THE ELECTRONIC BULLETIN OF THE SWISS PLATFORM FOR HIV/AIDS AND INTERNATIONAL COOPERATION February 2007

HIV-positive and pregnant: The South African Phindile is in a difficult, even dramatic situation. Nobody was there to give Phindile some good advice, neither the counsellors and health workers, nor the nurses or the doctors at the clinic. Even her own mother was mad at her because she thought that the child of a HIV-positive mother will automatically be born positive. In many countries, the health workers exert pressure on HIV-affected pregnant women and want them to abort their pregnancy or to get themselves sterilized - this is what the International Community of Women living with HIV reports. But Phindile was not swayed by their arguments: "I said to people, 'I'm positive, and I still have the right to have a baby.'"

In Switzerland, HIV-positive women have many options. In this country, HIV-positive babies are no longer born. By undertaking certain measures, the transmission rate from mother to child can be lowered down to almost zero: selected intake of antiretroviral drugs during pregnancy, delivery by a Caesarean, no breast-feeding and a preventive treatment of the baby with an anti-HIV drug.

Despite large steps forward worldwide, only 9 per cent of the pregnant women living with HIV in the countries of the South have these options. There are only a very limited number of clinics that feature Prevention of mother to child transmission programmes (PMTCT). Such programmes would include providing information and consultation to the future mothers, prenatal care, intake of medicine as a prophylactic measure for both mother and child as well as after-birth assistance. The infection rate could be halved just by administering a one-off dose of one drug only (Nevirapine). 300'000 children every year could be free from HIV, 300’000 mothers and fathers could be happy about the birth of their baby.

What about the desire of an African woman to have a healthy baby, is it less legitimate than the desire of a Swiss woman? Which are the opportunities and challenges of programmes to reduce a vertical HIV-transmission? What can we contribute to turn the right of all women and men to a comprehensive HIV prevention, treatment, care and support into reality?

These are some of the questions on the issue of „positive motherhood“ that we will take up and discuss at our aidsfocus.ch conference on April 26 in Berne. You are kindly invited to participate.

Helena Zweifel Coordinator aidsfocus.ch

INFORMATION FROM THE SWISS COMMUNITY OF PRACTICE - AIDSFOCUS.CH SUPPORTS MSF PETITION: "PEOPLE BEFORE PATENTS!"

BRIEFS FROM ALL OVER THE WORLD - NEARLY A QUARTER OF A MILLION PEOPLE URGE NOVARTIS TO DROP ITS COURT CASE IN INDIA - MICROBICIDE RESEARCH SUFFERS MAJOR SETBACK - WORLD SOCIAL FORUM: END TO HIV/AIDS. A TALL ORDER IN FACE OF VIOLENCE - TRADITIONAL HEALERS JOIN THE AIDS RESPONSE - SOUTH AFRICA: REPRODUCTIVE RIGHTS OF HIV POSITIVE PEOPLE UNDER DISCUSSION - INDIA: GOVT ARV PROGRAMME HITS STUMBLING BLOCK - ECUADOR: PREGNANT WOMAN URGED TO BE TESTED AND TREATED FOR HIV - SOUTH AMERICA: GETTING THE MESSAGE

NEW DOCUMENTS AND RECOURCES - WOMEN AND GIRLS LIVING WITH HIV/AIDS: OVERVIEW AND ANNOTATED BIBLIOGRAPHY - MAKING THE SEXUAL RIGHTS OF WOMEN LIVING WITH HIV COUNT - LET'S TALK ABOUT HIV COUNSELLING AND TESTING - FACILITATORS' GUIDE - CHILDREN AND AIDS: A STOCKTAKING REPORT - LEARNING FROM EXPERIENCE: BEST PRACTICE COLLECTION - ASIA: FACING THE HIV/AIDS CHALLENGE

EVENTS (IN ENGLISH) 26.04.2007 | AIDSFOCUS.CH CONFERENCE: POSITIVE MOTHERHOOD 06.06.2007 | SDC: MAINSTREAMING HIV/AIDS IN PRACTICE 27.08.2007 | AIDSFOCUS.CH: PEER REVIEW GROUP MAINSTREAMING HIV/AIDS

Bern | aidsfocus.ch conference 26 April 2007: If an HIV-positive woman becomes pregnant, there is a 35 per cent chance that she will transmit the virus to her child if no preventative action is taken. 95 per cent of pregnant women who are HIV-positive live in developing countries. More than 700,000 children become HIV-positive via vertical HIV transmission. However, this is preventable.

Every woman, every man must be guaranteed the right to decide whether and when to have children, irrespective of their HIV status. For many pregnant women, it is when seeking antenatal care that they learn about their HIV status. It is also the time and opportunity for HIV information, prevention, treatment and care of the women and their family members.

