South Africa

The role of Christian faith in responding to the AIDS epidemic was the focus of a consultation that took place in Johannesburg, South Africa from 28 January to 2 February.

The focus of the consultation was to discuss how Christian faith and practice can deepen engagement, compassion, and effectiveness in HIV prevention efforts -- not simply by focusing on personal behavior, but by addressing the wider social, political and economic injustices in society which make some people more vulnerable to HIV infection.

The consultation, convened by the Ecumenical Advocacy Alliance, brought together 35 theologians, ethicists, practitioners and Christians living with HIV from a broad range of Christian traditions including Anglican, Baptist, Evangelical, Lutheran, Orthodox, Reformed, Roman Catholic and Uniting churches.

"We are fully aware that HIV prevention touches on very sensitive issues in many cultures and faith traditions," said Linda Hartke, coordinator of the Ecumenical Advocacy Alliance. "For us, the most important element of HIV prevention is to break the silence, particularly in Christian communities, that surrounds evidenced- based HIV prevention, including addressing vulnerability and root causes of HIV transmission," she added.

The report of the consultation will be used to promote further theological reflection and networking, building on the long and active involvement of faith-based organizations in the response to AIDS. The report, once finalized, will be available from the Ecumenical Advocacy Alliance.

Atieno Odenyo, regional partnerships advisor for UNAIDS in Eastern and Southern Africa, emphasized the roles and responsibilities of faith communities in the international HIV arena. She challenged churches and faith communities to be involved in HIV prevention on the global, national, community and individual level.

Research shows that 89% of AIDS related home based care givers in the North West Province and Mpumalanga in South Africa were depressed or showed signs of depression. The research was presented at the recent World Federation for Mental Health expert forum convened in Cape Town, South Africa, on 29-31 January 2008.

The study conducted by the South African Depression and Anxiety Group and Wits University South Africa was one of several examples of the growing need for increased access to mental health care for people infected and affected by HIV.

"It is clear from our grassroots partners and members that there is demonstrated need for strengthened mental health services addressing stress management, social support and self-esteem among people living with and affected by HIV”, said the Secretary General of the World Federation for Mental Health, Preston Garrison. “Caregivers in particular, experience high levels of stress and their role can take a substantial mental health and physical toll as they care for the physical, emotional and economic needs of their family members,” he added.

World Health Organization consultant Melvyn Freeman referenced a study in Zambia that showed 85% of pregnant women diagnosed HIV positive had episodes of major depression and many had suicidal thoughts. Another study revealed an increase in depression and suicide among AIDS orphans in East and Southern Africa.

The forum, supported by the Ford Foundation brought together 23 leaders from different specialties within the AIDS and mental health fields, to explore mental health needs for all aspects of the AIDS response. Particular attention was given to the needs of care givers, people living with HIV and vulnerable children - groups identified as often experiencing the most significant mental health challenges as a result of AIDS.

The Cape Town forum was convened in part thanks to the advocacy of national level organizations such as the Zimbabwe National Association for Mental Health which has continually pushed to raise awareness of the need for increased mental health support services for caregivers of people living with AIDS and for children who are orphaned when their parents die of AIDS.

In a key note presentation at the meeting Frank Njenga, President of the African Association of Psychiatrists and Allied Professions, offered an overview of the status of mental health in Africa emphasizing how the trauma of AIDS experienced by individuals, families and communities has significantly increased the need for an urgent scale-up of comprehensive mental health services that work in collaboration with national and local AIDS programmes.

A series of roundtable discussions explored gaps in mental health that need to be addressed in order to optimize the well-being of people infected or affected by HIV in Africa. Among the issues considered was the need to better understand how mental health problems increase the vulnerability of individuals to HIV infection and the need to train health care workers in order to reduce the mental health and HIV related stigma.

It was also highlighted by the participants that any new intervention should seek to support the greater empowerment of people with mental health problems to respond to their own HIV needs.

