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

September 2011

At present, the chronic non-communicable diseases (NCDs) are handled as top priority on the international health policy’s agenda. Hence, the United Nations convene a high-level meeting in New York on NCDs on September 19 and 20, 2011. A Swiss delegation including Medicus Mundi Switzerland Network will participate. We welcome that the non-communicable diseases such as cancer, diabetes, cardiovascular and chronic respiratory diseases are put on the international agenda, because they also jeopardize the health of the populations in the developing countries. In 2008, 63 % of deaths worldwide were due to non-communicable diseases, of which 80 % were recorded in developing countries.

HIV and non-communicable diseases have many ways to interact with each other. HIV as well as chronic, non-communicable diseases take a greater toll on the poor than on the rich and place a heavier burden on poor countries than on rich. People living with HIV are particularly susceptible to tuberculosis, cancer and other non-communicable diseases. Approximately one third of the 34 million people living with HIV worldwide also suffer from TB-infection – and the mortality rate in the case of HIV/TB co-infections is five times as high than in the case of tuberculosis alone.

Today, owing to the availability of anti-retroviral therapies, HIV can be considered a chronic disease in large parts of the world. Anti-retroviral therapies substantially slow down progression of a HIV-infection, thus increasing the prospects for the future of HIV-positive people who are taking regular medication and are looked after. Many experiences and findings that were acquired in resource poor settings while treating HIV-positive people may now be effectively used when treating people with non-communicable diseases. Due to the necessity of having to regularly treat people who live in remote areas, HIV-treatments have been increasingly decentralised and integrated into primary health care programs.

What makes however HIV completely different from other chronic diseases, is that HIV-positive people and their families are stigmatised. Following up on thirty years, AIDS is still burdened with shame and disgrace. Stigma and exclusion prevent many people from testing for HIV and thus make it impossible for HIV-positive people to lead a „normal“ life with a chronic disease. Nelson Mandela’s statement has never been so up-to-date than now: “Many people suffering from AIDS and not killed by the disease itself are killed by the stigma surrounding everybody who has HIV or AIDS” .

Prior to the high-level meeting in New York, over 70 health-NGOs and groups representing thousands of HIV-positive people got together and sounded the alarm. They fear that the political declaration on NCDs could undermine better access to medication for all and progression would be sacrificed for trade and economic interests. As in the global AIDS movement, a strong movement is needed for non- communicable diseases as well, which is incessantly and with a strong voice working for the right to health.

Helena Zweifel Executive Director Medicus Mundi Switzerland Coordinator aidsfocus.ch

1. September 2011 - Civil society groups unite to tackle trade, fight for targets and to eliminate industry influence, and they file complaint with the UN Special Rapporteur on the Right to Health. Their concern is that a watered down political declaration will roll back the advances made realising access to medicines for all and will threaten the right to health of millions of people, especially those living in developing countries. “People with HIV need access to antiretroviral therapy, but we all are also susceptible to non-communicable diseases, which also need treatment,” says Gregg Gonsalves of the International Treatment Preparedness Coalition. “Whether we are advocating for access to HIV medicines or to NCD medicines, this is a battle for medicines for all.”

http://donttradeourlivesaway.wordpress.com

1. July 2011 - AIDS related stigma and discrimination refers to prejudice, negative attitudes, abuse and maltreatment directed at people living with HIV and AIDS (PLWHAs) leading to the victims being shunned by family members, peers and the wider community. The poor treatment of PLWHAs in health institutions and other public facilities tend to erode their fundamental human rights and inflict psychological damage on them. Stigma not only makes it more difficult for people trying to come to terms with HIV and how to manage their illness, but also interferes with attempts to fight the AIDS epidemic worldwide. On the national level, the stigma associated with HIV can deter governments from taking fast, effective action against the epidemic.

http://www.ghananewsagency.org

HIV/AIDS has become more and more a disease which is characterised by factors, which can be compared with chronic diseases. Many experiences in the treatment of people living with AIDS can be used for patients of non-communicable diseases. SolidarMed implements a region wide HIV treatment and prevention program in four Sub-Saharan countries since the year 2004. The following eight key lessons learnt, relevant for chronic diseases, can be drawn from this experience: 1) Human resources for health, 2) Adherence and Retention, 3) Interdisciplinary care teams and chronic disease units, 4) Infrastructure, logistics, communication and technology, 5) Prevention and Treatment, 6) Measure, measure, measure, 7) Global coalitions and realistic judgement of interests, 8) Diagonal, public health approach. (Bulletin MMS Nr. 115, 2010)

