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

Do we advocate routine testing? Do we think that everyone going to see a doctor or a hospital should undergo a routine testing for HIV-antibodies? This question led to lively discussions when the Advisory Group started to prepare the aidsfocus.ch conference on „Positive Motherhood“ taking place on April 26, 2007 in Berne.

The fact is that routine testing allows earlier detection and treatment of HIV-infections – which slows down further HIV-propagation by unknowing infections. Only if all expectant mothers are tested, and appropriate measures are in place it is possible to prevent the transmission of the virus to the baby and thus to the next generation. As most expectant mothers do go and see the doctor or a clinic during their pregnancy, there is an ideal opportunity to integrate HIV-testing into prenatal examinations. So much for the arguments advocating routine testing.

But what does a woman do, who has not been prepared to face the news that she is HIV-positive – and is left alone with such a shock? Does not routine HIV-testing dress up compulsory testing of all women? Is it not just a pipe dream to demand that expectant mothers must give their „informed consent“ to testing, in view of the fact that very often the overtaxed medical workers do neither have the competence, nor the motivation or the time for serious information and appropriate personal consultation!? Is it ethically justifiable to have women undergo routine testing when no emotional support or medical treatment can be offered to them?

I have read about examples from Kenya where expectant mothers are thrown out of their homes after the testing turned out to be positive. Or, I have read about women who are blamed to be the reason for the misfortune of the family. Studies show how stigmatization, discrimination and violence on women have increased in particular in connection with HIV-testing during prenatal examination.

As staff and representatives of aid agencies and development organisations – how can we work to see that both women and men can exercise their right to comprehensive health care, including to competent consultation? What do we consider our task to be in the struggle against stigmatization and discrimination of HIV-positive women and men?

Based on specific experiences, international studies and guidelines, the aforementioned questions are among those to be discussed at the aidsfocus.ch conference on „Positive Motherhood“ – apart from one’s own questions, of course. You are most welcome to join.

Helena Zweifel Coordinator aidsfocus.ch

aidsfocus.ch conference: “Positive Motherhood – Opportunities and challenges of HIV prevention, treatment and care”. April 26, 2007, Bern. Program and registration: http://www.aidsfocus.ch

INTERNATIONAL NEWS - CONCORD POSITION STATEMENT ON THE GLOBAL HIV AND AIDS PANDEMIC - TB ANYWHERE IS TB EVERYWHERE - INDIA: GENERIC MEDICINES WALK THE PLANK - SOUTH AFRICA: WOMEN WON'T WAIT - INDIA: NEW ORGANISATION FOR HIV-POSITIVE WOMEN - AFRICA: DONORS CALL THE SHOTS IN HIV/AIDS SECTOR

NEW DOCUMENTS AND RESSOURCES - INFANT FEEDING POLICY DEBATED - HIV AND AIDS REPORTER: FOCUS ON STIGMA - HIV AND PEOPLE ON THE MOVE: RISK AND VULNERABILITIES OF MIGRANTS AND MOBILE POPULATIONS IN SOUTHERN AFRICA - HIV AND REFUGEES. POLICY BRIEF - AFRICA WIDE BRIEFING NOTES: YOUNG CHILDREN AND HIV - TREATMENT LITERACY: EMPOWERING COMMUNITIES TO ACCESS AIDS TREATMENT - HIV/AIDS MONITOR: TRACKING AID EFFECTIVENESS

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

The various articles in the latest publication from the AIDS Legal Network (ALN) South Africa analyse different HIV testing models and approaches from a human rights perspective, and examine the extent to which the global call to scale up HIV testing, through the model of ‘provider-initiated opt-out routine testing’, creates an environment in which the fundamental human right to make an informed choice whether or not to test for HIV can be upheld, respected and protected.

http://www.icw.org

The position paper by the Conféderation Européenne des ONG d’urgence et de développement (CONCORD) was formulated with the active contribution of the Terre des hommes Foundation (Lausanne): “We, as a European confederation representing more than 1800 relief and development NGOs, urge the European Union to: ADDRESS immediately the AIDS pandemic as a global emergency, and to LEAD in the international HIV and AIDS response and in the achievement of universal access to comprehensive prevention, treatment, care and support by 2010”. (March 2007)

http://www.aidsfocus.ch

1. March 2007 - Tuberculosis (TB) is one of the biggest killers of people living with HIV. At least one third of the 40 million people estimated to be living with HIV around the world are likely to be infected with the TB bacteria and at greatly increased risk of developing TB disease. Up to 80% of TB patients are co-infected with HIV in sub-Saharan Africa. Improved collaboration between TB and HIV programmes will lead to more effective control of TB among people living with HIV and can ensure that HIV positive TB patients get the HIV treatment and care they need. World TB Day on 24 March aims to focus the world’s attention on these and other major challenges that face global TB control.

