29 November, 2006December 2006
Reminder to ICEM Affiliates
In our November e-bulletin we have encouraged you to join the campaign on
World AIDS Day, 1 December
against stigma, discrimination and victimisation, and for prevention, care and support and treatment.
Please, report back to [email protected] on any actions you have taken.
ICEM HIV/AIDS Workshop in India
21 participants from four ICEM affiliates in the mining, diamond, cement and chemical/electricity sectors participated in a workshop in Puri, Orissa, 16-19 November. The workshop was held at the Gandhi Labour Foundation, which is part of the network of Institutes for Miners and Metalworkers Education (IMME) of the Indian National Mineworkers’ Federation (INMF).
The workshop was inaugurated by veteran trade union leader, former General Secretary and President Emeritus of the INMF, long-time member of the ILO Governing Body and former Vice President of the MIF, Kanti Mehta.
The objectives of the workshop included the achievement of a solid knowledge about the HIV/AIDS epidemic; the introduction and advocacy of the ILO Code of Practice on HIV/AIDS and the world of work; the development of workplace policies and of a work plan of activities with sustainable funding sources.
It incorporated a baseline survey of what policies exist and what activities have taken place. IMME had run an HIV/AIDS awareness campaign in the Korba area of South Eastern Coal Limited, a subsidiary of Coal India Limited from December 2004 to April 2006 with the support from the Catholic Relief Services.
The workshop answered the question why unions should get involved in HIV/AIDS activities and how they could get involved. Participants drafted a workplace policy which includes non-discrimination and non-victimisation, confidentiality and care and support and came up with an action programme.
Focus on India
The Indian national response to HIV/AIDS is led by the National AIDS Control Organisation (NACO), a department of the Ministry of Health and Family Welfare. NACO was created in 1992 and provides the strategy and direction for the whole country. India is a decentralised federation and in each state, a State AIDS Control Society is responsible for coordinating the implementation of the national strategy.
Besides general awareness, information and behaviour change communication, the strategy is based on targeted interventions aiming at high-risk groups, providing access to VCT, prevention of mother-to-child transmission and, since 2004, access to antiretroviral treatment.
According to the UNAIDS/WHO 2006 Epidemic Update, India is experiencing a highly varied HIV epidemic which appears to be stable in some parts while growing in others. Approximately 5.7 million people, of whom 5.2 million were adults aged 15 to 49 years, were living with HIV in 2005. This is the highest absolute number of HIV infections in the world although the prevalence rate at 0.9% is relatively low due to the large population of more than 1.1 billion.
The majority of HIV infections occur in a few regions. About two thirds of reported infections have been in six of the country’ 28 states – mainly in the industrialised south and west and the north-eastern tip. On average, HIV prevalence in those states is 4 to 5 times higher than in the other Indian states.
The bulk of HIV infections in India happen during unprotected heterosexual intercourse. Consequently, women account for a growing proportion of people living with HIV (some 38% in 2005). A large proportion of women have acquired the virus from regular partners who were infected during paid sex.
In Mumbai and Pune in Maharashtra state, for example, 54% and 49% of sex workers have been found to be infected. In such a scenario the likelihood of transmission between sex workers and their clients and their other sex partners is extremely high. Prevention efforts have been started by organisations of sex workers themselves in the state of West Bengal but condom use is still inconsistent in other parts of India.
Injecting drug use is the main risk factor for HIV infections in the north-east and in major cities. In Chennai (formerly Madras), 31% of injecting drug users were found to be HIV positive.
The report states that above all, more must be done to combat stigma, which remains rife in all walks of Indian society and to reduce gender and other inequalities which make HIV prevention and treatment such a huge challenge.
The 3rd Five-Year Plan (NACP III) is currently under preparation. In early November, one of the largest Global Fund HIV/AIDS grants for US$ 259 million over the 5-year grant period was approved for India.