Furthermore, participants also underlined the need for a greater standardization of mental health and well being programmes to strengthen the many community based initiatives already focused on psycho-social support.

"The relationship between HIV, mental health and the pursuit of well-being is multi-layered and offers many opportunities for strengthening, scale-up and increased collaboration,” said Andy Seale, UNAIDS Senior Advocacy Adviser, East and Southern Africa Region. “Many aspects of HIV-related mental health needs have been addressed at the community level for years. However, local needs - particularly of people living with HIV and those with an increased care burden - are often inadequately addressed and programmes remain under resourced and could benefit from increased international support and advocacy,” he added.

In conclusion, it was agreed to move forward in mobilizing an Africa-wide initiative to address the complex and multiple interactions between mental health and AIDS through a focus on community-level mobilization.

The initiative will seek to mobilize further interest at the African Psychiatric Conference to be held in Ghana in April 2008, compile an online directory of joint HIV and mental health resources, develop a series of policy papers and information packs for key workers, and convene a partners' conference in early 2009 exploring the mental health consequences of AIDS for people living with HIV, their families, caregivers and communities.

“UNAIDS welcomes the involvement of Islamic religious leaders and scholars in the response to AIDS,” said UNAIDS Director of Partnerships and External Relations Elhadj As Sy during the plenary address of the ‘Islam and AIDS’ conference taking place in Johannesburg, South Africa, from 26 – 30 November. “The key messages of this conference are to halt the spread of HIV, care for the sick and eliminate stigma and discrimination faced by people living with HIV,” he added.

Hosted by Islamic Relief Worldwide, the conference brings together Islamic scholars from a diverse range of Islamic traditions, AIDS practitioners and people living with HIV to help generate and develop practical responses to AIDS by the Islamic community. “The conference aims to develop and subsequently apply approaches to AIDS which are both effective and Islamically sound. These approaches will be jointly developed and will be based on Islamic teachings of trust, respect and other examples of good practice. They will also build upon existing Muslim and interfaith declarations related to AIDS,” said the organizers.

Declarations of intent will be issued by each of the conference participants, stipulating what participants will do to contribute to addressing AIDS and to dealing with its consequences for individuals and communities.

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Links:

Visit the official web site of the conference

UNAIDS is working in partnership with NAM to provide news reports on key scientific findings and other important developments from the 38th World Lung Health Conference, taking place in Cape Town, South Africa from 8-12 November.

All stories featured here below were written by NAM and housed on the NAM web site.

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200,000 die each year because world still failing to treat HIV and TB together
HIV programmes are still failing to integrate TB prevention and care into their work, and TB remains the biggest killer among HIV-positive people as a result, experts and advocates said on the opening day of the 38 th World Lung Health conference in Cape Town.

“If we screened all people living with HIV for TB, we could save thousands of lives,” said Dr Alasdair Reid, TB/HIV Liaison at UNAIDS.

To read the full news report, go to http://www.aidsmap.com/en/news/EB1B111D-F861-4F76-8AA1-40FD572044D8.asp

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Focus on MDR TB threat
The growing problem of multi-drug resistant (MDR) tuberculosis threatens to derail TB control efforts unless there is greater investment in control and diagnosis, TB experts warned this week in the run-up to the 38 th World Lung Health conference, which opened on Friday in Cape Town, South Africa.

This year’s conference is taking place in South Africa in order to highlight the growing challenge of drug-resistant tuberculosis in the regions of the world most seriously affected by HIV.

Last year’s discovery of an outbreak of extensively drug-resistant TB among HIV-positive patients in the rural KwaZulu Natal town of Tugela Ferry rocked the worlds of TB and HIV treatment, and highlighted the need for greater integration of TB and HIV care.

“XDR TB is a wake-up call to ensure a better future of HIV treatment by strengthening TB control,” said Dr Haileyesus Getahun of the World Health Organization Stop TB department, speaking at a workshop on XDR and MDR TB in the context of HIV, organised by the Treatment Action Group and the Stop TB Partnership.

