Review by William Easterly of
"The Invisible Cure: Africa, the West, and the Fight Against AIDS" by Helen Epstein
...One of the classic works of journalism of the last couple of decades was Randy Shilts's And the Band Played On about the sluggish response to AIDS in the 1980s in the United States, which indicted both the Reagan administration and the leaders of the gay community. I still remember the sense of outrage I felt when reading Shilts's book; it struck just the right note, leaving one both horrified about the tragic incompetence of so many and yet also hopeful that someone, somewhere could do things better next time.
Yet after reading Helen Epstein's masterful new book, the response to AIDS in America now looks in retrospect like a model of courage, speed, and efficiency by comparison with the response in Africa. In the US, the government publicized the threat and funded research, the gay community reduced its infection rates by encouraging less risky sexual behavior, the dreaded breakout into the heterosexual population never happened, and AIDS receded to become a disease that, while still tragic, could in most cases be kept under control with expensive new antiretroviral drugs (ARVs)...
Read the whole review in the New York Review of Books
Monday, July 23, 2007
Friday, July 20, 2007
Sydney AIDS Conference: Scientific Advances Undercut by Rights AbusesAdvances in HIV/AIDS Prevention, Treatment Hinge on Respecting Human Rights
Advances in HIV/AIDS Prevention, Treatment Hinge on Respecting Human Rights
(New York, July 20, 2007) – Scientists and other delegates meeting July 22-25 at the 4th International AIDS Society Conference in Sydney should focus their attention on how human rights abuses against people living with HIV undermine the impact of scientific advances against AIDS, Human Rights Watch said today.
“Research is central to the fight against HIV/AIDS,” said Joe Amon, director of Human Rights Watch’s HIV/AIDS Program and a molecular biologist by training. “But scientific advances will have little impact if people living with HIV continue to be stigmatized and abused.”
Human Rights Watch cited examples from the Asia-Pacific region, where the conference is being held, of children and adolescents living with or at risk of HIV infection being discriminated against, sexually abused and socially marginalized:
· On July 14, police in Kathmandu beat and sexually abuses five Nepalese transgender youths. The officers also strip-searched the youths and examined them for signs of sexual intercourse. Police said that the carrying of condoms by transgender youth was an illegal act.
· On June 4, five HIV-positive children were barred from entering their school in Pampady, India. The students had not attended school since they had been kicked out in December.
· For over a year, hospitals have repeatedly refused to operate on a 5-year-old orphan living with HIV in the southern Chinese city of Guangzhou. Recent newspaper headlines have referred to the child as the “AIDS Boy.”
· In October 2006, Taiwanese officials ruled that residents of a home for people living with HIV/AIDS in Taipei should move out of the local community because they threatened the psychological health of neighbors.
· In January 2006, corrections officers at Buimo prison in Papua New Guinea beat and sexually abused male detainees by forcing them to have anal sex with each other. More than a year later, the officers continue to work at the prison.
Human Rights Watch also called on scientists attending the conference to protest government harassment and intimidation of AIDS activists. Human Rights Watch cited several recent cases from Burma, China and Zambia:
In Burma, authorities detained a leading HIV/AIDS educator between May 21 and July 2. Phyu Phyu Thinn, who has cared for people living with HIV/AIDS in her home, had protested against the lack of access to antiretroviral drugs in government hospitals. She was arrested and imprisoned along with other individuals while praying for the release of political prisoners.
In several cases in China this year, AIDS activists and people living with HIV have been detained: on May 18, two of country’s most prominent HIV/AIDS activists, Hu Jia and Zeng Jinyan, were placed under house arrest and banned from leaving the country; on April 11, about 350 people infected with HIV/AIDS were blocked by police from protesting over ineffective government-supplied drug treatments in Zhengzhou; and on February 1, Dr. Gao Yaojie, an 80-year-old Chinese doctor, was detained by government officials and put under house arrest to prevent her from leaving the country to receive an award for her work on transfusion-related HIV transmission.
