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“It’s only by God’s grace that you survive pregnancy.” This statement, made by a 19-year-old girl in the Democratic Republic of the Congo (DRC), illustrates the incredible situation of women in sub-Saharan Africa with little or no access to reproductive health care. The statistics are staggering: every year, approximately half a million women around the world die from pregnancy related causes. More than half are in sub-Saharan Africa, almost all are in impoverished countries, and most deaths are avoidable. Think about the women in your life – how many people do you know who have needed an emergency C-section because the baby was breach or the labor was taking too long? Issues like obstructed labor and post-partum hemorrhage occur with women everywhere. In developed countries, they lead to scary moments and extra medical care.  In the developing world, they often lead to death.

Dire as this situation is throughout the developing world, it is much worse in areas of conflict. Here, women are subjected to the additional burdens of violence and displacement. Emergency response to conflict areas usually consists of extremely basic supplies – food, clean water, sometimes first aid and shelter. But reproductive health services are just as important.

Yesterday I went to a film screening in DC to watch BBC Documentary “Grace Under Fire”, which focuses on Dr. Grace Kodindo, a Chadian Ob/Gyn who travels to the DRC to observe the special needs of women in conflict areas. The film was followed by a panel and Q&A featuring Dr. Kodindo, Mr. Clarence Massaquoi of Liberia, and Dr. Bouba Touré of the DRC. The film was fantastic and the information I learned was staggering. You can watch an excerpt of the film on YouTube, as it was televised on BBC. Read the rest of this entry »

We often forget that HIV/AIDS is not just a growing epidemic on other parts of the globe, but it is also an ever growing crisis that has also been plaguing America since the 1980s.  In 2006 the HIV virus was estimated by the Center for Disease Control to have infected 1.1 million people in the United States with the number of infections growing at a rate of 56,000 more Americans a year.  A recent study, conducted by the World Health Organization, concluded that AIDS is now the leading cause of death and disease for women between the ages of 15 and 44.  International AIDS Charity Avert estimated that there were 2 million children under the age of 15 in the world infected with HIV at the end of 2007. AIDS around the globe, including America, is a growing crisis that we as global citizens need to address.

Washington DC has the highest rate of AIDS of any city in the United States.   It is estimated that one In 33 DC residents is infected with HIV/AIDS giving DC an infection rate of 3%, though the number is believed to be higher.  According to The Washington Post, DC’s infection rate is comparable to San Francisco’s during the height of the AIDS epidemic and has double the infection rate of modern day New York City.  The Center for Disease Control views an infection rate of 1% to be a crisis yet the capital the United States has three times that number.

The nation’s capital is the perfect place to voice our concern and demand an ending to the epidemic, both in DC and abroad. During the start of the Obama administration, many promises regarding AIDS were made. Promises about increased global funding for US Global AIDS programs, access to affordable generic drugs in developing countries, and lifting the federal ban on federal funding of syringe exchange were all broken as none of the promises have materialized.

On December first, World AIDS day, Washington DC will urge the administration to follow through with their promises.  In an effort to inspire the US government to take action against the dire condition of the capital city, and in many places around the globe, DC Fights Back (www.dcfightsback.org), along with other groups including AIDemocracy, will be organizing a march/rally starting in Lafayette Park (the White House) at 12 pm and ending in Freedom Plaza at 2 pm.  The rally hopes to raise awareness of DC’s and the World’s AIDS crisis and inspire policy changes.

Interested in joining the rally? Just show up at the White House at 12pm on December first, OR for more information on joining the AIDemocracy team during the rally, contact Priti@aidemocracy.org.  On Facebook? You can RSVP for the rally and learn more about the issues there, visit: http://www.facebook.com/event.php?eid=187734974082&ref=mf.

As technological advances surge forward and permeate nearly every aspect of our lives from making our travels faster, communication easier and procrastination more action-packed via YouTube, it is of no surprise that technology has also thrown its metaphorical hat in the ring in regards to medication adherence.