http://www.medicusmundi.ch
http://www.medicusmundi.ch

At the aidsfocus.ch conference, held on the 7th of April 2011, participants discussed the challenges and opportunities of linking HIV with sexual and reproductive health and rights, in the light of the current international debate and of concrete experience in Africa and Central Asia. In the countries of the South, Swiss NGOs have been supporting innovative and effective initiatives that provide youth-friendly services concerning HIV and sexual and reproductive health and rights. They address the questions and concerns of young women and men and support them in their efforts to lead a self-determined, healthy life. The Network Medicus Mundi Switzerland has just published the reader of the conference. (September 2011)

http://www.medicusmundi.ch

Geneva, 6 September 2011 - For churches in Africa, the Old Testament has historically occupied a prominent place in theological thinking. “Our theology is constructed with the image of God in the Old Testament,” reflects Charles Klagba, theological consultant for the Ecumenical HIV and AIDS Initiative in Africa (EHAIA). “It is for that reason the reaction of many churches on this continent to the epidemic is very much influenced by the belief that illness is a punishment for individual sins,” he says. Deconstructing this theology and giving birth to an alternative approach that can give hope to people have been at the centre of Klagba's encounters with theologians, pastors and church leaders. (WCC)

http://www.oikoumene.org

Kampala, 26 August 2011 - A new national HIV/AIDS strategic plan for Uganda is due to be finalized before the year's end, and gay rights activists are urging its authors to break with tradition and, for the first time, provide for programming for men who have sex with men. A draft version of the new strategic plan distributed to civil society organizations mentioned the MSM community by name under an introductory section outlining groups that have prevalence rates above the national average, but the strategy concluded that MSM did not play "a big role" in the transmission of HIV in Uganda and did not warrant a high rank among prevention activities. "It's the first HIV programming to mention MSM by name... It's a big and overwhelming shift". (PlusNews)

http://www.irinnews.org

Nairobi, 17 August 2011 - International funding for HIV fell by 10 percent in 2010 from the previous year, according to the Kaiser Family Foundation and UNAIDS. Activists worry that a continued reduction will undermine progress in global HIV prevention and treatment efforts. Funding fell from US$7.6 billion in 2009 to $6.9 million in 2010. This is the first time funding has dropped in more than a decade of tracking HIV/AIDS spending; between 2002 and 2008, spending rose more than six-fold before levelling off in 2009. "The slowdown in spending is worrying because it comes at a time when treatment as prevention has been proposed to curb HIV infections, which will require heavy investment," said James Kamau, coordinator of the Kenya Treatment Access Movement.

http://www.irinnews.org
http://www.aidsfocus.ch

Nairobi, 11 August 2011 - Long seen as the ugly step-child of HIV prevention, the female condom seems to be gaining popularity through grassroots campaigns, according to a new report by the UN Population Fund (UNFPA). "For the fourth consecutive year, access to female condoms has increased dramatically, reaching a record number of 50 million... in 2009," the report states. The organization credits successful partnerships between governments and technical agencies for helping to increase access to female condoms. "In a number of countries, governments... are applying highly creative approaches to educating the public about condoms and to overcoming the stigma and taboos sometimes associated with them," the report's authors said. (PlusNews)

http://www.plusnews.org

1. July 2011 - Each year, MSF publishes a survey of the latest prices for antiretroviral medicines to treat people living with HIV/AIDS in developing countries. This year, the main finding is the growing and deadly divide in prices for antiretrovirals offered to the poorest countries versus lower and middle-income countries, where large populations of HIV-positive people live. Companies are increasingly not offering standardised price cuts in these countries, leaving them to negotiate on a case-by-case basis, which we have seen leads to high prices. Gabriela Costa Chaves, a pharmacist with MSF’s Access Campaign and based in Rio de Janiero in Brazil, talks in an interview about the impact of higher drug prices for countries like Brazil. (MSF)

http://www.msfaccess.org

This edition of HATIP looks at the question of integration between HIV services and other types of service within the health system. Integration has become a buzz-word in the HIV field over the past few years, but what do we mean by integration, who does it benefit, and where should the integration take place? When separate programmes integrate the delivery of services, other key health service functions — governance, financing, planning, procurement, monitoring and evaluation, and demand generation — may be involved, and may require joint co-ordination or sometimes, full integration. (September 2011)

