ICW: Reproductive Rights and Wrongs

The International Community of Women Living with HIV/AIDS (ICW) is the only international network of HIV positive women and has 5000 members worldwide.

Our vision is a world where all HIV positive women:
Have a respected and meaningful involvement at all political levels, local, national, regional, and international, where decisions that affect our lives are being made;
Have full access to care and treatment; and
Enjoy full rights, particularly sexual, reproductive, legal, financial and general health rights;
Irrespective of our culture, age, religion, sexuality, social or economic status/class and race.

Here we feature the story of Sthemiso, an ICW member, whose experiences powerfully illustrate why the sexual and reproductive rights of HIV positive women are a key focus of ICW's advocacy work and communications.

For more information about ICW's work and for copies of publications please see www.icw.org . Or get in touch - info@icw.org.



My Story of Motherhood: Reproductive Rights and Wrongs

We all know that life circumstances change and feelings shift. Perhaps something that you felt certain about five years ago is not necessarily so certain now. Sthembiso* tells us the story of her daughter, born when she was only a girl. She describes the stigma of being the HIV positive mother of a disabled child who she now knows is also HIV positive. She explains why previously she did not want another baby. Today her life is very different and she longs to have one.

'For me motherhood is a complex issue. I have an HIV positive child who has another, completely separate disability. I feel guilty each time I talk directly about her. My daughter was born in 1993. In 1996 I had a stillborn child. In 1998 I had a termination of another pregnancy and was pushed into being sterilised. At the same time I was living with no hope for treatment, had an abusive partner, and was jobless with no real home of my own. At that point I would have said I absolutely did not want to have any more children.

When I went into labour we were building a little mud house outside the main house. When I felt the pain and saw things coming out I told my mother but she insisted that I work even harder. I had to fetch and carry a 25-litre container of water from the tap at the main house. (That mud house is where my daughter and I ended up sleeping because my mother did not want the noise of the baby to disturb her.) I worked the whole day mixing the mud, fetching the water and cooking. According to my mother this was to help the labour process. Obviously I couldn't complain – I had committed the worst sin ever by falling pregnant at 16 without being married. My parents were doing me a favour keeping me at home when they could have rightfully kicked me out. After 3 pm when the pain was unbearable my mother allowed me to have a bath and to
take a taxi to the clinic – on my own. When I got there they shouted at me for arriving late.

After being examined they called an ambulance – I needed medical attention at the hospital. But the baby came before the ambulance. She was a girl and she did not cry – I was told she was too tired. Finally we were ferried to hospital where she was kept in the nursery for five days. I only learned nine months later that loss of oxygen at birth caused her disability. I do not want to blame my mother but there is a part of me that says if she had not made me work so hard, things would have turned out differently. Had she sent me to the clinic earlier my daughter would probably not be disabled. I would have felt better had she at least accompanied me to the clinic. I do not know why I am writing this. It is the first time I am actually acknowledging this
disturbing reality of my life.

Changes and challenges

My life has changed now. My daughter is almost 15. She is in care after I realised it was the best option for her as her needs are becoming more complex the older she gets.

It was after coming to terms with my HIV diagnosis, meeting other women in similar situations, and beginning a new life, that the desire to have another child cropped up. Having another child (if I do have one) would give me the opportunity to enjoy being pregnant by choice and to be a mother in different circumstances. I think of my daughter too; I am her only family. What will happen if I die? I would pass on peacefully if I knew that I was not leaving her alone no matter how long it took her sibling to grow enough to understand there is a sister who needs love and nurturing.

My desire for another child has thrown up many challenges. The first is to get a partner. I am in my 30s, have HIV, a disabled child, and I am a feminist. HIV helped me to discover myself as a woman and I am finding it really hard to find and keep relationships with men. I have explored in vitro fertilisation (IVF) as an option. It turns out that male partner participation in treatment is essential. One boyfriend agreed to take the treatment with me. However, he refused to go for a fertility test, arguing that he did not need to as he already has children. In the end he went after I negotiated and traded off a fair degree of my power in the relationship. The results showed that his sperm count was low and he needed fertility treatment for the IVF to
be successful. He did not receive the news very well, and he blamed me for bringing it to his attention. A couple of months later the relationship was over.