A common discussion surrounding many arenas in health, from prevention and risk reduction to improving quality of life and longevity, adherence to medication is a pressing issue in ensuring that drug resistance is kept at a minimum, particularly in contexts where limited drug development is unable to maintain pace with rapidly morphing diseases such as extremely drug-resistant tuberculosis (XDR-TB) or human immunodeficiency virus (HIV). In the developing world, limited drug development is often compounded by limited access to those drugs that are already on the market; thus increasing the demand to maintain the effectiveness of accessible drugs.

A wide range of new technologies have been developed to assist with adherence issues throughout the world. From time-release pill boxes to regional medication exchange protocols, the possibilities stretch wide and far. Here are a few that I found particularly intriguing:

UBox – a pillbox that reminds the user to take the drug on time, records dosages and prevents a patient from double-dosing by using special software. Also, allows health center workers to monitor patient vitals.

SMART drugs – enables the creation of a breath-detectable version of any pharmaceutical drug by using markers and hand-held detector

MagneTrace – a magnetic sensory necklace that tracks medication adherence by identifying a tiny magnet in specially-designed pills, then transmits, notifies or reminds user and doctor of success or missed doses

Ambient Orb – system designed to increase medication adherence by sending signal from PillBox to Orb when it is time to take medication

Despite their glittery appeal these devices have yet to prove their applicability and usefulness in the field is yet to be determined. As with many types of technology, the paths (and funding) for distribution along with the difficulties associated with maintaining devices in the field can be quite difficult. The issue of cost also leads to the question of whether funds would be more effective if diverted to increasing the number of accessible drugs.

Finally, as a colleague suggested over lunch recently, “Sometimes the most effective approaches are those that use simple devices in new ways for the context.” We were discussing expanding access to care in rural, mountainous Nepal, where it is incredibly difficult to schedule regular visits from community health workers due to terrain and weather, though the villagers needed some indication of when the health workers would arrive.

The solution? A bike horn that had not yet been introduced into the villages. Sounded from several miles away, this unique sound provided the appropriate, advance notification that health was on the way.

Only time will prove whether the high-tech luster fades from the aforementioned devices (and others) in favor of simpler means.

An editorial in today’s New York Times talked about Mr. Bush’s Health Care Legacy. An important piece of this legacy, and one that has been discussed frequently on this blog, as well as hotly debated in the health world is President Bush’s most recent reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR). This important piece of legislation will renew the original PEPFAR for the next five years to fight global AIDS, malaria and tuberculosis, and increase the funding for it to $48 billion.

While many criticize the Bush administration for it’s dismal handling of many other health issues, the reauthorization of PEPFAR stands out as a significant achievement in the global fight against HIV/AIDS, and one that could not have been done without President Bush’s support and consistent work on this issue.

However one must also wonder what spurred the original creation of PEPFAR in 2003 and then reauthorization by President Bush, especially with an increasingly severe economic crisis at hand, America’s steady fall from being a great power, and the continuous difficulties the US faces with war, oil dependence, job loss and more.

Maybe we should be looking at the possibility of how PEPFAR has been used as a political maneuver to make the US look better in the eyes of the rest of the world. With little else to show for in the past 8 years, this could be viewed as a way for President Bush to use this as the exemplar for how good the US is about providing foreign assistance, which maybe will make other countries cast a slightly less disapproving eye towards to US.

Either way, PEPFAR certainly will stand out in the Bush administration as a shining jewel amidst a whole lot of bad policy and governance muck.

