In late 2003, largely as a result of pressure exerted by TAC, the government formally committed itself to rolling out HIV treatment. This policy shift has posed several questions related to TAC’s interim and long term political future, given the reality of the roll-out. Will the ‘centre fail to hold’ as factions emerged in the politically ‘broad umbrella’ social movement that is TAC? Will it simply become a service-delivery focused NGO working for the Department of Health? Will the government’s commitment to HIV treatment policy reform lead to TAC’s co-option? Will it render itself obsolete through its own success lobbying for wider HIV treatment access?
Equity and HIV/AIDS
Walking on the Edge of a Chasm: The youth of Africa
Statement by Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa, released at a satellite session: \"Africa-Asia Interaction, Lessons to Be Learned\" at the XV International AIDS Conference, Bangkok, Monday, 12 July 2004
"Yesterday, July 11th, at the opening of the Conference, UN Secretary-General, Kofi Annan, used the words "a terrifying pattern" to describe the toll that the pandemic has taken on the women of the world, and the women of Africa in particular. He was both scathing and unsparing in his characterization of male behaviour which has led to the carnage. In the process of his remarks, he talked particularly of the vulnerability of young women and girls in Africa, the 15-24 year-old age group, and then noted that on a world-wide basis, the numbers of women and girls in that age group represented nearly two-thirds of the total infected."
Further details: /newsletter/id/30562
What positive outcomes for the poor in Bangkok?
Sanjay Basu
Ongoing coverage of the International AIDS Conference in Bangkok is bewildering to those who are familiar with the current political battles in the HIV/AIDS arena, and no doubt disheartening or annoying to those reading from a distance. The AIDS industry is in full swing: government forces delivering glittering generalities; actors and ex-presidents discussing their "outrage" while eating five-course dinners in Bangkok hotel penthouses.
Further details: /newsletter/id/30515
Cheap multivitamin slows time to AIDS and death in African women
Multivitamins costing $15 per person per year significantly reduced the risk of HIV disease progression and death in HIV-positive pregnant women in Tanzania, according to a study published in the July 1st edition of the New England Journal of Medicine. The investigators conclude that multivitamins would be a cheap, simple, and effective means of delaying the need for antiretroviral therapy in HIV-positive pregnant women in resource limited settings. An accompanying editorial praises the rigour of the investigators study, and although it calls for further studies into the benefits of multivitamins involving large populations it says that treatment programmes and doctors would be justified in offering multivitamins.
Free ARV's for Uganda
Statement by Ugandan health minister at the launch of free ARV programme
"The introduction of antiretroviral drugs will bring with it new challenges because this treatment is different from that for opportunistic infections, palliative care, home based care and cotrimoxasol prophylaxis which we have been providing and will continue to provide. It is different in the sense that these drugs are delicate, have a variety of side effects and have to be taken regularly and correctly for life. However, I am confident that Uganda will succeed to roll out this treatment to our people."
Further details: /newsletter/id/30491
HIV/AIDS, democracy and governance in Africa
The GAIN Issues Brief is being launched in response to a perceived gap in current news analysis on the issues of HIV/AIDS, its implications for democracy and governance in Africa, and the challenges of ensuring that the response to HIV/AIDS is consonant with democratic principles. This Issues Brief is a product of the African Civil Society Governance and AIDS Initiative (GAIN), launched in October 2003. The aim of this Issues Brief is to provide civil society activists, journalists and policymakers with a concise analytical digest of developments in the field of HIV/AIDS, governance and democracy.
Reframing the HIV/AIDS debate in developing countries: an effective, equitable response
In Southern Africa, only 100 000 out of 4.1 million people who need HIV/AIDS anti-retroviral therapy (ART) are able to access it. The drop in the price of ART has led to opportunities to increase the numbers receiving treatment, but problems remain. Increasing health service focus on HIV might poach staff and resource from other important programs like TB, malaria or child health. Developing countries need to balance resources for treatment and prevention.
The HIV/AIDS Pandemic: Implications for Agricultural Policy
This paper considers how the design of agricultural policies and programmes might be modified to better achieve policy objectives in the context of severe HIV epidemics and underscores the central role of agricultural policy in mitigating the spread and impacts of the epidemic. It is argued that - even though the absolute number of working age adults in the hardest-hit countries is projected to remain roughly the same over the next two decades - the cost of labour in agriculture may rise in some areas as increasing scarcity of capital (notably, animal draft power for land preparation and weeding) will increase the demand for labour in agricultural production or shift agricultural systems to less labour- and capital-intensive crops.
** Ensuring universal treatment access through sustainable public health systems
Abstract of paper presented at the Equinet conference, Durban, 8-9 June 2004, by David McCoy and Rene Loewenson, Equinet
There is no question that an effective and urgent response is needed to extend access to antiretroviral therapy (ART) in southern Africa. The efforts of treatment activists, national governments, the World Health Organisation and the Global Fund to highlight this unmet health need are commendable. However, after decades of under-investment, harmful structural adjustment programmes and de-skilling, many health systems face significant obstacles in rising to the challenge of meeting the treatment needs. Treatment activism now needs to join with broader public health activism to ensure that treatment can be extended in ways that are sustainable, effective and equitable. This paper draws on work carried out by EQUINET and others to discuss the threats and opportunities entailed with the expansion of ART access in Southern Africa- threats that must be managed and opportunities tapped to realise aspirations of treatment access for more than a minority.
Further details: /newsletter/id/30454
ARV's and the prevention of MTCT in resource-constrained settings
Interventions focusing on HIV-infected pregnant women need to be complemented by interventions that address primary prevention of HIV infection, particularly in women of child-bearing age and their partners, and prevention of unintended pregnancies among HIV-infected women. This is one of the findings of a paper that analyses the different alternatives that are available for the prevention of mother-to-child transmission (MTCT) of HIV in resource-constrained settings, and makes recommendations about the best course of action in a number of situations.