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What does World AIDS Day mean?
Some people with HIV/AIDS and activists object to World AIDS Day – essentially saying it allows people to ignore the epidemic the rest of the year, as long as they remember it for a single day.
Paying lip service. Window dressing. Look at the Onion cover in that light.
From my side, World AIDS Day does have advantages. It’s the one time of the year that all media make space for HIV/AIDS stories.
A new Ugandan study offers great hope for people with AIDS in rural areas in Africa needing antiretroviral treatment.
The trial tested a model in which lay-trained counsellors, not doctors or nurses, treated people at home – and they were as healthy as the patients being treated in clinics.
The cluster randomised trial took place in 44 areas in Jinja, Uganda.
The results, published in the Lancet journal online this week, suggested: “This home-based HIV-care strategy is as effective as is a clinic-based strategy.
“(This) could enable improved and equitable access to HIV treatment, especially in areas with poor infrastructure and access to clinic care.”
The researchers found after two and a half years that:
*Home-based ART by trained lay workers achieved equal health gains;
*Reduced mortality, hospital admission and viral supression were used to measure health gains;
*Patient costs were cut by half or more in the home-based care;
*Home-based care cost the health service slightly less.
Supporting the model, an editorial in Lancet stated: “This result provides compelling evidence for rolling out home-based ART to complement facility-based delivery and facilitate access.
“(This is true) especially in rural settings with weak health systems, shortage of clinical staff , and poor patients for whom transport cost and lost work-time provide obstacles to treatment initiation and adherence.”
The results are exciting but Uganda has one huge advantage over South Africa. Stigma around HIV/AID is far less prevalent and people are much more open about having the virus.
New HIV infections have come down 17% over the last eight years, UNAIDS and WHO reported today.
This finding, reported in the 2009 AIDS epidemic update, is good news.
New infections were down by about 400 000 in sub-Saharan Africa last year, about 15% lower than in 2001 when the UN Declaration of Commitment on HIV/AIDS was signed.
But HIV is rising again in some countries, according to the report.
More people are living with HIV than ever before, an estimated 33.4 million worldwide – with about 5.5 million in South Africa.
“To better connect the 33.4 million people living with HIV and the millions of people who are part of the AIDS response”, UNAIDS has launched a free social networking site, called AIDSspace.org.
UNAIDS executive director Michel Sidibé said today: “The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention.
“However, the findings also show that prevention programming is often off the mark.”
Over the past five years the number of AIDS-related deaths has declined by over 10%, with antiretrovirals saving some 2.9 million lives, the report indicated.
Dr Margaret Chan, Director- General of WHO said: “International and national investment in HIV treatment scale-up has yielded concrete and measurable results. We cannot let this momentum wane.
“Now is the time to redouble our efforts, and save many more lives.”
Sidibe said: “AIDS isolation must end. Half of all maternal deaths in Botswana and South Africa are due to HIV.
“This tells us that we must work for a unified health approach bringing maternal and child health and HIV programmes as well as tuberculosis programmes together to work to achieve their common goal.”
'Putting pen to paper' to help children with HIV
“Sick kids need medicine. Please share with them,” Zoia Kallimanis Foster, from New York, read from her letter to pharmaceutical executives and government leaders.
Children from 14 countries have written letters to drug companies and governments, urging them to help children living with HIV/AIDS – through the ‘Prescription for Life’ campaign, launched today on Universal Children’s Day.
They are asking them “to improve testing and treatment for infants and children living with HIV”, estimated to number more than two million in 2007.
Only about 15% of those children get the antiretroviral drugs they need to stay alive.
“Without treatment, nearly a third of HIV-positive infants die by their first birthday, and half of all children born with HIV die before they are two years old,” the Ecumenical Advocacy Alliance says.
The alliance and UN partners held a panel today at the UN headquarters in New York on children with HIV, as well as launching an exhibition of the letters last night at the UN.
“These letters remind us that if children can figure it out, why can’t we?” Canadian Karen Plater, co-chairperson of the Ecumenical Advocacy Alliance’s HIV and AIDS Strategy Group, asked at the exhibit.
I know this is the second “campaign” post this week but, like the Lords of Bling campaign, I think it’s an outstanding initiative.
African heads of state are squandering money instead of spending it on HIV/AIDS and TB programmes, activists in Cape Town said today launching a campaign called: Show Us the Money for Health.
“HIV is not over-funded: Health is Under-Funded!” they declared in a statement signed by nearly 100 organisations around the world for the campaign, spearheaded by ARASA (AIDS and Rights Alliance for Southern Africa).
They released a short report – Sick and Tired – highlighting the major challenges on the continent and music videos on the extravagant spending of African heads of state.
“We will call for African governments to meet their commitments to health, to ensure accountability in the use of health funding.
