2006

Overview of research into female controlled prevention in the Asia Pacific regionAugust 2006 (PDF 28 KB, 12PP). A presentation of the research related to biomedical prevention, including vaccines, microbicides and PrEP.

AFAO's submission to the Parliamentary Group Population and Development Coalition to Empower Women in Research: " Sexual and reproductive health and the Millennium Development Goals in the Australian Aid program – the way forward".  July 2006 (PDF 36KB, 4pp).

South Asia Workshop for Collaborative Fund Grantees and RACChennai, India: 25 – 29 April 2006

Universal Access for HIV Prevention, Care & Treatment, AFAO Position Statement, February 2006

2005

AIDS Vaccines 2005 Mark Bebbington outlines developments reported on at the recent conference. (PDF 22 KB, 3pp)

A True Leap Forward: China Community Treatment Preparedness Workshop Kunming, China: 24 - 27 Sept 2005

The Gay-MSM Challenges Satellite at the Kobe ICAAP: Challenges in developing gay-MSM HIV prevention programs in complex environments This half-day Pre-ICAAP Conference Satellite provided a forum for those directly involved in initiating, developing and implementing HIV prevention and advocacy programs for gay men and men who have sex with men (MSM) in Asian countries to share experiences and lessons learned. View reports and presentations.

Realising the Right to Health A Global South dialogue on HIV/AIDS and access to treatment, “Realising the Right to Health”, was held in Mumbai, India 18 - 21 March 2005.

Reports archive

Reports 2003 - 2004

• AIDS Vaccines 2004
• Alternative Community Forum
• Don Baxter's presentation at the 18^th World Conference on Health Promotion and Health Education
• ITPS Cape Town report
• WHO Bi-regional meeting report;
• Regional Treatment Access Survey
• Jogjakarta Roundtable; WHO 3x4 Informal Consultation.

Reports 2001 - 2002

• The Advocacy Guide to the Asia-Pacific Ministerial Statement on HIV/AIDS
• Report on the Canberra roundtable on treatment access
• Brighton Civil Society Consultation
• Asia Pacific Global Fund Brief
• UNGASS Declaration.

A True Leap Forward:
China Community Treatment Preparedness Workshop

Kunming, China: 24 - 27 Sept 2005

The China Community Treatment Preparedness Workshop was held in Kunming, China from 24 – 27 Sept 2005 organised by a steering committee of thirteen community advocates with administrative support from the International HIV/AIDS Alliance. Sponsored by the Tides Foundation, this successful 4-day meeting was attended by forty-five Chinese participants of which forty were people living with HIV and AIDS. Sixteen out of China’s twenty-eight provinces were represented. An additional fifteen resource people, presenters and planning committee members also participated. It was possibly the largest and most geographically diverse gathering of PLWHA in China ever.

China has moved quickly from its initial pilot programs to provide antiretroviral treatment to its citizens in 2002. Moving from treatment of a few hundred people, the government, with Global Fund support, set a target of treating 30,000 PLWHA by the end of 2005. While this goal was too ambitious and won’t be achieved, there are treatment programs across the country as part of China’s “Four Frees and One Care” program.

The problem is in implementation. Access to programs varies from place to place. Many PLWHA have dropped out of treatment programs due to a lack of treatment education and support. There is a need for PLWHA to be able to understand side effects, adhere to treatment, and find ways to ensure that they can stay on treatment. This workshop addressed these issues while aiming to improve treatment programs in China, stimulate progress in treatment education and advocacy, and empower and give skills and knowledge to the participants of the meeting.

The meeting is a part of a global program, the Collaborative Fund for Treatment Preparedness, a collaboration between the International Treatment Preparedness Coalition (ITPC) and Tides Foundation. Following the International Treatment Preparedness Summit in Cape Town in 2003, the need was identified for funding for grassroots treatment education and advocacy initiatives. Since then, nineteen funders have agreed to fund a collaboration to provide grants to community based organizations to do treatment education and advocacy projects in nine regions in the world. Johnston and Johnston agreed to fund a program specifically for China, and this workshop also established a process for distributing small grants to PLWHA groups and other community-based organisations for treatment preparedness for early 2006.

The workshop program included presentations, interactive sessions, and small group discussions on a broad variety of topics. Day 1 included an introduction to the Collaborative Fund, ITPC, and Tides Foundation; an overview of China’s national treatment policy, an overview of treatment available in China, an introduction to the topic of treatment literacy and education, and a discussion of treatment for children. Two PLWHA, who have been on treatment for many years each, told their personal stories of the challenges of adherence and access to treatment.