http://www.aidsmap.com

A new report highlights that global commitments will be achieved only if the unique needs of young women and men are acknowledged and their human rights fulfilled, respected, and protected. The report highlights that young people are a key resource to reverse the global AIDS. It stresses that the legal and policy barriers that prevent young people from accessing HIV services must be addressed, and young people should be engaged more effectively in the response. Empowering young people and particularly young women to exercise their rights to sexual and reproductive health, improve programmes for young people and repeal national laws and policies that restrict access to HIV services for young people is required to protect future generations from HIV. (2011)

http://www.unaids.org

The Asia-Pacific region is at a critical point in its HIV response, states a UNAIDS report that shows a mix of successes and challenges over the past decade. HIV in Asia and the Pacific: Getting to Zero, launched at the 2011 International Congress on AIDS in Asia and the Pacific (ICAAP), found that more people than before had access to HIV services, but most countries in the region were still a long way from achieving universal access to HIV prevention, treatment, care and support. Wider access to services that prevent new HIV infections among children had led to a 15 percent decrease in new HIV infections among children in the region since 2006. However, there are still nearly two new HIV infections for every person who starts treatment. (PlusNews, August 2011)

http://www.irinnews.org
http://www.aidsfocus.ch

This publication by GNP+ and UNAIDS highlights the importance of placing the person living with HIV at the centre of managing their health and wellbeing. Among other things, this Framework takes us beyond the more limited concept of ’positive prevention’ which focuses only on people living with HIV ’preventing’ the transmission of HIV. Positive Health, Dignity and Prevention stresses the importance of addressing prevention and treatment simultaneously and holistically. It also emphasises the leadership roles of people living with HIV in responding to policy and legal barriers within the socio-cultural and legal contexts in which they live, and in driving the agenda forward toward better health and dignity. (July 2011)

http://www.unaids.org

This toolkit has been developed by USAID, AED, and collaborating organizations. K4Health eToolkits are electronic libraries of resources on a particular health topic that are vetted and selected by technical experts. They are designed for health program managers, service providers, and policy makers. The resources in this toolkit cover a broad range of topics pertinent to the treatment, care, and support of ALHIV, including training; treatment literacy and adherence; counseling and disclosure; life skills; prevention and reproductive health; psychosocial support; human rights and advocacy; peer education; adolescent transitioning and research, policy, and promising practices. (2011)

http://www.k4health.org

Biel | HIV and AIDS are a hard reality in a number of countries involved in International Cooperation. It affects not only every aspect of the lives of the people concerned, but also considerably impacts the life and work of IC expatriate personnel. This seminar has the objective of working with participants so that they can better manage this challenge. The participants will explore various levels of impact which the epidemic of HIV and AIDS can have on the life and the work of expatriate personnel, and explore strategies that might help to effectively manage the challenges at personal, institutional, and intercultural levels

http://www.cinfo.ch

Bern | The Annual Meeting 2011 of aidsfocus.ch will have a brief formal part with annual report and decision on the theme of the aidsfocus.ch conference 2012. The focus, however, will be on sharing of knowledge and experience and discussion. The topic: What are advantages and disadvantages of a wider focus that goes beyond AIDS and sexual and reproductive health (SRH)? Some of our partner organisations have good experience in linking HIV and SRH in their programs. Share-Net, the network of Dutch development organisations and individual consultants working in the field of SRHR and HIV, links them both. What are the experiences of Share-Net and aidsfocus.ch partners? What are lessons learnt?

http://www.aidsfocus.ch
http://www.share-net.nl

Basel | Health is a human right: too often forgotten, this is the central issue of international health policy and health cooperation. And yet millions of people die each year in developing countries due to easily preventable diseases. This is a basic violation of the human right to health. In addition, women, minorities and marginalized people often have limited access to healthcare due to poorly functioning healthcare systems. This year's Swiss Health Cooperation Symposium is organised by the Network Medicus Mundi Switzerland and the Swiss Red Cross.

http://www.medicusmundi.ch

Partners: Afro-European Medical and Research Network, AIDS & Child, Caritas Switzerland, cinfo, CO-OPERAID, Déclaration de Berne, FEPA, Fédération Genevoise de Coopération, Gemeinschaft St. Anna-Schwestern, HEKS, IAMANEH Switzerland, INTERTEAM, Kindernothilfe Schweiz, Kwa Wazee, medico international Switzerland, mediCuba-Suisse, missio, 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 and Public Health Institute (Swiss TPH), Tear Fund, Terre des hommes Foundation, terre des hommes schweiz, and World Vision Switzerland.

http://www.aidsfocus.ch