In Zambia, Paul Kasonkomona and Clementine Mumba, the chairperson for Treatment Advocacy and Literacy Campaign (TALC), were detained by the police on July 9 as they were demonstrating outside parliament in solidarity with striking healthcare workers.
“While scientists are able to travel freely to Sydney to discuss the international response to AIDS, activists around the world are jailed and harassed for their work against HIV,” said Amon.
Conference delegates should also focus attention on human rights abuses faced by women, and acknowledge that technological advances such as vaccines or vaginal microbicides will have little impact unless they are accompanied by a greater respect for women’s rights. Governments have consistently failed to protect women from the violence that leads to infection or violence targeted against women living with HIV. Human Rights Watch pointed to two examples from India:
· In New Delhi this spring, an HIV-positive woman was beaten to death by her in-laws who feared she would infect the family.
· On September 1, 2006 in Kolkata, an HIV-positive woman was forced to perform an abortion on herself at a state-run hospital. The doctors had refused to treat her because of her HIV status, instructed her as to how to terminate her six-month pregnancy, and forced her to leave the hospital afterwards.
“We can not end the AIDS epidemic solely through science,” said Amon. “Scientific advances and human rights advances must go hand in hand.”
For additional Human Rights Watch reporting on abuses related to HIV/AIDS, and broadcast-quality interviews with AIDS activists, please visit:
http://www.hrw.org/campaigns/aids/2006/toronto/index.htm
Wednesday, July 18, 2007
HRW: Health and Human Rights
Check out Human Rights Watch's new Health and Human Rights webpage!
"It is my aspiration that health will finally be seen not as a blessing to be wished for; but as a human right to be fought for."
—former United Nations Secretary General, Kofi Annan
Promoting and protecting health and respecting, protecting and fulfilling human rights are inextricably linked, and every country in the world is now party to at least one human rights treaty that addresses health-related rights, and the conditions necessary for health. The United Nations Universal Declaration of Human Rights recognizes that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family..".
Governments are obligated to respect, protect and fulfill the “right to health” by taking positive actions that ensure access to high quality health services and by refraining from or preventing negative actions that interfere with health. Human Rights Watch is committed to researching and advocating on behalf of populations that are being denied their right to health.
—former United Nations Secretary General, Kofi Annan
Promoting and protecting health and respecting, protecting and fulfilling human rights are inextricably linked, and every country in the world is now party to at least one human rights treaty that addresses health-related rights, and the conditions necessary for health. The United Nations Universal Declaration of Human Rights recognizes that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family..".
Governments are obligated to respect, protect and fulfill the “right to health” by taking positive actions that ensure access to high quality health services and by refraining from or preventing negative actions that interfere with health. Human Rights Watch is committed to researching and advocating on behalf of populations that are being denied their right to health.
HIV infection in conflict settings
by Clara Presler
(New York, July 17, 2007)--It has long been believed that conflict fuels HIV infection. High incidence of human rights abuses, including sexual violence, and mass displacement have been shown to heighten the risk of HIV transmission. As UNAIDS stated in Guidelines for HIV/AIDS Interventions in Conflict Settings, “Sadly, the very conditions that define a complex emergency—conflict, social instability, poverty and powerlessness—are also the conditions that favor the rapid spread of HIV/AIDS and other sexually transmitted infections.”
But the exact relationship between HIV infection and conflict settings is not understood and difficult to track. A recent study by UNHCR, in fact, questions whether or not conflict heightens HIV-infection at all. "Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review" looks at seven countries affected by conflict and that have data on HIV prevalence over the last 5 years: DRC, southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia, and Burundi. The study found that there is insufficient evidence to conclude that populations affected by conflict have a higher prevalence of HIV infection. Among its specific findings was that that 9 out of 12 sets of refugee camps surveyed had lower HIV-prevalence than the host community. In some urban areas affected by conflict, prevalence decreased at similar rates as those unaffected by conflict.