Day 2 featured presentations on treatment education tools, counseling skills and models of treatment education which included a discussion of the role of community and PLWHA in treatment support. Participants also worked together in groups to report on the status of treatment access in each province represented at the meeting. Common problems faced by PLWHA in China include confidentiality issues, excessive hospital charges for CD4 testing and Opportunistic Infection treatment, a lack of treatment education, counseling and other information, and a shortage of qualified medical staff.

On Day 3 there was a report of an advocacy meeting sponsored by Oxfam that took place in July 2005 with about thirty participants to discuss TRIPS and the availability of ARVs in China, followed by a discussion of what actions could be taken to increase access, including negotiations with manufacturers, and lobbying for the use of compulsory licensing for domestic production. An example of advocacy was given through a presentation on the experiences of a haemophiliacs’ group.

Day 4 focused on project design, management and implementation with an additional session on grant writing. The workshop was also about building community and encouraging networking between participants. So, the cultural program included a visit to Kunming’s one gay bar, a special dinner featuring a local specialty, Cross-Bridge Rice Noodles, and a special cultural show from Yunnan with dozens of singing and dancing children, drumming and light shows, and the amazing “peacock dance.”

Zhong Jing describes herself as a joker, but she is serious in her commitment to responding to AIDS. “I’m very tired but learned so much I want to know,” she said at the workshop’s close. “The sessions I found most useful were on project writing and management." She is currently forming a group for positive women called “Home of Colour Clouds” in Yunnan.

Perhaps the most exciting achievement of the meeting was the establishment of a National Treatments Advocacy Network. Workshops participants elected five people as the steering group to look at actions in three areas: working with drug companies to lower prices and increase accessibility of needed HIV drugs, tackling stigma and discrimination - especially within the government and its health structures, and improving the implementation of national treatment policy. As part of this new advocacy initiative, the group drafted and reviewed two public statements that will be released in the near future, one directed at a pharmaceutical company and the other regarding stigma among medical workers in China.

The full report from the workshop will be made public when it is available. A call for submissions for applications to the China Collaborative Fund will be distributed widely. Grants are available only to groups working in China on treatment access issues.

Enquiries about the Collaborative Fund in China can go to Thomas Chai atthomasinalliance@hotmail.com, Country Coordinator, or Andy Quan,aquan@afao.org.au, Project Manager for Asia.

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AFAO Position Statement

February 2006

Issue:

UNAIDS is facilitating a multi-partner effort, driven by the countries themselves, to scale up towards universal access to HIV prevention, treatment, care and support services by 2010.

Background:

At their July 2005 Gleneagles Summit, in the end-of-summit communiqué, G8 leaders pledged to increase official development assistance by around US$50 billion a year by 2010, committed to applying the Three Ones principles in all countries, and called on UNAIDS, WHO and other international bodies to develop and implement a package for HIV prevention, treatment and care, with the aim of coming as close as possible to universal access to treatment for all those who need it by 2010.

The World Health Organisation (WHO) 3x5 program aimed to get 3 million people with HIV on treatments by 2005. As the 3x5 plan has now ended, this could be seen as a replacement for it: an expanded target that goes beyond only treatment access with a new deadline of 2010. UNAIDS with other partners have embarked a process of regional consultations. A Global Steering Committee has also been formed which includes civil society representatives.

There has been some criticism of the initial consultations for the campaign – that rather than setting targets and milestones, a “consultation conversation” is taking place about “meta” issues, i.e. what is universal access. On the other hand, if consultation meetings create buy-in by key national government stakeholders, as well as establish or develop processes by which these stakeholders work in partnership with community representatives, then the process will be off to a good start. The campaign will certainly need strong and visible leadership to gain momentum – WHO’s leadership, such as Jim Kim, were brave and tireless regarding 3x5, which faltered arguably from lack of resources, an inability to spur national governments to action, and a lack of coordination. 

A strength of the "universal access by 2010" campaign is that it could build on the work done for treatments access and engage countries in a meaningful way that need to put attention to prevention. With 3x5, there was (rightfully) a focus on the countries with the poorest treatment access, and the most PLWHA. Hopefully, this campaign can include all countries in a region so that no one feels they can remain uninvolved. The focus in some countries will be prevention and in others treatment, but key goals and milestones - cheaper commodities, increased financing, better coordination, strong national leadership -  will apply equally well to either area (and hopefully contribute to the prevention-treatment continuum so the areas are not seen as opposed).

