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11 January, 2011
In this issue of the ICEM HIV/AIDS newsletter, we report on the approval of Global Fund Round 10 grants, on World Aids Day activities, and on HIV and AIDS targets.
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ICEM affiliates are engaged in a wide range of HIV/AIDS activities. To spread the information on new agreements, awareness, and prevention campaigns, and educational activities, affiliates and project coordinators are invited to send news and information to [email protected]. Any feedback on the format and contents of the e-bulletin is also welcome.
Global Fund Approves Round 10 Proposals
The Global Fund Board has approved all 79 Round 10 proposals recommended by the Technical Review Panel (TRP), at a cost of US$1.73 billion over the first two years and US$4.72 billion over five years. This makes Round 10 the third largest round ever, after Rounds 8 and 9, respectively. These decisions were made at the Fund’s 22nd board meeting, held from 13-15 December in Sofia, Bulgaria.
Unlike in previous rounds, the Fund did not have to delay approval of certain proposals pending further funding becoming available; sufficient funding will be available to cover all Round 10 proposals that the TRP recommended for approval. Also, the Board has not required that budgets be reduced.
The Board's decision as to which proposals to approve was, as always, entirely based on the advice it received from the TRP, an independent and non-political body of 43 experts from around the world. In total, the TRP reviewed 150 proposals, of which 78 were for HIV/AIDS, 48 for TB, and 24 for malaria. Malaria proposals were by far the most successful in Round 10, with 79% approved (as against 54% for TB proposals and 44% for HIV/AIDS). Over the last three rounds, malaria and TB proposal success rates have always been above 50%, but HIV/AIDS proposal success rates have always been below 50%.
HIV proposals from the countries where the ICEM also has activities did not fare well: proposals from Botswana, DR Congo, Côte d’Ivoire, Ethiopia, Ghana, India, Mauritius, Mongolia, Namibia, Nigeria, Tanzania, Uganda and Zimbabwe were rejected; most of these for repeated rounds. Only the HIV proposals from Guinea, South Africa, Zambia, and a smaller grant for Uganda were approved.
(Source: Global Fund Observer, Issue 135 of 16 December. GFO is a free service of Aidspan www.aidspan.org; to receive GFO send an email to [email protected])
World AIDS Day 2010
ICEM affiliates all over the world organised or participated in activities on 1 December, World AIDS Day.
In Trinidad and Tobago, the Oilfield Workers’ Trace Union (OWTU) organised an HIV/AIDS workshop in cooperation with the Humanity Fund of the Canadian affiliate Communications, Energy, Paperworkers (CEP) Union (see e-bulletin No. 63, December 2010).
The Chemical, Energy, Paper, Printing, Wood and Allied Workers’ Union (CEPPWAWU) of South Africa focused on their own staff and organised a “Lights for Rights” commemoration at the union’s head office. Mary Nxumalo, National Gender and HIV Coordinator, spoke of a positive step in engaging trade union officials in dealing with the pandemic.
The Canadian Automobile Workers (CAW) launched its new HIV/AIDS information manual entitled “HIV/AIDS: A Worker’s Issue, A Union Issue” on World AIDS Day. The booklet offers information on HIV/AIDS in Canada, prevention and transmission, model collective agreement language, and a wealth of other data.
The International Transport Workers’ Federation (ITF) reports on activities of its affiliates in Argentina, Chile, Colombia, Ethiopia, Ghana, India, Indonesia, Kenya, Tanzania, Uganda, and Venezuela. In Namibia, the Namibian Transport and Allied Workers’ Union organised a trucker convoy which travelled through the capital Windhoek, distributing male and female condoms and leaflets.
Commentary by the Editor:
Does the World Need More HIV and AIDS Targets?
“UNAIDS in 2011 – Getting to Zero,” says the feature story on the UNAIDS website which introduces the new UNAIDS strategy 2011-2015 adopted by the Programme Committee Board in December 2010. The strategy aims to advance global progress in achieving country set targets for universal access to HIV prevention, treatment, support, and care and to halt and reverse the spread of HIV and contribute to the achievement of the Millennium Development goals by 2015.
Sounds familiar? Well, yes, 2010 just closed without having reached universal access – a commitment from the G8 summit in 2005. And a few years ago the WHO “3 by 5” initiative to provide three million people with antiretroviral treatment by the end of 2005 barely reached more than half of the target.
Have such ambitious targets positively affected global HIV/AIDS efforts? Two views on targets are current. “People need targets,” says Sheila Tlou, UNAIDS head in eastern and southern Africa. “Aim for the sky and you’ll reach somewhere. Had countries been given lower targets, chances are they would only have realised half of that.”
However, Alan Whiteside, executive director of the Health Economics and HIV/AIDS Research Division at the University of KwaZulu-Natal says “unreachable targets are demoralising and unfair to health workers expected to meet them with often inadequate resources.”
A closer look at the details of targets also reveals that “universal” and “zero” do not necessarily mean what is commonly understood by it. The G8 universal access to treatment target was achieving “as close as possible to universal access to treatment of all who need it by 2010.” As close is possible was often defined as 80%.
And do not be deceived by the fancy zero in the UNAIDS “Getting to Zero” logo. The goal for 2015 is: sexual transmission of HIV reduced by half. Universal access to antiretroviral therapy for people living with HIV who are eligible for treatment is also to be achieved by 2015. But that was already the target for the year that just ended.
