systematic review of the literature on linkages between these two areas - published by WHO, UNFPA, UNAIDS, IPPF and UCSF - was conducted in order to gain a clearer understanding of the effectiveness, optimal circumstances, and best practices for strengthening such links. (2009)

http://www.unfpa.org

The current issue of the World Vision journal “Global future” highlights the achievements in respect to the Millennium Development Goals 4 and 5, that is, the global commitment to reduce under-five mortality by two thirds and to improve maternal health. It explores the nature of political will and what is required to reverse our failure. The authors lay out the “why, who, what and how” of the actions needed to realise MDGs 4 and 5. (2009)

http://www.globalfutureonline.org

Women living with HIV and AIDS use language like anyone else, language influenced by culture, class, race and geography. But there is also a whole AIDS language, grown out of AIDS activism, organisations and networks, as well as language which has arisen from more formal responses, such as UNAIDS, governments, research initiatives, donor interests. If we then put on a gender lens how do these words look to HIV positive women? How do they resonate with the way women living with HIV live their daily lives? (ICW News Issue 45 August/September 2009)

http://www.icw.org

This Guidance Note from UNAIDS has been developed to provide the UNAIDS Cosponsors and Secretariat with a coordinated human-rights-based approach to promoting universal access to HIV prevention, treatment, care and support in the context of adult sex work. The document provides clarification and direction regarding approaches by the Joint United Nations Programme on HIV/AIDS to reduce HIV risk and vulnerability in the context of sex work. A number of next steps are listed. (2009)

http://data.unaids.org

For a number of years, STOP AIDS NOW! and its partners have been investing in stimulating workplace responses among civil society organisations (CSOs) to HIV and AIDS. This report, published by STOP AIDS NOW!, summarises the lessons learnt, and draws on over 40 documents that have been produced detailing the work of STOP AIDS NOW! and its partners. The authors provide a tool for many people to learn from others’ experiences, and so to improve responses to HIV and AIDS in the workplace. (2009)

http://www.stopaidsnow.org

Worldwide | The World AIDS Campaign has announced the global theme of Universal Access and Human Rights for World AIDS Day 2009. Started on 1st December 1988, World AIDS Day is marked throughout the world and is important in reminding people that HIV has not gone away, and that there is still much to be done to tackle this global epidemic. A focus on universal access is timely because next year will be a milestone for the Millennium Development Goals – encouraging high level review of what has and has not been accomplished in relation to achieving access for all to essential care by 2010.

http://www.worldaidscampaign.org

The annual meeting of aidsfocus.ch, the Swiss platform on HIV/AIDS and international cooperation, is an important forum for the sharing of information and experiences. Besides the annual report and accounts, there will be a window open for sharing of information and experiences. The topic this year: Solution focused approaches in working with youth in the context of HIV, AIDS and violence in Southern and Eastern Africa. Irene Bush (terre des homes schweiz) will lead into the topic, followed by a short film, sharing of experiences and discussion. Information and registration: info@aidsfocus.ch, or tel. 061 383 18 12.

At 5.30 p.m. aidsfocus.ch will also show the Film "Memory Work. Damit du mich nie vergisst" (Dokumentarfilm Deutschland/Schweiz 2008), followed by an open discussion with the filmmaker Christa Graf (in German).

http://www.aidsfocus.ch

Wien | The International AIDS Conference is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess where we are, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.

"Rights Here, Right Now", the theme of the conference, emphasizes the central importance of protecting and promoting human rights, including the rights of women and girls, as a prerequisite to a successful response to HIV. Vienna, 18 to 23 July 2010.

http://www.aids2010.org

Partners: Afro-European Medical and Research Network, AIDS & Child, Bethlehem Mission Immensee, Caritas Switzerland, cinfo, CO-OPERAID, Déclaration de Berne, Doctors without Borders, Esperanza Medicines Foundation, FEPA, Fédération Genevoise de Coopération, Gemeinschaft St. Anna-Schwestern, HEKS, IAMANEH Switzerland, INTERTEAM, Kindernothilfe Schweiz, Kwa Wazee, medico international Switzerland, mediCuba-Suisse, missio, REPSSI, SolidarMed, Swiss Aids Care International, Swiss Aids Federation, missio, mission 21, Swiss Aids Care International, Swiss Catholic Lenten Fund, Swiss MIVA, Swiss Red Cross, Swiss Tropical Institute, Tear Fund, Terre des hommes Foundation, terre des hommes schweiz, and World Vision Switzerland.

http://www.aidsfocus.c