9 February, 2011
In this issue of the ICEM HIV/AIDS newsletter, we report on the ICEM’s HIV/AIDS Project in 2010, on why the Global Fund is in the headlines for the wrong reasons, and on the five countries to watch in 2011 on the development of the pandemic.
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The ICEM HIV/AIDS Project in 2010: Another Successful Year
The ICEM’s HIV/AIDS Project implemented a full programme in 2010, the first year of a new cycle with sponsorship from solidarity support organisations SASK of Finland and FNV Mondiaal of the Netherlands.
At sub-regional level, the feminisation of the HIV/AIDS pandemic has been addressed in a women’s workshop that was an overwhelming success. In some countries, activities only for women were organised taking the experience of women who had attended the workshop to the national level.
Two sub-regional workshops for English and French speaking West Africa and for Southern Africa focussed on HIV/AIDS workplace policies and programmes. They also made participants familiar with the new ILO Recommendation No. 200, concerning HIV and AIDS and the World of Work. The concept of a worker’s passport, which gives basic information on HIV and AIDS, as well as information on sites and clinics where support and care are available, was discussed and endorsed by participants.
At national level, programmes were implemented in 11 sub-Saharan African countries. The space in this newsletter is not sufficient to give a full account of activities in all 11 countries, which include Côte d’Ivoire, the DR Congo, Ghana, Guinea, Mauritius, Nigeria, Sierra Leone, Tanzania, Uganda, Zambia and Zimbabwe.
In Zimbabwe, training courses were again organised after an interruption of many years. Good examples in some countries, especially Nigeria and Tanzania, prompted the national coordinator in Ghana to organise the first VCT campaign under the auspices of the HIV/AIDS project in the country. In Mauritius, the national coordinator overcame the difficulty to access workers at their workplace by producing a DVD on HIV/AIDS and distributing it to shop stewards. Excellent results can also be reported from Côte d’Ivoire where companies have been cooperating with trade unions on HIV/AIDS. Guinea is a relatively new target country. New foreign investment in the mining sector gives additional significance to the HIV/AIDS project in Guinea.
Gratefully, additional funding from the Humanity Fund of the ICEM affiliate, the Communication, Energy, Paperworkers (CEP) Union of Canada enabled us to run additional HIV/AIDS activities in Nigeria and Trinidad and Tobago.
In the first six months of 2010, programmes also continued in India with the support from the German pharmaceutical company Boehringer Ingelheim, which has agreed to continue its support in 2011.
With a financial contribution from the ICEM affiliated Industri Energi (IE) of Norway, the ICEM broke ground with a first HIV/AIDS workshop in a Middle Eastern country, Jordan.
The second phase of the VCT campaign, sponsored by the Women’s Department of the German ICEM affiliate IG BCE, was successfully implemented in Mwasa, Tanzania.
The Danish solidarity support organisation LO/FTF continued support for the HIV/AIDS project in Ethiopia in cooperation with ICEM affiliate, the National Industrial Federation of Energy, Chemical, and Mine Trade Unions (NIFECM).
HIV/AIDS – Five Countries to Watch in 2011
Things are generally more positive on the global HIV front: the number of new infections is down, treatment figures are up, and headway is being made in the fight to end discrimination against people living with HIV. However, there is still work to be done and progress in the fight against the pandemic has been uneven. IRIN/PlusNews lists five countries that could determine the future of the pandemic this year:
South Africa - The sheer size of the epidemic in South Africa means it cannot be ignored: more than one million people are on treatment – the biggest antiretroviral programme in the world - and more than five million people are living with HIV.
The country also offers the best-case scenario in terms of HIV/AIDS funding since the government is largely responsible for financing the country's AIDS efforts. South Africa does not rely heavily on external resources as other countries do. After years of dragging its feet, the government has introduced policies and initiatives aimed at strengthening the HIV/AIDS response, including a national HIV counselling and testing campaign, and the decentralization of ARV treatment, from doctors prescribing at hospitals, to nurses providing the drugs at health facilities. This year will provide an idea of how these measures pan out.