The question is, do I wish to meet another man and tell him my story, beg him for his sperm and loose some power in the process? The answer is, I would rather not, but what choice do I have? Maybe I should try the sperm bank, but will they take me if I disclose my HIV status?

Pain and Joy

All those years ago when I was sterilised I felt as though I was being punished and judged. I did not want to have a child then. But I did not want to be sterilized either. Recently my doctor suggested that perhaps we could reverse the sterilisation. Two weeks ago I learned
with shock that the sterilisation was irreversible. I am still dealing with this. I have not lost hope. I will continue to explore the options and the possibilities I have.

I draw strength and support from a woman living with HIV who is in a similar situation. We talk and cry over the dramas as they unfold. I always claim my case is the worst, but she tells me no, because she is married and hasn't told her husband she was sterilised. If she had revealed this, her husband's family would not have paid lobola (bride price) for her. She is worried about what will happen to her if she discovers her sterilisation cannot be reversed either, as this is her only solution.

As I live and grow with HIV, I see other women with HIV having healthy children. I feel joy and pain when I learn that someone has had a baby. I do not go anywhere near baby shops. I avoid places with infants.

I love my daughter very much, I love her gorgeous smiles, I enjoy the way she creatively uses her body to communicate her needs, wants and emotions with me using MAKATON (a communication technique she uses as she cannot speak). I enjoy the way she propels her wheelchair to dangerous places in the house to attract my attention, the way she is self-aware, how she will not take on another activity before you clean her hands, how she will behave when she sees another disabled child, how she is when I am with her alone or with her carers and teachers, how she learns and copies games from able-children and imitates them using the abilities she has, and how she recognises anything said and sung in her home language Zulu although she has not spoken or lived in a community that speaks the language in years. I love the way she portrays my character and how our interests and behaviour are the same sometimes. I love reading her school reports. Dear daughter. I cannot begin to say how grateful I am that she's almost fifteen. My daughter and I are very lucky. I know many children in her situation no not have access to what she has.

HIV has become less of a worry as far as my desires are concerned. I am on treatment and receive high quality care. All my medical professionals are supportive. My state of health is excellent. Unlike many women, I have access to information, services, resources and support. For me the most stigmatising thing was having a disabled child and having HIV. Now with support and love from other HIV positive women, and professionals, I am surviving that double stigma. There is no way I could be brought down by the stigma of being HIV positive and pregnant.'

(Source ICW News 34 -please link to http://www.icw.org/files/ICW%20English%2034%20Web.pdf)

*Sthembiso's name has been changed

Intensive course in Health and Human Rights

Intensive Course in Health and Human Rights:
June 18-22, 2007 Boston, Massachusetts

Learn How to Incorporate a Human Rights Framework Into Your Professional Activities

Presented in Collaboration with:

• The Boston University School of Public Health, Department of Health Law, Bioethics and Human Rights
• The Harvard School of Public Health, Department of Population and International Health

This rigorous 4.5-day program helps a wide range of professionals acquire the skills and knowledge they need to successfully incorporate a human rights framework into their daily activities. Participants will acquire a basic understanding of both the history and present status of international human rights and international humanitarian law as they apply to public health practice. The faculty will show participants how to:

· Analyze the human rights dimensions of public health policies and programs
· Access international mechanisms and procedures to further the human rights of persons whose health status is threatened

About the Program:

Expert faculty members create a dynamic learning environment in which a large body of material can be covered in a short amount of time.

The program progresses from general to specific topics:

· Basic Concepts of Health and Human Rights
· Application of the Human Rights Framework to Public Health Policies and Programs
· Skills for Putting the Health-Human Rights Linkage into Practice
· Institutional Settings for Linking Health and Human Rights
· The Way Ahead: Making the Health-Human Rights Linkage Work

Program Format:

Small group settings provide further opportunity for direct interaction with the faculty and with your fellow participants. Repeated offerings allow you to attend more than one session of interest. The individualized attention you receive in the Intensive Course in Health and Human Rights will help you formulate your strategy for implementing newly acquired knowledge and skills in your professional work as well as provide invaluable networking support.