While the study acknowledges some weaknesses of the survey—the restricted nature and quality of the work, the fact that populations once affected by conflict may not have been identified in the surveys due to displacement and/or death, and that traumatized populations may be unwilling to undergo voluntary HVI testing—it offers numerous explanations for its findings. Among these are that mass killings, forced displacement, and hiding can reduce social interactions that expose individuals to HIV. Also, refugees tend to come from rural areas, which often have lower rates of HIV infections.
Another important consideration is that the risks may be balanced: while some modes of transmission may be less prevalent during conflict (e.g. male migration), other modes may be more prevalent (e.g. sexual violence). Also, in post-conflict reconstruction, mobility and transport increase again which, compounded with the recent violence of war, could create an upsurge in infection. Moreover, conflict can, in the long term, damage the government’s ability to carryout education programs around health and limit the delivery of health services.
Press coverage of study:
AllAfrica.com (7/9/07)
Reuters (6/29/07)
(New York, July 17, 2007)--It has long been believed that conflict fuels HIV infection. High incidence of human rights abuses, including sexual violence, and mass displacement have been shown to heighten the risk of HIV transmission. As UNAIDS stated in Guidelines for HIV/AIDS Interventions in Conflict Settings, “Sadly, the very conditions that define a complex emergency—conflict, social instability, poverty and powerlessness—are also the conditions that favor the rapid spread of HIV/AIDS and other sexually transmitted infections.”
But the exact relationship between HIV infection and conflict settings is not understood and difficult to track. A recent study by UNHCR, in fact, questions whether or not conflict heightens HIV-infection at all. "Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review" looks at seven countries affected by conflict and that have data on HIV prevalence over the last 5 years: DRC, southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia, and Burundi. The study found that there is insufficient evidence to conclude that populations affected by conflict have a higher prevalence of HIV infection. Among its specific findings was that that 9 out of 12 sets of refugee camps surveyed had lower HIV-prevalence than the host community. In some urban areas affected by conflict, prevalence decreased at similar rates as those unaffected by conflict.
While the study acknowledges some weaknesses of the survey—the restricted nature and quality of the work, the fact that populations once affected by conflict may not have been identified in the surveys due to displacement and/or death, and that traumatized populations may be unwilling to undergo voluntary HVI testing—it offers numerous explanations for its findings. Among these are that mass killings, forced displacement, and hiding can reduce social interactions that expose individuals to HIV. Also, refugees tend to come from rural areas, which often have lower rates of HIV infections.
Another important consideration is that the risks may be balanced: while some modes of transmission may be less prevalent during conflict (e.g. male migration), other modes may be more prevalent (e.g. sexual violence). Also, in post-conflict reconstruction, mobility and transport increase again which, compounded with the recent violence of war, could create an upsurge in infection. Moreover, conflict can, in the long term, damage the government’s ability to carryout education programs around health and limit the delivery of health services.
Press coverage of study:
AllAfrica.com (7/9/07)
Reuters (6/29/07)
Wednesday, July 11, 2007
Civil Society Leaders Announce New Global Call to Stop Cervical Cancer
Thirteen civil society and public health organizations, including World YWCA and Rockefeller Foundation, seek global access to new HPV vaccines and screening
NAIROBI (6 July 2007) – A coalition of leaders at the World YWCA International Women’s Summit in Nairobi today announced the launch of the Global Call to Stop Cervical Cancer, a disease that kills more than a quarter of a million women each year. The Global Call aims to end cervical cancer by mobilizing political support to ensure that every woman and girl has access to newly available life-saving vaccines and new tools for screening and treatment.
“Cervical cancer is entirely preventable, so it is unacceptable that women in developing countries do not have access to new innovations in preventing and treating this disease,” said the Hon. Betty Tett, MP, Chairperson of the Kenya Women Parliamentary Association. “Political leaders must prioritize cervical cancer to ensure that all women, no matter how rich or poor, have access to new medical technologies that can save their lives.”