Russia - With 37% of the country's estimated 1.8 million intravenous drug users (IDUs) believed to be living with HIV, Russia is dealing with one of Eastern Europe's largest HIV epidemics. The country has been heavily criticized for its refusal to adopt evidence-based, harm-reduction techniques for treatment of drug users. Russia prefers instead to put IDUs in prison, where clean needles are harder to find, thereby raising the HIV threat. Experts say unless the drug policy changes, HIV prevalence is likely to continue increasing.
Uganda - Once hailed as a beacon in the fight against HIV, Uganda’s prevalence rate fell from 18% in 1992 to about 6.1% in 2004. The government's aggressive prevention campaigns focused on abstinence, sexual fidelity, and condom use, becoming the foundation of national HIV prevention programmes across sub-Saharan Africa. Today, however, UNAIDS reports that the country's HIV prevalence is between 6.5 to seven percent.
There is also evidence of apparent reversals in preventive sexual behaviour in the general population, reports the Uganda AIDS Commission. The proportion of adults who say they had sex with a person who was not a permanent partner has grown since 1995, from 12% to 16% for women and from 29% to 36% for men.
Haiti - The 7.0 magnitude earthquake that hit the country a year ago damaged its health infrastructure extensively. While most patients who were on life-prolonging anti-retroviral drugs before the quake were traced and put back on treatment, the country's HIV programmes remain unstable.
Reports of sexual abuse and transactional sex in Port-au-Prince's tent cities raise the possibility of increased infections, while the threat of tuberculosis in the overcrowded camps is also high. As the country continues to rebuild basic services this year, it will be important for the government, faced with multiple competing interests, to ensure that HIV/AIDS receives the attention it needs.
India - More than 80% of all donor-funded antiretroviral drugs used in developing countries are Indian-manufactured generics. However, an imminent Free Trade Agreement (FTA) with the European Union could potentially see the country lose its ability to produce the cheap generic medicines so vital to healthcare in poor nations.
The EU is pushing for data exclusivity, which means Indian generic manufacturers would no longer be able to use existing drug trials to make identical generic drugs. Instead, they would be required to conduct their own clinical trials, delaying access to poor countries for these drugs for several years. EU officials say data exclusivity clauses in the FTA will take into consideration the role India plays in producing generic medicines for the developing world.
With increasing pressure on India and other developing nations to adhere to tighter intellectual property laws, 2011 could be critical to the future of HIV treatment in sub-Saharan Africa and other regions.
(Source: PlusNews, Nairobi, 28 January)
Global Fund in the Headlines
On 23 January, the Associated Press (AP) ran a long story about the Global Fund entitled, "Fraud Plagues Global Health Fund." The story was picked up by nearly 200 media outlets in the U.S. and 50 in other parts of the world.
The story stated that in Mali, the Fund's Office of the Inspector General (OIG) found that US$4 million in funding was misappropriated. Half of Mali's TB and malaria grant money went to supposed "training events," for which signatures were forged on receipts for per diem payments and travel expense claims. Mali has arrested 15 people suspected of committing fraud, and its health minister resigned without explanation two days before the audit was made public.
The AP story added that in Mauritania, the OIG found "pervasive fraud," with US$4.1 million – 67% of an HIV grant – lost to faked documents and other fraud. And in Djibouti, the OIG found that about 30% of grant funding they examined was lost, unaccounted for, or misused. Much of this money went to buy motor vehicles. Almost US$750,000 was transferred out of one account with no explanation.
In a commentary, GFO Editor Bernard Rivers wrote, “When any entity gives multi-million dollar grants, there will always be corruption. The key issue is what is being done to unearth the corruption and minimise losses. The Global Fund is far better at investigating allegations of corruption and at recovering stolen monies than most or all other major aid donors.”
Another thing that distinguishes the Global Fund from other donors is its willingness to publish the details of the corruption that it has unearthed. In that sense, the Global Fund has become the victim of its own toughness and transparency. The Global Fund says that it has a “zero tolerance” policy with respect to corruption. That's the right approach! Every stolen Global Fund dollar is a dollar that can't be spent on saving lives.