Learn more at: http://sph.bu.edu/index.php?option=com_content&task=view&id=556&Itemid=692#Program%20Fee

Update: Global Fund names Executive Director

The Global Fund selected Michel Kazatchkine to replace Richard Feachem as its Executive Director. Kazatchkine has spent much of the last 20 years working on HIV/AIDS, both as a physician and as the leader of an AIDS research agency. Feachem's term ends on March 31, 2007.

Read more about the Global Fund's selection and Professor Kazatchkine:
Global Fund
Boston Globe
Agence Nationale de Recherches sur le SIDA

AIDS doctor detained by Chinese officials

Dr. Gao Yaojie, a 79-year old Chinese doctor who has been internationally recognized for her fight against the spread of HIV, has been detained by Chinese officials since Thursday, February 1st. Dr. Gao was scheduled to arrive in the US this week to accept an award from Vital Voices. As of Feb 6, Dr. Gao has been under house arrest in Zhengzhou with no access to modes of communication.

Dr. Gao spent her retirement traveling around Henan Province, spreading information about AIDS and distributing medicine. She was instrumental in exposing how a blood-selling program in central China infected thousands of people with HIV in the 1990s. She was been nominated for a Nobel Prize and has been awarded several international prizes, such as the Jonathan Mann Award for Global Health and Human Rights in 2001, and she was nominated for a Nobel Prize in 2005.

Dr. Gao has been repeatedly prohibited from traveling abroad. This time, according to news reports and AIDS activists within China, Henan officials went to her house to warn her not to travel to the US where, in addition to accepting her prize from Vital Voices, she was scheduled to hold meetings with politicians and advocacy groups in Washington.

Dr. Gao has taken extraordinary risks to expose the scope of the AIDS epidemic in China. Although China has received increasing accolades from the international community for frankly addressing AIDS, her detention is a sad illustration that speaking openly and honestly about the epidemic is still threatening to officials within China.

More information on Dr. Gao Yaojie’s detention:
International Herald Tribune
Globe and Mail
Reuters

More information on Dr. Gao:
TIMEasia.com: Asian Heroes
PBS (1/3/07): China from the Inside
Women of China (12/12/05): “Gao Yaojie: a Crusader for AIDS Prevention”
China Daily (7/14/05): 108 Chinese grassroots women in race for Nobel
AFP (3/7/04): “China's AIDS whistleblower Gao Yaojie vows to continue helping sufferers”
The Peking Duck (2/26/04): “China's leading AIDS activist Gao Yaojie publicly honored”
Dr. Gao Yaojie: “My AIDS Prevention Journey” (5/1/01)

Other information on AIDS in China
Human Rights Watch’s Report: “Restrictions on AIDS Activists in China”
ABC News: “Stigma and Discrimination Fuel Spread of AIDS in China”
Letter to New York Times re: ''China's Muslims Awake to Nexus of Needles and AIDS''
Kaiser Network (1/06): “Estimated Number of HIV-Positive People in China Is 650,000”

Update: Global Fund Executive Director

Three finalists for the position of Executive Director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria have been announced. Richard Feachem, who has been the Executive Director since 2001, will be replaced by either Michel Kazatchkine, France's HIV/AIDS ambassador; David Nabarro, a British national now leading the United Nation's efforts to fight avian flu; or Alex Coutinho, executive director of the AIDS Support Organization in Kampala, Uganda.

The Boston Globe followed up on this story.

Update: Médecins Sans Frontières to Novartis

Quarter of a Million People Urge Novartis To Drop Case Against India
Company Would Effectively be Shutting Down the "Pharmacy of the Developing World"

New Delhi/Geneva, 29 January 2007 – As pharmaceutical company Novartis proceeded with its legal challenge against the Indian government in a court hearing in Chennai, India, today, nearly a quarter of a million people from over 150 countries 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 the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF), called on the company again today to immediately cease its legal action in India.

The court hearing will continue February 15.

Read MSF's entire press release at: http://www.doctorswithoutborders.org/pr/2007/01-29-2007_1.cfm

Listen to the teleconference and see the transcript here:
http://www.doctorswithoutborders.org/news/access/novartis_teleconference.cfm

********
Listen to Loon Gangte, participant in this press conference and Regional Coordinator of South Asia Collaborative Fund for HIV Treatment Preparedness (formerly from Delhi Network of Positive People), talk with Human Rights Watch: http://www.hrw.org/campaigns/aids/2006/toronto/audio2.htm

Update: Thailand to allow generic versions of Plavix and Kaletra

Thailand’s government, in a landmark decision today, approved the production of cheaper versions of two major medicines for heart disease and HIV/AIDS (Plavix and Kaletra respectively). The government took advantage of the World Trade Organization’s rules on intellectual property to declare a “national emergency”, allowing them to produce and sell already patented drugs.