(Source: UNAIDS/WHO AIDS 2006 Epidemic Update and UNAIDS country profile)
The Gates Foundation in India
The Bill and Melinda Gates Foundation has given a US$ 200 million five-year grant to operate an HIV prevention programme on a scale never done before. The Foundation’s prevention efforts, known as Ahavan – a Sanskrit word meaning “call to action” – target the commercial sex trade, which is a main transmission route for the infection.
The challenge is complex. Often the sex trade is nearly invisible with sex workers working out of truck stops or even in small village homes.
One of India’s hardest-hit areas, the remote northeast, has an entirely different problem. There, most HIV transmissions come from needles shared by hundreds of drug addicts.
All these problems are confounded by the stigma attached to AIDS in a very conservative society.
Ahavan’s strategy has been to adopt a business-style structure. The product is prevention, and the Foundation formed a pyramid structure to get to its consumers. It contracted 15 other organisations which, in turn, work with about 150 grass-root groups. They engage some 5,000 sex workers, many of them HIV-positive, to get the message about condom use out.
(Source: Abbreviated article by Gavin Rabinowitz, AP US and WorldMonday, 3 July 2006)
NUM Calls for Accelerated Conversion of Hostels
The ICEM affiliated National Union of Mineworkers (NUM) called upon the South African mining industry to accelerate the conversion of single-sex hostel accommodation to decent family housing.
Speaking at the 2nd Mining Industry Tripartite HIV/AIDS Summit, NUM General Secretary Frans Baleni reiterated that doing away with single-sex hostels would go a long way in dealing with HIV, AIDS and TB. He said that migrant labour travelling between their communities and the mines was fuelling the epidemic and added that a mineworker housing scheme would establish a family environment, which was more likely to deal with the spread of HIV.
Baleni also urged the mining industry to extent antiretroviral treatment to the partners of mineworkers and singled out AngloGold Ashanti, Anglo Collieries, Gold Fields, Harmony and De Beers as firms only treating their workers.
He told the summit that little progress has been made in prevention since the first summit held in 2003. Baleni called on employers and the government to create a more supportive environment for voluntary counselling and testing (VCT) and said that the peer group support system should be improved.
(Source: Mining Weekly, South Africa, 6 November 2006)
AIDS in Zimbabwe – Facts and Fiction
In its latest report, UNAIDS cites Zimbabwe as an example of successful prevention measures. Between 2002 and 2005, the prevalence rate among pregnant women has dropped from 29.6% to 20.1%. That would make Zimbabwe one of the most successful countries in the world in the fight against the epidemic.
There are, however, strong indications that government-supplied statistics are more based on fiction than on facts. The almost complete collapse of the health system in the wake of a long and severe economic crisis and an absence of prevention campaigns make it hard to believe that prevalence rates have come done. Furthermore, according to the government’s own figures, only 23,000 persons received anti-retroviral treatment at the end of 2005 when 321,000 needed it.
If the prevalence rates among different groups have come down, it is due to other factors such as persons living with AIDS simply dying or that HIV-positive people have left the country in search of work elsewhere. It is estimated that two to three million Zimbabweans have emigrated, mainly to South Africa.
(Source: Neue Zürcher Zeitung, Switzerland, 20 November 2006)
Global AIDS Epidemic Continues to Grow
The global AIDS epidemic continues to grow and there is evidence that some countries are seeing a resurgence in new HIV infection rates which were previously stable or declining. However, declines in infection rates are also being observed in other countries, as well as positive trends in young people’s sexual behaviours.
According to the latest figures published in the UNAIDS/WHO 2006 Epidemic Update (www.unaids.org), an estimated 39.5 million people are living with HIV. There were 4.3 million new infections in 2006 with 2.8 million (65%) of these occurring in sub-Saharan Africa and important increases in Eastern Europe and Central Asia, where in some countries infection rates have risen by more than 50% since 2004. In 2006, 2.9 million people died of AIDS-related illnesses.
(Source: UNAIDS/WHO Press Release, 21 November 2006)