(Source: Global Fund Observer, Issue 139 of 27 January. GFO is a free service of Aidspan www.aidspan.org; to receive GFO send an email to [email protected])
Ethiopia: Transport Sector Launches HIV Policy
The Ethiopian government has unveiled an HIV policy for its transport sector, which has grown significantly in recent years alongside the rapidly expanding road network. Various national studies have shown that those working across the transport sector - especially drivers and their assistants - are vulnerable to HIV infection as they spend considerable time away from their families.
The country's Federal Transport Authority (FTA) and commercial transporters jointly issued the policy in December (Comment from the editor: no mention of the union having been consulted or involved). It sets up a national taskforce to raise funds from state and non-state actors to finance projects, including condom distribution, and helping transport staff and family members living with the virus.
Transport workers often have sex with local sex workers when on the road for days at a time. According to the latest UN General Assembly Special Session on HIV/AIDS country progress report on Ethiopia, a 2009 study found that truckers and intercity bus drivers formed 22% of the client base of sex workers.
A 2009 government survey from mobile counselling and testing clinics in 40 towns located on the major transportation corridors that link Addis Ababa to Ethiopia's borders, found that 25.3% of the sex workers were HIV-positive.
(Source: IRIN PlusNews, Addis Ababa, 17 January 2011)
South Africa: Fighting Back
With only 0.7% of the world’s population, South Africa has 17% of its HIV/AIDS sufferers – some six million in a population of almost 50 million. After a decade of denial by the government, authorities are fighting back.
South Africa has the world’s biggest antiretroviral treatment programme, providing ARVs to around one million patients. This means that two-thirds of those in need of ARVs are now getting them. But the target of 80% by the end of 2011 is unlikely to be hit, mainly because of the lack of medical staff.
South Africa has also launched the world’s biggest testing campaign aimed at checking 15 million people within 15 months. But although new infections fell by a third between 2002 and 2008, they are still running at more than 400,000 a year. According to research in South Africa, barely four out of ten sexually active men use condoms. Another reason for the continued spread is the exceptionally high rape rate.
(Source: The Economist, 4 December 2010)
News from Global Unions
The International Transport Workers’ Federation (ITF – www.itfglobal.org) in its latest HIV/AIDS update No. 98 of 15 December and 1 January, reports on a seminar organised by the Communication and Transport Workers Union of Tanzania (COTWU-T) on HIV/AIDS workplace policies and collective bargaining. COTWU-T believes that serious and continued HIV/AIDS workplace interventions can minimize or control the transmission of HIV to workers. It is therefore the union’s strategy to ensure that there are guidelines for implementation so as to combat the epidemic from the grassroots. As long as the Collective Bargaining Agreement is a tool for improving working conditions, a clause specifically mentioning the fight against HIV/AIDS and its impacts should be openly elaborated. This is why COTWU-T looks for every opportunity to establish and conclude a CBA with a clause on HIV/AIDS.
Five Years Ago: From the February 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 February 2006 issue of the e-bulletin, we reported on the preparations for the 16th International AIDS Conference (IAC), which was to be organised in Toronto in August. In cooperation with the Canadian Labour Congress (CLC), a Global Labour Forum was planned to be organised during the IAC to underline the impact and effectiveness of HIV/AIDS policies and actions at the workplace to fight the pandemic. Labour has since made sure that its voice be heard at subsequent International AIDS Conferences.
We also gave figures which had been jointly released by China’s Ministry of Health, the WHO, and UNAIDS on 25 January 2006 and which estimated the number of people living with HIV at 630,000 in 2005, down from an estimate of 840,000 in 2003. This was not necessarily a success story in prevention but rather due to errors in estimates.
The survey therefore cautioned against complacency, saying the figure was still rising and the virus was spreading from high-risk groups to the general population. Experts have warned that China’s increasingly mobile population faces a broader risk as more infections occur through drug injection and sexual contact.
It is interesting to note that now on the UNAIDS website, AIDSinfo, on which country fact sheets can be accessed, information is given in graphs with rather wide brackets. One has to look very closely to determine that about 750,000 people were living with HIV in China in 2009. The band width is an extraordinary 550,000 to one million. Only one fact can be determined with certainty: the number of infected people has gone up constantly.
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