http://www.unaids.org

Bangalore, 6 Mar 2007 - A controversial legal challenge by Swiss pharmaceutical company Novartis to India's patent laws was postponed on Monday, but still casts a shadow over the future of the country's generic drugs industry. A verdict is expected in about a month. Chan Park, of the New Delhi Lawyers' Collective, which provides free legal representation to an association for cancer patients, contested Novartis's claim. He said the outcome of the case would affect all patients dependent on generic drugs, particularly people living with HIV. (PLUSNEWS)

http://www.plusnews.org

Johannesburg, 8 March - On International Women's Day, local and international women's and human rights groups urged donors to devote more funding to HIV/AIDS programmes aimed at reducing women's vulnerability to infection. A report released on Tuesday by 'Women Won't Wait', a new international coalition of women's groups, cited the sexual violence and coercion women experience at the hands of their male partners as a leading factor in the increasing "feminisation" of the AIDS pandemic.(PLUSNEWS)

http://www.plusnews.org

As the feminisation of HIV/AIDS infection increases in Kerala as well as across the country, a new organisation has been formed to address the problems of women and children living with HIV/AIDS in the State. The Kochi-based Kerala Positive Women Network (KPWN+) will work exclusively to help women and their children. Women living with HIV/AIDS (WLHIV) face harsher stigma and discrimination within the family as well as outside. In many cases, WLHIV lose the emotional and financial support of their families and relatives, their jobs and the social support mechanisms. Of the 900 women members of the CPK+, a sizeable number had been infected by their husbands and in many cases, had lost their husbands. The women are left to fend for themselves and their children, many of whom are HIV-positive too. (The Hindu, 20 January 2007)

http://www.hindu.com

Johannesburg, 21 Feb 2007 - Large international donor agencies have become major players in Africa's response to the HIV/AIDS pandemic. Despite talk of partnering with their recipients, they have usually called the shots. Unsurprisingly, considering the millions of dollars in play, the donors have insisted on high levels of transparency and accountability from recipients and have punished perceived corruption or mismanagement by hasty withdrawals of funds. But after several breaking news stories in recent months, the conduct and accountability of donors themselves has come under similar scrutiny. (PLUSNEWS)

http://www.plusnews.org

One of the most discussed topics at the Conference on Retroviruses and Opportunistic Infections in Los Angeles 26th February to 4th March 2007 was how HIV-infected mothers can safely feed their infants in resource-limited settings. Should public health programmes in resource-limited settings encourage mothers with HIV to avoid breastfeeding or does this cause more harm than good? Should infant feeding decisions be made on a case-by-case basis, or would a public health approach unambiguously in favour of exclusive breastfeeding — and against early weaning — cause less confusion and lead to better outcomes? Key reports and related studies, information on WHO’s emphasis on the mother’s individual circumstances, and making exclusive breastfeeding AFASS. (March 2007)

http://www.aidsfocus.ch

The HIV and AIDS Reporter aims to provide readers with a more in-depth look at a particular area of health policy. This month's theme is stigma. There is increasing recognition that prevention, treatment, care and impact mitigation must be planned and delivered with the full inclusion of people living with and affected by HIV. However, as a result of HIV-related stigma, many people still feel unable to disclose their HIV status and to participate in HIV programmes or use HIV services.

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

The overall aim of this project was to share experiences and raise awareness about the issues of HIV, population mobility and migration in the Southern African region. This publication of the ‘Speak Your World Primer’ series is a summary report of a structured discussion on the AF-AIDS eForum. The main themes of this discussion centered on how migration and population mobility leads to increased HIV vulnerability, conversely how HIV affects migration and mobility patterns, and the impact of the brain drain of healthcare professionals from Southern Africa.

http://www.hdnet.org

In order to reduce the risk of HIV infection and improve access to HIV-related prevention, treatment, care and support of refugees, UNAIDS in collaboration with one of its Cosponsors, UNHCR, has developed a new policy brief that focuses specifically on actions required to prevent HIV and mitigate the effect of HIV on refugees and their host communities. The policy brief focuses on emergency and post-emergency phases and suggests actions for governments, civil society and international partners in order to ensure that refugee and human rights laws are applied, and that the needs of refugees are included into national HIV policies and programmes. (2007)

http://data.unaids.org

Building Blocks briefing notes is a set of resources that provide issues and principles for guiding strategy on supporting orphans and other vulnerable children. ‘Young children and HIV’ provides practical guidance on meeting the developmental needs of young children affected by HIV and the care and treatment needs of young children living with HIV. Focusing on children under eight years of age, it aims to help local organisations and service providers to strengthen family and community support for these children. (December 2006)

http://www.aidsalliance.org

This findings paper by Healthlink Worldwide focuses on the role of communication in ensuring that people, individually and in communities, understand what anti-retroviral therapy (ART) is, why it is needed and what it can and cannot do. The paper, which draws on research from across the world, explores the issues of access, uptake and adherence of ARTs. It urges that learning from community responses is recognised as important for maximising access to and impact of treatment. (Healthlink Worldwide 2006)

http://www.healthlink.org.uk

Billions of dollars in aid are flowing to developing countries to confront HIV/AIDS but relatively little is known yet about the effectiveness of this aid. The HIV/AIDS Monitor is designed to help fill this knowledge gap by tracking and analyzing key features of the way aid for HIV/AIDS is allocated and disbursed, while identifying lessons relevant to broader questions about the effectiveness of development assistance. Important website on the issue, with many links.

http://www.cgdev.org

Bern | aidsfocus.ch conference 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.

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 now what is understood by the comprehensive approach and be able to apply the concept of risk/vulnerability reduction and impact mitigation, 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. Course language: English

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.

http://www.aidsfocus.ch

aidsfocus.ch is a project set up by Medicus Mundi Switzerland. aidsfocus.ch is sponsored and shaped by 31 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, Kindernothilfe Schweiz, 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.