Cervical cancer, which is caused by the human papillomavirus (HPV), strikes more than 500,000 women every year. Due to extremely limited access to screening and treatment, 80 percent of cervical cancer cases and deaths occur in developing countries, making it the most common cause of cancer-related death for women in these countries. New vaccines which protect against the most dangerous strains of HPV are largely unavailable in the developing world. These vaccines and innovations in HPV screening and treatment for women have the potential end the threat of cervical cancer worldwide.
“Cervical cancer, like HIV and AIDS, affects many women in Africa. African women must therefore play a leading role in prevention efforts,” said Dr. Musimbi Kanyoro, General Secretary of the World YWCA, which is hosting a meeting this week in Nairobi that brings together 1,500 leaders from around the world to discuss issues related to HIV and AIDS. “AIDS activists have taught the world that there is a moral imperative to provide access to prevention and treatment services. We must extend these lessons to cervical cancer.”
Researchers have long recognized a link between HIV and cervical cancer. HIV-positive women are about four times more likely to develop the pre-cancerous lesions that can lead to cervical cancer than HIV-negative women. By launching the Global Call at a conference focused on HIV and AIDS, the organizers hope to encourage HIV activists and cervical cancer activists to learn from one another and share strategies to expand access to prevention and treatment.
“The world cannot afford to wait for new HPV vaccines and screening tests to eventually trickle down from wealthy countries to developing countries where women need these life-saving products,” said Dr. Ariel Pablos-Mendez, a Managing Director at the Rockefeller Foundation. “Cervical cancer is largely preventable, so we must not let women die for want of access to these products. We have an historic opportunity to save lives.”
“The world cannot afford to wait for new HPV vaccines and screening tests to eventually trickle down from wealthy countries to developing countries where women need these life-saving products,” said Dr. Ariel Pablos-Mendez, a Managing Director at the Rockefeller Foundation. “Cervical cancer is largely preventable, so we must not let women die for want of access to these products. We have an historic opportunity to save lives.”
The Global Call to Stop Cervical Cancer urges governments to prioritize cervical cancer in national development and health budgets, calls on multilateral agencies to ensure accelerated regulatory processes, appeals to international donors to ensure new vaccines and diagnostics are widely available, and calls upon industry to provide adequate supplies of new technologies at radically tiered prices. The Global Call is available online at www.cervicalcanceraction.org, and organizations and individuals around the world are invited to sign on to show their support.
Over the coming months, the Global Call will be presented to policymakers at important high-level political events in an effort to demonstrate broad-base support to stop cervical cancer worldwide. The European Commission is organizing a meeting in September to fully engage political leaders in the fight against cervical cancer.
Over the coming months, the Global Call will be presented to policymakers at important high-level political events in an effort to demonstrate broad-base support to stop cervical cancer worldwide. The European Commission is organizing a meeting in September to fully engage political leaders in the fight against cervical cancer.
“Far too many women are still dying of cervical cancer,” said Dr. Lieve Fransen, Head of Human and Social Development for the European Commission’s Directorate General for Development. “The public, private and non-profit sectors need to work together to ensure that these new technologies are made available without delay to all women and girls who need them, wherever they live.”
CONTACT:
Kenya: Brad Tytel, +254 (0) 73 785 9016, btytel@ghstrat.com
Kenya: Brad Tytel, +254 (0) 73 785 9016, btytel@ghstrat.com
Editors note: Thirteen global civil society and public health organizations make up the strategic advisory committee for the Global Call to Stop Cervical Cancer: The World YWCA, The Rockefeller Foundation, PATH, The International Planned Parenthood Federation (IPPF), The International Federation of Gynecology and Obstetrics (FIGO), Family Care International, JHPIEGO, American Cancer Society, The AIDS Vaccine Advocacy Coalition (AVAC), The International AIDS Vaccine Initiative (IAVI), the Medical Women’s International Association (MWIA), the International Union Against Cancer (UICC), Sociedad Latinoamericana y del Caribe de Oncologia Medica (SLACOM). The Global Call is supported by funding from the Rockefeller Foundation and PATH. Global Health Strategies, New York, is the secretariat for this effort.
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