Yesterday, December 1st, or the 20th annual World AIDS Day, 5 incredible women came together at Georgetown University Medical Center to talk about the Feminization of HIV/AIDS. Their discussion took the form of a panel sponsored by Americans for Informed Democracy (AID), American Medical Student Association (AMSA), University Coalitions for Global Health (UCGH), Physicians for Human Rights (PHR), and the Georgetown Medical AIDS Advocacy Network (GMAAN) to host a panel for World AIDS Day on the feminization of HIV. The Panel included experts Jacqui Patterson form Women of Color United, Paola Barahona of PreventionWorks and Physicians for Human Rights, Carolyn Massey of Massmer Associates, and Crystal Lander from the center for Developemnt and Population Activities (CEDPA). The panel was a great success, due in main part to the views and perspectives of these women. The panel was also webcasted, and had more than 80 online and in-person viewers.

Probably most compelling was each woman’s perspective on why this thought HIV rates among women were increasing so dramatically. Each woman had a unique perspective, be it as a woman or color, an HIV+ individual, a community organizer, a doctor, an international health worker, or a combination of these designations.

All in all, the event was a great success, and a video podcast of the event will be available shortly here.

“We Must Never Forget and Never Relent in Our Fight Against AIDS”
Rep. Jim McDermott (D-WA)
World Aids Day, December 1, 2008
Original source:  Huffington Post Article

World Aids Day is a day to bear witness, to celebrate the progress we have made and to re-dedicate ourselves to the fight by telling our own personal stories. When experiences are shared from every corner of the globe, we remind the world of the urgency to act, and we renew our faith in the belief that one day soon we will eradicate the AIDS pandemic.

I witnessed the first outbreak of the AIDS pandemic in the 1980s in Africa. As a physician and psychiatrist in the U.S. State Department, I traveled across the African continent serving U.S. missions and working with local leaders. At the time the AIDS virus was largely unknown and mysterious, and it spread with stunning and devastating ferocity from country to country, killing millions.

One couldn’t help but feel a sense of helplessness, but many of us resolved to fight this scourge from whatever vantage point we occupied. For me, that was the U.S. House of Representatives, which I entered in 1989. At the urging of then-Speaker Thomas S. Foley, I co-founded a congressional caucus on HIV/AIDS. It gave America a platform in which to educate and organize Congress against the threat.

Congressional colleagues representing every political viewpoint across America spoke with one passionate and determined voice to ensure that we would lead, not merely respond to this global crisis. And we have. Led by the United States, the world has gained ground against AIDS, inch by inch, but inextricably forward.

In 2003, an estimated 50,000 people in Sub-Saharan Africa were receiving antiretroviral treatments to fight AIDS through various programs. Then, the U.S. launched PEPFAR, the President’s Emergency Plan For AIDS Relief, to urgently concentrate our efforts and it has been a tremendous success. Today in Sub-Saharan Africa, 1.7 million people are being treated, and we have provided care for almost seven million worldwide.

What’s more, our commitment remains strong. A few months ago, Congress passed and the President signed into law a PEPFAR re-authorization bill that takes major steps forward. It includes provisions I co-authored to strengthen our efforts to prevent mother-to-child transmission of HIV, and to significantly increase the number of infected children who will receive treatment. Every day, 1,000 children are born into the world infected with AIDS, and we believe this new legislation will cut that number in half.

Still, many of us are concerned. We fear the global economic crisis will jeopardize the life-saving success. Last year, the World Bank warned that poverty is much greater than previously estimated: 1.4 billion people worldwide live on about a dollar a day. And this alarm was sounded largely before the current economic crisis had unfolded. We have to address global poverty as part of our commitment to eradicate AIDS.

Furthermore, we know that the developed world is enticing trained personnel to relocate to meet our medical needs, but this leaves fragile and vulnerable developing countries dramatically short of healthcare professionals. Unless we address this shortage globally, we will undermine on one hand the very health and humanitarian efforts we support on the other hand.

There is no easy solution to the AIDS crisis, but there is a path to hope and those who have walked it, as I have, know that awareness unites the world. That’s why watching a PBS documentary like “We Will Not Die Like Dogs,” by filmmaker Lisa Russell, is so important. It can be seen at: http://www.SnagFilms.com. Many do not realize the impact AIDS is having on women and children worldwide, but the film will open our eyes and that is a major step forward.