Health Minister Mongkol na Songkhla has been widely quoted today for saying,“We have to do this because we don’t have enough money to buy safe and necessary drugs for the people under the government’s universal health scheme”. Ms. Kannikar Kijtiwatchakul of Doctors Without Borders commented, “It is a brave decision”.

Read more on this recent development in:
Bangkok Post
International Herald Tribune
BBC
Scientific American
Wall Street Journal
Business Week

Access to essential medicines

Lancet‘s recent editorial, “Undermining TRIPS: protectionism at its worst”, brings to light two international campaigns that will likely be of great signficance for the future of poor countries’ access to medicines. The campaigns, led by Doctors Without Borders and host of other organizations, are working to uphold the rules of Trade Related Aspects of Intellectual Property (TRIPS) agreement that allow, in certain situations, essential medicines in developing countries to be distributed at affordable prices. This agreement is currently threatened by large pharmaceutical companies that are taking steps to expand their rights to patent their medicines. Of particular urgency right now is a case pursued by Novartis, a Swiss company, against the Indian government, and a case led by Merck against the Thai Government.

These are important and complicated cases with implications for the future of free trade, public health, and human rights. Here is a list of important links—certainly not exhaustive—to provide background on the issue:

Novartis & India
"Novartis Challenges Indian safeguards"

MSF: Q&A on patents in India and the Novartis case

"MSF Urges Novartis to Drop Case Against Indian Government"

"India’s 2005 Patent Act"

Merck et al. & Thailand

Thai Health Ministry To Issue Compulsory License for Merck's HIV/AIDS Drug Efavirenz
MSF: Open Letter to Condaleezza Rice

Intellectual Property & Free Trade

WTO: TRIPS
“What are Intellectual Property Rights?”
The Doha Declaration
Declaration on TRIPS agreement and Public Health

“The FTAA, Access to HIV/AIDS Treatment, and Human Rights”, a Human Rights Watch Briefing Paper

Harvard Political Review: "Patients vs. Patents"

Listen to Sangeeta Shashikant, Researcher for Third World Network in Kuala Lumpur, comment on patents and access to generic medicines.

Boston Globe: Global Health Organization prepares to name leader

WASHINGTON -- The next leader of a global organization that fights major infectious diseases, including AIDS, may come from a group that includes the former health minister of Mexico, France's AIDS ambassador, the former leader of UNICEF, and several leaders of the World Health Organization, according to a list of names obtained by the Globe.

The board overseeing the organization, Global Fund to Fight AIDS, Tuberculosis and Malaria, failed to select a new executive director last November and now hopes to name one at a meeting in Geneva early next month.

Read this article at: http://www.boston.com/news/nation/articles/2007/01/09/global_health_organization_prepares_to_name_leader/

The two sides of opium

Afghanistan has a booming opium trade, which has increased seven-fold since 2002 and supplies an estimated 90 percent of the world's illegal heroin. Much of this goes to (or through) nearby Pakistan where injecting drug use is a main concern and HIV prevalence is rising. Recently, Pakistan's Health Minister expressed frustration at the Afghan government for not moving more effectively towards poppy eradication. The US eradication efforts since entering in 2002 have also been largely ineffective.

The WHO raises different concerns about Afghanistan's opium production: that it does not reach enough people worldwide for pain relieving purposes, causing a "world pain crisis". Opium is also the raw material for morphine. Developing countries as a whole only consume 6 percent of medical opioids yet by 2015 may have 10 million cancer cases. In the US, half of those suffering from chronic pain-most commonly AIDS and cancer patients-do not receive adequate pain relief. Pain relief worldwide is not only distributed unequally, but altogether insufficiently.