If and when the campaign develops, there will be issues for the community sector to monitor:

• Are PLWHA and affected communities fully involved at global and national levels, particularly in management and planning processes?
• How will community representatives monitor the progress of the Universal Access?
• What role are community representatives playing in terms of national scale-up of access?

AFAO position:

AFAO encourages representation and involvement of community in all processes of the universal access campaign, encourages ambitious and specific targets, and strong leadership by all partners concerned, particularly national governments, to attain this goal.

AFAO intends to participate in the key regional and international meetings which contribute to the establishment of the Universal Access framework and its monitoring during the years 2006-2010, with a particular focus on strengthening input by our partner communities at the national, regional and international levels.

Download Statement with attachments (PDF, 83KB, 12 pp):

• Scaling Up Towards Universal Access - Concept Paper (UNAIDS, 27 Dec 20005)
• Scaling Up Towards Universal Access - Issues Paper (Global Steering Committee on Universal Access, 9-10 January 2006)

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Learning from Each Other:Technical Assistance and Monitoring and Evaluation Workshop

for the South Asia Collaborative Fund for HIV Treatment Preparedness

Chennai, India: 25 – 29 April 2006

From 25 – 29 April 2006, nearly forty community advocates from India, Pakistan, Bangladesh and Nepal gathered in Chennai for a technical assistance and monitoring and evaluation workshop as part of the South Asia Collaborative Fund for HIV Treatment Preparedness. Workshop participants were members of the Regional Advisory Committee (RAC) for the International Treatment Preparedness Coalition (ITPC) and the Collaborative Fund, and project managers and representatives from the 21 projects who received small grants from USD 8,000 – 20,000 as part of first round grants for the Fund. The focus of the workshop was on sharing lessons learned between the grantees and bringing technical assistance to grantees in the form of sessions on topics such as monitoring and evaluation. Members of the RAC also spent a day planning for the 2^nd round of grants. The logistics of the meeting were organized by the Indian Network of PLWHA ( INP+). Funding for the meeting was through the Collaborative Fund as administered by Tides Foundation.

The three day program included:

• An overview of the status of treatments access in the four participating South Asian countries
• Presentations on the funded projects
• Sessions on developing strategic plans on treatments advocacy, human rights, and monitoring and evaluation.
• Panel discussions on producing treatments literacy materials and access to treatment for marginalized groups.
• An update on ARVs and co-infections

While individual projects are doing positive work in terms of reducing stigma and discrimination, building capacity of PLWHA groups, and working with healthcare providers to improve counseling and treatments education, none of the countries has widespread treatments access. At the International Treatment Preparedness Summit in Capetown in March 2003, a report was given on the state of treatments access in South Asia, where only a handful of individuals were receiving treatment. There were no CD4 testing facilities at the time and only a few voluntary testing and counseling centres throughout the entire region. Three years later, there has been a lot of change – but still not enough! Representatives from each of the four countries estimated that:

• In Nepal, there are now over fifty VCT centres with over 500 people now on ARVs, about 400 through the government, and 100 – 150 through NGOs.
• In India, as of February 2006, there are 26231 PLWHA on treatment supported through NACO ART Supported Centres, 766 in State ART Supported Centres, 3699 in NGO supported ART centres, 2327 in Sectoral supported centres, and 2399 in Private centres. The total is: 35,422
• In Pakistan, currently 109 persons are on treatment, mostly through government hospitals
• In Bangladesh there are five VCT centres, and two NGOs are providing ARVs to about 50 people.
• In each country, there is a huge gap between what is being provided and what is being needed (i.e. the estimated need in India as of May 2005 was 500,000)
• There is a huge discrepancy in each case between government estimates and WHO estimates of numbers of PLWHA.

Other key treatments issues are the lack of second line regimens and pediatric doses, and the high costs of tests.

A call for submissions for applications to the South Asian Collaborative Fund will be distributed widely at a later date. Grants are available only to groups working in South Asia on treatment access issues.

Download full workshop report (PDF 109 KB 30 pp)

Enquiries about the Collaborative Fund in South Asia should go to Loon Gangte, regional coordinator, atloon_gangte@yahoo.com.