We all hope for the day when medical research discovers an AIDS vaccine and it will come. Until then, we must never forget that we honor those who have died by fighting for those who are alive and for those yet to be born. In the final analysis, the shield that can protect us is our humanity that unites us.

“Yeah, but it’s true that condoms can’t protect against HIV, right? I just heard from my friend that some new research just came out that said that HIV is so small it can pass right through condoms.”

As the new woman behind the chair at my barber shop made this comment and went about her handiwork, I realized just how wrong “campaign” was in the context of HIV prevention.

It’s common to read about an organization conducting an HIV prevention campaign for a certain population or during a certain period of time, which in and of itself is splendid. The more people being educated about HIV the better…period; however I often wonder if HIV prevention is viewed in the same context as an immunization campaign, one shot and you’re done. You receive the information once, you’re good to go. This sentiment is often expressed by schools when they say that they provide HIV prevention and proceed to describe a series of health classes that students get once during middle school. Unfortunately, HIV prevention doesn’t work like that.

New HIV information, for that matter health information in general, isn’t in the major headlines or on the radar like the latest episode of Dancing with the Stars. It’s buried in scholarly journals that gradually trickle down to the general populace. Perhaps, as a result of this distance between the information source and the recipients, many misconceptions of HIV/AIDS continuously circulate as “new” facts or information. And it doesn’t just happen in my barber shop, I have seen it happen in small-town Wisconsin and in Bangkok, in Washington, D.C. and rural Kenya. I’ve read about it all throughout the world.

When there isn’t a regular, convenient, comfortable and reliable source of HIV information available, people look to their friends, those they trust the most and feel comfortable discussing sexually-related issues with. What their friends say becomes the latest information.

This calls for HIV prevention that is not a one and you’re done, but a continuous process that revisits information and builds upon it with the most recent findings in the field. It calls for a long-term view of HIV prevention.

So…easy to say, how do we get it done? A couple of sparks…

Novice: start with your captive audiences. Educate kids in school at least once a year, starting in late elementary/early middle school and continuing through high school. It’s time for parents and administrators to acknowledge that kids are engaging in sexual activities at younger ages and need education about it.

Amatuer: Urge organizations, companies, etc. to have annual “campaigns”, so it’s not one and done. Or coordinate information so that it is regularly available, but in engaging formats so you don’t get the, “oh it’s the drug commercial again” tune-out.

All-star: Find a point from which to get the community engaged so there are individuals in the community who are championing these issues and are known as safe points of information related to these issues and constant and accurate peer-to-peer education is occurring.

This being my maiden voyage into the sea that is the AIDBlog, please let me preface all future posts by saying that I’m gunnning for as much reader participation as possible. Drop me a comment with opposition, support, an idea for the greater communtiy, a partnership proposal, just to bounce ideas back and forth, a question. It helps me, it helps you. That’s how we’re going to shake things up.

Hi Everyone!

My name is Melanie and I am the new Reproductive Health Associate here at Americans for Informed Democracy.img_4409

Yesterday, over a thousand people (myself included) came together in Washington D.C. to hold President-elect Obama accountable to the promises he made to improve U.S. HIV/AIDS policies and programs both domestically and abroad. The election of Barack Obama is, for many HIV/AIDS activists, a light at the end of a grim tunnel that saw the Bush administration ignoring the needs of Americans living with HIV/AIDS and disseminating prevention programs to countries abroad that focused more on ideological beliefs than on best public health practices.

Over the past year, Obama has stated that he would create a national strategy to prevent HIV/AIDS and make care, treatment and housing a priority for people living with HIV/AIDS in the United States. Obama has also committed to the removal of funding restrictions on needle exchange programs and PEPFAR prevention policies.

Despite the promises made along the campaign trail, we cannot afford to let our guard down and hope for the best. In fact, now, more than ever before, we need to make sure our voices are heard and that we mobilize to advance U.S. HIV/AIDS policies. The political capital of a new and popular President combined with Obama’s progressive stances on HIV/AIDS issues opens a large window for improvement.