The Security and Development Policy Group (Senlis Council ), an international policy think tank with offices in Kabul, London, Paris and Brussels, has argued that the answer to Afghanistan's illegal drug trade is not poppy eradication, which: 1) deprives local farmers of a major source of income; 2) contributes further to the inadequacy of global pain relief; and 3) most likely will not eliminate the drug trade. Instead, it argues that the International Narcotics Control Board(INCB) license growing in Afghanistan. It is estimated that the price of buying the entire Afghan poppy crop would cost less than what the US is spending on eradication campaigns that have not worked.

The INCB's main function is to mediate exactly the dilemma that is presented in Afghanistan: balancing the medical needs of opioids while controlling illegal trafficking. The INCB has sent multiple missions to Afghanistan. They’ll outline their recommendations in their upcoming Annual Report to be released in February.

What will it say? Will it address only trafficking or also the need for more access to legal opiods?

Stay tuned.

Read more:
“There's a way to end Afghanistan's and the world's pain”

“Afghan drugs a worry as Pakistanis confront AIDS”

“Let a Thousand Poppies Bloom”

Parallel messages, similar results

A recent New York Times editorial on the ineffectiveness of Phillip Morris’ anti-smoking ads bears more than a little resemblance to current debates about abstinence-only education for teenagers.

We’ve all seen the Phillip Morris ads saying, “Think, Don’t Smoke” and recent ads target parents, telling them to warn their children against smoking. In short, “just say no”.

A recent research study published in the American Journal of Public Health found that the ads have had no beneficial effect on teenagers and that those aimed at parents actually had an encouraging effect on teenagers.

The study found a direct relationship between exposure to the ads and likelihood of smoking in the past 30 days.

The New York Times observed that “their theme—that adults should tell young people not to smoke mostly because they are young people—is exactly the sort of message that would make many teenagers feel like lighting up.” The Times also noted that the goal of the ads is not actually to prevent smoking for a lifetime, but to put it off until adulthood, and that the ads have no mention of the fact that smoking is addictive or even harmful.

Likewise with abstinence-only education. Nearly two-thirds of US high school seniors have had sexual intercourse and there were 822,000 reported pregnancies among women 15-19 years old in the year 2000. While there is no evidence to show that abstinence-only classes changes this, there is evidence to show that education about contraception and sexually-transmitted infections reduces risk-taking and pregnancy among teens (see PP, Kaiser, ACLU, Guttmacher). And if the goals of abstinence-only programs are the same as the anti-smoking ads—to delay intercourse until adulthood (i.e. marriage)—then we will still have rampant ignorance about STIs, protection, and reproductive health.

While the motivations of the two campaigns may be different (those behind the Phillip Morris ads are looking to keep sales (i.e. smoking) up while “avoiding a governmental crackdown” and those preaching abstinence-only arguably do want to keep teens from having sex), each scenario, through the evasion of straightforward conversation and disregard for proven studies, threatens young people with bitter ends: lung cancer and AIDS.

Signs of a new Congress: Questioning the roots of US HIV/AIDS policy

The Boston Globe reported yesterday on some important questions that Democrats are asking about President Bush’s faith-based initiatives:

• Have current faith-based initiatives violated the separation of church and state?
• Did the Bush administration really give 98.3 percent of the faith-based foreign-aid money to Christian groups? How does this affect, among other things, our foreign relations?
• What are the effects of such faith-based initiatives on our fight against AIDS?

Questions such as these are being articulated mainly by Representative Barbara Lee (D) from California and Representative William Delahunt (D) of Massachusetts.

Representative Lee is sponsoring a bill that would overturn a measure that requires that one-third of the money spent by the US government on AIDS prevention overseas go for "abstinence until marriage" programs. This is a $1 billion measure and many Democrats have suggested that the money could be better spent on other measures such as condoms. "When you look at what has been exposed and revealed, I think we have a factual basis to move forward with this," Representative Lee said.

Representative Delahunt, who will soon chair the International Relations subcommittee on Oversight and Investigation, said that if US-funded Christian groups work in Muslim-dominated countries, the effort could be "perceived to be proselytization and it can generate a harsh negative reaction that implicates and impacts in a negative way on America's image in the world and have significant consequence to our foreign policy goals."

Democrats are also attempting to repeal a measure that required US groups receiving faith-based funds to have a policy opposing prostitution. Many groups have said the pledge impedes their work with sex workers who are at high risk for HIV. Organizations have also raised a question of the constitutionality of the pledge as compelled speech. Two federal judges have ruled that the pledge is unconstitutional and the Bush administration has appealed these rulings. Read more.