“We will also call on Western governments not let African lives be caught in political crossfire, by backtracking on their commitments to HIV and health funding,” they said.
Demonstrators are using their giant eyeball – a reminder they are watching leaders and will hold them accountable – to mobilise people today in Nyanga, Khayelitsha and the city centre if you want to join the protest.
They will put up large screens with the ‘King of Bling’ music videos and distribute the Mswait dollar bills.
To sign the petition and support the campaign visit the ARASA website.
Kami challenges stigma in Takalani Sesame
Sesame street has been exported to 120 countries which adapt it to their needs. In South Africa one of the stars of Takalani Sesame is healthy, happy Kami – a five-year-old yellow muppet living with HIV.
Her name Kami means “acceptance” and her puppet tackles difficult issues such as loss – in the fifth season last year she mourned her mother’s death – and rejection with courage.
Kami is loved by everyone and her impact on children aged three to five has even been studied by the HSRC.
Lesotho is successfully doing nurse-initiated AIDS treatment at a primary health care level, a study in the current issue of the Journal of the International AIDS Society shows.
And Lesotho is doing better than South Africa despite having fewer resources.
Patients in Lesotho are starting treatment earlier than in South Africa – at CD4 counts of below 350 instead of below 200.
Their programme is using tenofovir in its first line regimen, which is better for patients.
Once again MSF – which initiated a programme in Lusikisiki in the Eastern Cape – is a major player in this rural care and treatment programme.
MSF, the Lesotho Health Ministry and the Christian Health Association of Lesotho rolled out the decentralized HIV/AIDS care programme in a rural area with 14 clinics and one district hospital.
“More than 13 243 people have been enrolled in HIV care (5% children), and 5376 initiated on ART (6.5% children), 80% at primary care level,” according to the study – and the results are encouraging.
“The proportion of adults arriving sick (CD4 <50 cells/mm3) decreased from 22.2% in 2006 to 11.9% in 2008.
“Twelve-month outcomes are satisfactory in terms of mortality (11% for adults; 9% for children) and loss to follow up (8.8%).
“At 12 months, 80% of adults and 89% of children were alive and in care, meaning they were still taking their treatment; at 24 months, 77% of adults remained in care.”
Committed singer songwriter honoured for HIV/AIDS campaign
Lennox convinced 23 of the “world’s most acclaimed female vocalists” to record their voices for the SING anthem, which has raised about $2 million (almost R15 million) since 2003.
She says she started the campaign after visiting South Africa to perform in the first of Nelson Mandela’s 46664 HIV campaign concerts.
I was at that concert and her rendition of ‘Here Comes the Rain Again’ was spellbinding.
Lennox says on her website that during that trip she “witnessed the lack of resources available to help the world’s largest population living with the devastating disease”.
SING has partnered with the Treatment Action Campaign to promote HIV/AIDS treatment, testing, education, and prevention programmes.
Lennox explains why the campaign is called SING: “The stigma of HIV is so high that people are afraid to talk openly about the issue, or their status. South Africa has a tradition of activist songs and singing…When people get together to sing, they become encouraged and inspired.”
She says: “In the words of Nelson Mandela: ‘Let us use the universal language of music, to sing out our message around the world.’”
Structure of the HIV-1 CA Helical Assembly and Domain Docking
The researchers from the medical school of Pittsburgh University used structural biology tools to describe “both the overall shape and the atomic details” of the architecture of the protein complex.
“This strategy allowed us to see both the forest and the trees,” explained study co-author Dr Peijung Zhang.
“Knowing what the CA (capsid) protein looks like and how the capsid is built will allow scientists to rationally design therapeutic compounds that interfere with assembly of the protein and affect its function.”
Senior author Dr Angela Gronenborn said: “Our lab experiments show that if we replace a few of the pivotal stitches in the seam by mutation, the resulting viruses are less infectious or even non-infectious.
“The capsid, and therefore the virus, can no longer function properly.”
Health Minister Dr Aaron Motsoaledi has told Parliament that South Africa’s death rate more than doubled from 1997 to 2008.
He acknowledged not only that AIDS is driving this escalation, but also that HIV denialism under former president Thabo Mbeki fuelled this trajectory.
“Our attitude toward HIV/Aids put us here where we are,” Motsoaledi said.
The total number of deaths registered in South Africa in 2007 from all causes was 573 408. By 2008 the death toll was 756 062.
“If this trend goes on – I don’t have 2009 figures, [but] we might easily have reached 900,000 [deaths] by now – I’m worried because… in 1997 the death rate was about 300,000,” he said.
“The rate of deaths increased by more than 100 percent within… 11 years.”
The South African Medical Association today expressed its concern at these figures and committed itself to support campaigns to stop HIV/AIDS.