What are the challenges and opportunities of voluntary counselling and testing in antenatal care and of prevention of vertical HIV transmission? What are the criteria for breastfeeding by positive mothers and/or supplying infant formula? What is the impact of socio-cultural significance of motherhood on HIV prevention and care? These are some of the issues which will be explored at the conference, looking at them from a socio-cultural as well as a medical perspective, reflecting on theory and practice. Program and registration:

http://www.aidsfocus.ch

The Steering Committee of aidsfocus.ch decided unanimously to support the petition launched by Médecins Sans Frontières. With the petition, Novartis is asked to drop the case against the Indian government and the Indian patent law. aidsfocus.ch considers the right to health care as a human right, and demands equity in access and access to free or at least affordable ARV treatments for all. If the Indian patent law is revised, India would no longer be allowed to manufacture generics and to supply much of the developing world with cheap essential medicines – with a devastating impact on women, men and children living with HIV.

http://www.msf.org

For more news or more detailed information on the activities of the Swiss Community of Practice, please consult our aidsfocus.news in German or French.

http://www.aidsfocus.ch
http://www.aidsfocus.ch

New Delhi/Geneva, 29 January 2007 - As pharmaceutical company Novartis proceeds with its legal challenge against the Indian government in a court hearing in Chennai today, nearly a quarter of a million people from over 150 countries have expressed their concern about the negative impact the company's actions could have on access to medicines in developing countries. The Indian Network for People with HIV/AIDS (INP+), the People's Health Movement, the Centre for Trade and Development (Centad), together with Mèdecins Sans Frontiéres (MSF), called on the company again today to immediately cease its legal action in India.

[backPid]=5&cHash;=365002aabd" target="_new">http://www.msf.ch

Nairobi/ Johannesburg, 1 February - Progress in developing an effective anti-HIV microbicide was dealt a major blow this week when researchers halted trials of a microbicide gel after preliminary results showed it could increase the risk of HIV infection. The trial was being carried out in Benin (West Africa), India, South Africa and Uganda by the reproductive health research organisation, CONRAD. (PLUSNEWS)

http://www.plusnews.org

1. February - African traditional medicine is often the primary, and frequently the only, accessible health-care option for many people living in sub-Saharan Africa. Attempts to bring biomedical and traditional health care together for people living with HIV began in the early 1990s when the World Health Organisation recommended that traditional medicine be included in national responses to HIV.

http://www.unaids.org

Nairobi, 24 Jan - The issue of violence exacerbating the spread of HIV/AIDS, particularly in women, has remained a hot one at the World Social Forum (WSF). From Africa to Asia, activists are reiterating that violence against women remains a threat to the HIV/AIDS fight, and that without governments addressing the matter, winning the war against the disease will be an uphill task. (IPS)

http://www.ipsnews.net

Johannesburg, 20 December - As more and more HIV-infected South Africans access life-prolonging antiretroviral (ARV) treatment, the question of whether or not to have a child, and how to do so as safely as possible, is bound to become more common. There is no official framework to guide health workers on advising HIV-positive people about their reproductive rights and options. (PLUSNEWS)

http://www.plusnews.org

New Delhi, 26 January - As India grapples with one of the world's largest HIV/AIDS caseloads, the government faces the challenge of rapidly scaling up the provision of first-line antiretroviral (ARV) drugs to people who need them, while a growing number require more expensive second-line medication. (PLUSNEWS)

http://www.plusnews.org

Guayaquil, Ecuador, 4 January 2007 – When Andrea, 20, discovered that her husband had HIV, she immediately got tested. Already five months pregnant, she discovered that she was HIV-positive. - About 8,000 cases of people living with HIV and AIDS have been registered in Ecuador, with women increasingly among those infected. In response, UNICEF-supported public service announcements (PSAs) on radio and television are now advising pregnant women in Ecuador to take a free, voluntary HIV test. (UNICEF)

http://www.unicef.org

January 2007 - The Pan American Health Organization has produced a DVD anthology of nearly 200 television spots about HIV that have been shown around the Americas region over the last ten years. The disc set “VIHdeo America” was compiled to share information and experiences and help encourage new approaches to AIDS communications and messaging.