Regarding the AIDS fight, Representative Tom Lantos, the California Democrat who will chair the International Relations Committee in January, said, "Our global HIV/AIDS policy should be about saving lives…It is inconsistent with this goal to place ideologically driven restrictions on the implementation of efforts to prevent spreading the virus."

HRW: World AIDS Day 2006: Ideology Trumps Action as Epidemic Worsens

Governments Must Respect Rights to Advance AIDS Fight

(New York, November 29, 2006) – Twenty-five years after AIDS was first identified, programs to fight the disease continue to be undermined by conservative ideologies and moralistic approaches, Human Rights Watch said ahead of World AIDS Day on December 1.

“The most effective approaches for preventing HIV/AIDS are not being used,” said Joe Amon, director of the HIV/AIDS program at Human Rights Watch. “Governments are refusing to adopt evidenced-based programs that respect individual rights, and are instead promoting ideological campaigns that make people more vulnerable to infection.” Human Rights Watch identified a number of examples from around the world affecting those most at risk of HIV infection, including youth, women, and injecting drug users.

• In sub-Saharan Africa, a majority of young adults lack adequate knowledge of HIV transmission. Yet some governments emphasize “abstinence-only” approaches and promote inaccurate information about the effectiveness of condoms. For example, in Uganda the government promotes “virginity parades” and restricts the availability of condoms to youth while the epidemic – in a country once considered a “success story” – has worsened dramatically.
  
• Women are increasingly recognized as the “face” of AIDS, but governments refuse to address the human rights abuses that cause their vulnerability. One in three women will face some form of gender-based violence in her lifetime, and studies have found that women who experience violence are up to three times more likely to become infected.
  
• One in three new infections outside Africa affects injecting drug users. Few governments, though, are adopting such proven strategies as substitution therapy for drug addiction or the provision of clean needles. In Russia, where the epidemic is concentrated among injecting drug users, the government has refused to permit the use of methadone and has hindered the widespread availability of clean needles.

Six months ago, UN members signed a declaration recognizing that the protection and realization of human rights is essential in the global fight against AIDS. “The theme for this year’s World AIDS Day is ‘Keep the Promise,’” Amon said. “But unless governments adopt effective approaches that respect the rights of those most vulnerable to the disease, their broken promises will add up to millions more infected with HIV.”

At the International AIDS Conference in Toronto last August, Human Rights Watch collected audio testimony from AIDS activists and individuals living with HIV worldwide, who present personal stories and perspectives on what is needed in the global AIDS fight. “Listen to their stories and you can begin to understand the impact of the AIDS epidemic and the failure of the world’s governments to address it,” Amon said. To hear the testimonies of AIDS activists and those living with HIV which Human Rights Watch recorded at the 16th annual International AIDS Conference, please visit: http://www.hrw.org/campaigns/aids/2006/toronto/audio.htm

For broadcast-quality audio interviews of other leading AIDS activists around the world, as well as a 30-minute radio program produced by Human Rights Watch for the International AIDS Conference, please visit: http://www.hrw.org/campaigns/aids/2006/toronto/audio2.htm

Chinese Release Detained AIDS Activist

On November 24th, Dr. Wan Yanhai, an advocate for AIDS patients in China and founder of the AIZHIXING Institute, was taken in for questioning by the Beijing police and detained for 48 hours. His detention forced the cancellation of a planned workshop, “Blood, Safety, AIDS, and Legal Human Rights”, which planned to focus on the rights of people infected with HIV/AIDS through blood transfusions. After Dr. Wan cancelled the workshop, he was released.

Dr. Wan has been detained before. In 2002, he was in police custody for four weeks after posting information on the internet about unsafe blood exchanges that were contributing to the rising incidence of AIDS in the province of Henan. He was charged with “illegally leaking state secrets.” Upon his release, Dr. Yanhai declared, “If this incident helps attract more concern and support for victims of AIDS and their families and children here in China, then it can be considered an opportunity we should grasp.''