Of course there are several special interest groups that would like Obama to focus on their cause, but yesterday’s rally was the FIRST to demonstrate in front of the Obama transition team’s office. The ingenuity of the AIDS advocacy community to reach out to the President-elect so early in the game proved to be a success and a member of the Obama transition team was gracious enough to come out and address the concerns of the crowd.

Overall, the World AIDS Day rally was the most hopeful demonstration I have ever attended; people were genuinely excited by the prospects of what the new Administration can accomplish in the fight against AIDS. But for this to happen, we need to continue to make our voices heard loud and clear.

We’ve all heard about AIDS. We know the devastation, the tragedy, the loss of human life. It happens everywhere. But often times the face attached to the disease is that of an African woman, maybe holding her child, looking sullenly at the camera. High infection rates in many countries in Africa have created this type of typical imagery. But according to the most recent reports from the US Center for Disease Control and Prevention, HIV infections in areas of Washington, DC and Baltimore, MD have higher HIV infection rates than many African countries.

While there are still many problems with the PEPFAR funding many Third World countries are receiving, it is a step in the right direction. But what about Baltimore, DC and many of America’s inner cities? It seems THEY also need a PEPFAR plan to help slow infection rates, teach comprehensive sex education, and focus attention on prevention measures. By helping individuals protect themselves from infection, we are also decreasing the costs of healthcare nationwide, because keeping HIV negative people healthy is a lot easier and cheaper than keeping people who are HIV+ and especially those who have AIDS healthy. Robert Gallo, a professor at the University of Maryland School of Medicine, talks about the importance of a PEPFAR plan in the US in his most recent article in the Washington Post on November 16th, which could “help build clinical infrastructure for diagnosis and treatment in inner cities.” He also explains that “Federal and state officials have already allocated enormous sums to fight bioterrorism. But in the past seven years, more Americans have been the vicitms of HIV/AIDs that have been affected or killed vt any bioterrorist attack.” Robert is exactly right: the US needs a program that effectively teaches people, young and old, about prevention, early detection, and encourages people to get tested regularly. Gallo makes an important point I think resonates loudly; “As long as socioeconomic conditions prevail, those living in HIV/AIDS ‘hotspots’ without education about the disease and facing other life challenges – such as mental illness, drug abuse, homelessness and lack of health insurance – will be at risk even if we do develop an AIDS vaccine.” Gallo’s point is well taken. While he is an expert, and has been a leader in the discovery of HIV’s correlation to AIDS and the development of the HIV blood test, most Americans could tell you this equation: where poverty and drug use levels are high and education levels low, HIV infection is high. Thus we MUST develop a comprehensive program to effectively fight AIDS in the US (especially the inner cities) or else we will be facing a much worse situation in the coming years.

The “travel ban” has been a contentious piece of HIV and AIDS legislation for a long time. Added by Sentor Jesse Helms in 1987, this amendment puts a ban on immigration or travel to the US by HIV-infected individuals. But a month ago, a hopeful light at the end of this horribly discriminatory tunnel was seen.

On September 29th, the US Department of Homeland Security announced that effective immediately the Department would begin issuing short-term visas (up to 30 days) for people who are HIV positive. Under previous regulations, HIV positive people had to receive a special waiver determined by a case-by-case evaluation for entry into the USa. The new visas will not identify any traveler as HIV positive.

This is great news for microbicides advocates, considering the Microbicides 2010 conference will take place in Pittsburgh, Pennsylvania in the US. The Global Campaign for Microbicides (GCM) has been lobbying tirelessly to repeal the tavel ban on HIV positive people.

The US Department of Health and Human Service still must go through a formal rule making to remove HIV from the list of “communicable diseases of public health significance,” the designation triggers the travel restrictions. But for now, this short-term solution for HIV positive individuals is a welcome development and a much-needed improvement.


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