http://www.unaids.org

HIV/AIDS is both driven by and entrenches gender inequality, leaving women more vulnerable than men to its impact. This BRIDGE report - consisting of an overview, annotated bibliography, and contacts section - considers the specific challenges faced by women and girls who are living with HIV and AIDS. Women's social, economic, and legal disadvantage is exacerbated by a positive HIV status, and vice versa. Violations of women's social, economic, and legal rights in turn obstruct their ability to seek care, treatment and support, and to realise their sexual and reproductive health and rights (February 2007)

http://www.bridge.ids.ac.uk

This issue of Exchange, produced in association with the International Community of Women Living with HIV/AIDS (ICW), focuses on the experience of women living with HIV. The issue focuses particularly on sexual and reproductive rights. It shows how the ABC (Abstain; Be Faithful; Use Condoms) approach, currently favoured by funding bodies such as USAID, ignores the complexity of human needs and desires. It also includes a report from India on women who have lost their land due to their HIV status, and a report from Uganda on the ’memory work’ project in which mothers living with HIV and their children have been involved. (Exchange on HIV/AIDS, Sexuality and Gender, 2006)

http://www.kit.nl

This toolkit is designed to help NGOs, CBOs and other civil society organisations responding to HIV/AIDS in developing countries increase their knowledge and improve the quality of their work on HIV counselling and testing. The toolkit has eight sections covering different aspects of HIV counselling and testing. Each section begins by providing essential information comprising key definitions, concepts and messages after which participatory activities are presented for carrying out with NGO/CBO staff. Available in English and Spanish. (December 2006)

http://www.aidsalliance.org

‘Unite for Children, Unite against AIDS’ was launched in October 2005 with the goal of putting the ‘missing face’ of children at the centre of the global HIV/AIDS agenda. This new Report by UNICEF shows that in several countries in Eastern and Southern Africa, trends in access to antiretroviral regimens for preventing mother-to-child transmission are starting to show remarkable gains. Increasing numbers of children living with HIV are now receiving treatment, although the numbers are far too few. The increases are a result of improved testing, better skills among health workers, lower drug prices and simpler formulations. There are, however, huge gaps in progress. (UNICEF 2007)

http://www.unicef.org

There are literally thousands of AIDS-related programmes around the world. To help drive the knowledge-sharing process, in 1997 UNAIDS began the production of its ‘Best Practice Collection’ — a series of publications ranging from guidelines, updates and policy papers to case studies, handbooks, and examinations of particular challenges and responses, all designed to promote learning, share experience and empower people and partners engaged in the AIDS response. The Best Practice Collection provides a wealth of ‘hands on’ experience that is useful and may be replicated. (UNAIDS 2007)

http://www.unaids.org

PlusNews Special Report documents that South East Asia has the largest number of people living with HIV after Africa, and its share of the global epidemic is growing - an estimated 8.6 million people in the region were living with the virus in 2006, with the epidemic expanding faster than anywhere else in the world. Because of the size of the region's population, relatively modest HIV prevalence can translate into millions of cases. Unless determined action is taken now, the virus could move into the general population. ( 2007)

http://www.irinnews.org

Bern | aidsfocus.ch conference 2007: What are the challenges and opportunities of voluntary counselling and testing in antenatal care and of prevention of vertical HIV transmission? What are the criteria for breastfeeding by positive mothers and/or supplying infant formula? What is the impact of socio-cultural significance of motherhood on HIV prevention and care? These are some of the issues which will be explored at the conference, looking at them from a socio-cultural as well as a medical perspective, reflecting on theory and practice. Program and registration:

http://www.aidsfocus.ch

Ausserholligen | The course offered by SDC aims to provide information on and skills in mainstreaming HIV/AIDS. It aims to strengthen participants’ motivation and competence to mainstream HIV/AIDS as relevant for their work. At the end of the day, participants should understand the concept of “mainstreaming HIV/AIDS” and its multisectoral dimension and know the most important elements of the SDC toolkit “mainstreaming HIV/AIDS in practice” and understand how to work with the toolkit.

http://www.deza.ch

Bern | Sharing of experiences and learning from each other is an effective way in the process to mainstream HIV into one’s own organisation. The Swiss Red Cross is inviting partners of aidsfocus.ch to the next meeting. The focus will be on sharing of experiences and information on monitoring and evaluation of mainstreaming HIV and AIDS. Participants preferably have participated in the SDC training module or studied one of the toolkits in order to make sure that we share a common basic understanding of the concepts. No formal group will be created - so attendance to the meetings can be decided case by case.

http://www.aidsfocus.ch

aidsfocus.ch is a project set up by Medicus Mundi Switzerland. aidsfocus.ch is sponsored and shaped by 30 partner organizations who support the aims and activities of the platform through their financial contributions, expertise and commitment.

Partners: AIDS & Child, Bethlehem Mission Immensee, Caritas Switzerland, cinfo, CO-OPERAID, Déclaration de Berne, Doctors without Borders, FEPA, Fédération Genevoise de Coopération, Gemeinschaft St. Anna-Schwestern, HEKS, IAMANEH Switzerland, International Federation of the Blue Cross, INTERTEAM, medico international Switzerland, mediCuba-Suisse, mission, 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.