The detention of Dr. Wan by the Chinese authorities on the eve of World AIDS Day emphasizes the restrictions on the rights of people living with HIV/AIDS in China. A press release by the Network of Chinese Human Rights Defenders (CRD) states that the Beijing police have been working to block villagers living with HIV/AIDS from entering the city—whether to visit or to express grievances to the government—in part as preparation for the 2008 Olympics.

UNAIDS reported in its 2006 annual report that the epidemic in China has reached more than 650,000 individuals. In contrast to most regions, the epidemic began in rural areas and spread to the cities, perhaps explaining why awareness has remained low and stigma has soared. Nearly half of the people living with HIV in China are believed to be infected from injecting-drug use. In some provinces such as Henan, one percent of pregnant women are found to be HIV-positive. UNAIDS also cites blood and plasma donations as a contributing factor to the epidemic, the issue that Dr. Wan has focused on. HIV-positive persons find little protection or help—the UNAIDS report estimates that “almost one in three (30%) health professionals in Yunnan Province…said they would not treat an HIV-positive person.”

Dr. Wan’s work continues to drawn attention to not only the discrimination facing people living with HIV/AIDS in China, but also the denial of the civil and political rights of those fighting on their behalf. Learn more about his work:

Human Rights Watch talks with Dr. Wan (7/2006)

Network of Chinese Human Rights Defenders press release (11/27/06)

“China Frees AIDS Activist After Month of Outcry” (9/21/02)

“China Now Set To Make Copies of AIDS Drugs” (9/7/02)

“China's Top AIDS Activist Missing; Arrest Is Suspected” (8/29/02)

Update on the AIDS Epidemic

UNAIDS and the WHO released the yearly report on HIV and AIDS. The 94-page report, "AIDS Epidemic Update: December 2006", estimates that 4.3 million new HIV infections occurred worldwide this year and that about 2.9 million people died of AIDS-related illnesses.

Site to check out

An anonymous AIDS Combat Zone reader leads us to AIDS: Remember me?, a site put up by the European Commission to encourage dialogue about HIV/AIDS. It's being done in conjunction with an event in Brussels, Belgium on the eve of World AIDS Day to screen new HIV commercials and select a favorite. Other areas of the site to check out include a contest encouraging you to write your own HIV/AIDS 60 second TV spot (European Union nationals only) and a vlog (video blog) you can participate in. This is the citizen-driven web at its finest!

New York Times: Needles, AIDS, China

To the Editor:

In "China's Muslims Awake to Nexus of Needles and AIDS", Howard French shows one bright spot in China's war against the AIDS epidemic: in Xinjiang, authorities are beginning to offer methadone to drug users.

However, the article does not show an uglier piece of the picture. Every year, authorities around the country also forcibly detain thousands of drug users in prisons, "treatment centers" in name only. As a researcher at Human Rights Watch, I visited one such facility and interviewed detainees from others. Under Chinese law, police may sentence individuals to three to six months --sometimes, longer-- in these prisons, without trial. Detainees are kept in unclean, overcrowded cells. They get no counseling. They are compelled to take part in forced, unpaid labor, working long hours on farms or in sweatshops that profit the prisons. Chinese sex workers also face similar detention.

As interviewees told me, all this punitive approach accomplishes is to marginalize those at high risk of HIV infection and drive them underground, away from authorities and any program that could teach them about HIV and how to prevent its spread. China should abolish these fake "treatment centers" and replace them with real ones.

Sara Davis
Executive Director
Asia Catalyst

WHO Names New Director-General

Dr. Margaret Chan was nominated for the position of WHO Director-General. The World Health Assembly will meet on Thursday, November 9th to review the nomination. More on the WHO website. The news release is pasted below:

Dr Margaret Chan nominated to be WHO Director-General

8 NOVEMBER 2006 GENEVA -- Dr Margaret Chan of China was nominated today by the Executive Board of the World Health Organization for the post of Director-General. The Director-General is WHO's chief technical and administrative officer.

The nomination will be submitted to the World Health Assembly, which will meet for a one-day special session on Thursday, 9 November to appoint the next Director-General.

The procedures for the current nomination and election process were decided following the sudden death of Dr LEE Jong-wook, WHO Director-General, on 22 May 2006. At its meeting on 23 May, the WHO Executive Board agreed on an "accelerated process" for electing a Director-General.