We may need targets but we must not forget that the people who are held responsible for missing them are not the people who rolled them out, but the people on the ground charged with implementing them. And we must also consider that sometimes the goal posts shift and targets become more distant, as was the case when the WHO raised the recommended threshold for starting treatment form a CD4 count of 200 to one of 350.
(Source: IRIN PlusNews, Johannesburg, 1 December 2010; circular World AIDS Campaign of 13 December and feature story UNAIDS, 30 December)
Drug Kit Helps Mothers to Protect Babies
Close to 400,000 African babies are infected with HIV every year, in pregnancy, during birth, and through breastfeeding. The situation points back to the high HIV prevalence among women of reproductive age. Zambia, where some 85,000 women in the age group 15 to 40 are HIV positive, is one of the countries recognised for making progress in addressing the problem.
The introduction of a new drugs kit called Mother-Baby Pack is expected to further reduce transmission. The kit is a pre-packaged set of medicines including maternal and baby prophylactic anti-retroviral medicines in line with WHO Guidelines.
(Sources: IPS, Lusaka, 30 November)
Indonesia: Dramatic Increase in New HIV Infections in Bali
Bali's dramatic increase of HIV prevalence among sex workers has changed the face of the epidemic on this famed tourist destination of 3.9 million local residents. In 2010, 25.9% of Bali’s 3,945 sex workers were living with HIV, up from 1.6% in 2000, according to the provincial health department. The HIV prevalence rate among sex workers nationwide in 2007 was 10.4%.
The virus is taking hold of the general population in Bali as some 100,000 clients engage with commercial sex workers, of whom more than half do not consistently use a condom, and then go home to their regular partners.
A decade ago, Bali's HIV problem – as was the entire country’s – was concentrated among intravenous drug users (IDUs). HIV in heterosexual men and women began its steady upward climb in 2005 in Bali, as the number of new infections of IDUs living with HIV steadily declined. Needle exchange programmes as part of an overall “harm reduction” initiative targeting drug users since 2007 helped to bring down new drug-related infections.
(Source: IRIN PlusNews, Denpasar, 3 January 2011)
Ethiopia: 5-Year Plan to Half New HIV Infections
Ethiopia's government has come up with an ambitious plan to halve new HIV infections, quadruple its annual condom distribution and put 85% of people who need life-prolonging HIV medication on treatment within five years.
An estimated 1.2 million Ethiopians are HIV-positive. According to the government, the country's national prevalence is 2.4%, with stark differences between urban HIV prevalence, which stands at about 7.7% and rural levels of under one percent.
According to UNAIDS, Ethiopia has already managed to bring down new HIV infections by over 25% since 2001. The country's HIV/AIDS Prevention and Control Office (HAPCO) says prevalence among young people is dropping even more; in the capital it was halved.
While this progress is impressive, stigma and ignorance are still common among young people. According to a recent study, a considerable percentage of young people had never heard of condoms or had no exposure to them. One third of young people aged 12-24 felt that moral people do not use condoms; 48% of young people felt that condoms should not be used within marriage; and roughly half felt that condoms are used by promiscuous people.
According to the five-year plan, the government also plans to increase the coverage of antiretroviral therapy from 60 to 85%. Close to 400,000 Ethiopians require treatment for HIV.
(Source: IRIN PlusNews, Addis Ababa, 23 December 2010)
News from Global Unions
The International Transport Workers’ Federation (ITF – www.itfglobal.org) in its latest HIV/AIDS update No. 97 of 1 to 15 December, reports on World AIDS Day activities of its affiliates (see article on WAD above).
The ITF also published an HIV/AIDS survey in the civil aviation sector in order to improve understanding of the impact of HIV and AIDS in the aviation industry.
The Building and Woodworkers’ International (BWI – www.bwint.org) reports on in its work with loggers in Guyana. Guyana, a country of around 750,000, has an HIV prevalence of 2.5% in the age group 15 to 49. Thanks to the cooperation with the ILO and the support from the workplace programme of the US Department of Labor, HIV/AIDS workplace education and prevention programmes are now reaching even the most remote areas of the country, such as logging sites.
Five Years Ago: From the January 2006 Issue
The first issue of the ICEM HIV/AIDS e-bulletin was published in October 2005. In current issues, we refer to an article from the same month five years ago and reflect on developments.
In the January 2006 issue of the e-bulletin, we reported on the long overdue commitment by the Global Fund to Fight AIDS, Tuberculosis and Malaria to ensure continued funding for treatment-based grants when they are denied Phase 2 funding, or they are approaching the end of their term. (Global Fund grants are approved for five years but can be suspended on the basis of a review after two years). Concern had earlier been raised over the fate of the people on treatment when a grant is suspended.
The situation in South Africa, at the time, was characterised by denial at the highest level of government. The Congress of South African Trade Unions (COSATU) joined activist group Treatment Action Campaign (TAC) to push for a new approach to AIDS. In a joint statement with TAC and the South African Council of Churches, COSATU said, “We lament the continued refusal of our national government to declare the seriousness of the epidemic and to mobilise a response on the scale that is needed.” The new campaign, which was launched on World AIDS Day 2005, was designed to more deeply involve unions, employers, and churches in the fight against HIV/AIDS. The organisations demanded that by the end of 2006, at least 200,000 AIDS patients were enrolled for anti-retroviral treatment (the figure at the end of 2005 was 70,000). By the end of 2009, nearly one million were on ART; yet, according to UNAIDS, that is still only 37% of those needing drugs.
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