On Monday the Executive Board, chaired by Dr Fernando Antezana Araníbar of Bolivia, selected a short list of five candidates. Yesterday the Board interviewed the five candidates and today selected Dr Margaret Chan as its nominee.

Dr Chan is a well-known public figure because of her record of leadership in fighting disease first in Hong Kong, and more recently at WHO. During her nine-year tenure as Director of Health, Dr Chan confronted the first human outbreak of H5N1 avian influenza in 1997 and successfully defeated Severe Acute Respiratory Syndrome (SARS) in Hong Kong in 2003. She also introduced primary health care 'from the diaper to the grave' with a focus on health promotion and disease prevention, self-care and healthy lifestyles. In 2003, she joined WHO and rose to the position of Representative of the Director-General for Pandemic Influenza as well as Assistant Director-General for Communicable Diseases. Now 59, Dr Chan obtained her Medical Degree from the University of Western Ontario in Canada and a public health degree from the National University of Singapore.

The WHO Executive Board is composed of 34 Members who are technically qualified in the field of health. The main functions of the Board are to give effect to the decisions and policies of the World Health Assembly, to advise it and generally to facilitate its work.

The countries represented on the current Executive Board are: Afghanistan, Australia, Azerbaijan, Bahrain, Bhutan, Bolivia, Brazil, China, Denmark, Djibouti, El Salvador, Iraq, Jamaica, Japan, Kenya, Latvia, Lesotho, Liberia, Libyan Arab Jamahiriya, Luxembourg, Madagascar, Mali, Mexico, Namibia, Portugal, Romania, Rwanda, Singapore, Slovenia, Sri Lanka, Tonga, Thailand, Turkey and the United States of America.

Dr Anders Nordström, appointed by the Executive Board as Acting Director-General of WHO in May, will continue in this role until a new Director-General takes office.

For more information contact:
Christine McNabActing-Director, WHO Communications Department
Telephone: +41 22 791 4688Mobile phone: +41 79 254 6815E-mail: mcnabc@who.int

Iain SimpsonTeam leader, News and AdvocacyWHO, Geneva
Telephone: +41 22 791 3215Mobile phone: +41 79 254 3215E-mail: simpsoni@who.int

Fadéla ChaibCommunications OfficerWHO, Geneva
Telephone: +41 22 791 3228Mobile phone: +41 79 475 5556E-mail: chaibf@who.int

Candidates for WHO Director-General Respond to Questionaire

PEPFAR Watch has posted the answers to the questionaire put forward by civil society partners to the candidates for Director-General of the WHO. Read what several candidates said about critical issues such as HIV/AIDS, TB, and sexual and reproductive health.

Yesterday, the Executive Board of the WHO announced in a news release that the short-listed candidates are: Ms. Elena Salgado Méndez, Dr. Kazem Behbehani, Dr. Margaret Chan, Dr. Julio Frenk, and Dr. Shigeru Omi.

Abstinence Forever

USA today reports that the federal government is targeting unmarried adults up to age 29 as part of its abstinence-only programs because unmarried women in the 20-29 year age group are having children.

But really, why stop at 29? I bet there are 30 year old women, even perhaps 35 and 40 year old unmarried women having sex, and having babies too.

I don't know if it was taken out of context, but Wade Horn, assistant secretary for children and families at the Department of Health and Human Services, was quoted in the article as saying: "The message is 'It's better to wait until you're married to bear or father children,' " Horn said. "The only 100% effective way of getting there is abstinence."

The only 100% effective way of getting "there" - meaning to be married with children? - is abstinence??? Has HHS decided to totally abandon evidence, and pursue its ideological goals untethered to data? The article goes on to say:

The revised guidelines specify that states seeking grants are "to identify groups ... most likely to bear children out-of-wedlock, targeting adolescents and/or adults within the 12- through 29-year-old age range." Previous guidelines didn't mention targeting of an age group.

"We wanted to remind states they could use these funds not only to target adolescents," Horn said. "It's a reminder."

Last year, 46 states applied for the federal abstinence-education money, to fund programs in schools, neighborhood clubs and faith-based organizations.

Hmmm, so if HHS is telling states they can target 29 year olds with abstinence messages, how will they do that: schools? probably not. Neighborhood clubs? doubtful. Faith-based organizations? Bingo.