To read an extended report on MDR and XDR TB from the 38 th World Lung Health Conference in Cape Town, go to http://www.aidsmap.com/en/news/40A6BE12-72BC-4B9E-ACBE-9348DD330091.asp

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Key scientific findings from the conference:
 

Tugela Ferry XDR TB outbreak continues to grow

Two hundred and sixty-six people in the South African town of Tugela Ferry have now been diagnosed with XDR TB in the world’s largest outbreak of extensively drug-resistant TB. A further 205 cases of MDR have also been discovered, and eight staff at the Church of Scotland Hospital, Tugela Ferry, have died of MDR or XDR TB. Eight-four per cent of all XDR TB patients have died, Dr Tony Moll reported.

Southern Africa becoming MDR hot-spot

Re-analysis of MDR TB reports by Dr Ruth McNerney of the London School of Hygiene, using available data, shows that ten out of 20 regions with the highest incidence of MDR TB per 100,000 inhabitants are in southern Africa, and eight of ten are in South Africa. The highest incidence was found in the Karakalpakistan district of Uzbekistan (35 cases per 100,000), with Kazakhstan ranked second (22 per 100,000), and four provinces of South Africa (Limpopo, North-West, Mpumalanga and KwaZulu-Natal) reported 1 – 15 cases per 100,000 notifications.

Dr McNerney noted that although MDR TB cases comprised a low proportion of total TB cases in the region, the population incidence was nevertheless high.

MDR TB risk elevated in HIV-positive TB cases in Ukraine

An analysis of all TB cases in the southern Ukraine district of Donetsk, a large industrial city also seriously affected by HIV, has found that among 1293 consecutive TB patients diagnosed smear-positive between July 2005 and June 2006, 15.5% of those diagnosed with TB for the first-time had MDR TB. Among those previously treated for TB, 41.5% had multi-drug resistant TB.

The Ukrainian researchers found that 21% of their TB patients were HIV-positive, and that the rate of MDR TB was significantly higher in HIV-positive patients, who had a 50% higher risk of being diagnosed with MDR TB as their first TB infection.

Intensified case finding of TB cases in people with HIV: look for multiple symptoms

Studies from Cambodia and Ethiopia suggest that encouraging health providers to look for a range of symptoms, rather than just cough, may yield a higher rate of TB case identification in HIV-positive people.

Research in Cambodia reported by Dr Michael Kimerling and Dr Kevin Corn found that a cough lasting three weeks was a less sensitive predictor of TB than prolonged fever and sudden weight loss within the previous month, while research in Ethiopia found that screening only for cough would miss 56% of cases in HIV-positive people.

Current WHO guidelines for identification of smear-negative TB (which is more common in HIV-positive people) recommend looking for a number of symptoms, including cough, prolonged fever, weight loss, night sweats and swollen lymph nodes. Symptoms other than cough may be particularly important indicators of TB in patients with extrapulmonary TB (outside the lungs), which is also more common in HIV-positive people.

MDR death rates lowest in South Africa where patient-centred approaches followed

Patients in the North-West province of South Africa have the lowest risk of death from MDR TB when compared to the rest of the country, probably due to a patient-centred treatment approach, a national survey has found. Incentives such as nutritional support, transport to visit the MDR treatment centre after follow-up, a dedicated transport network for MDR patients and active follow-up for defaulters resulted in a 9.5-fold lower risk of death compared with Eastern Cape province, and 4.2-fold lower risk of death compared to Gauteng.

HIV-positive MDR patients, regardless of their location in South Africa, were 3.6 times more likely to die, and those with ofloxacin resistance 4.2 times more likely to die. All differences were statistically significant.

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Link:

Read more on the conference
Visit the oficial web site

More than 3,000 delegates are expected to attend the main annual conference on tuberculosis, which starts today in Cape Town , South Africa . This year’s theme for the 38 th Union World Conference on Lung Health is "Confronting the challenges of HIV and Multi-Drug Resistance in TB prevention and care”.  In addition to the focus on HIV, the conference will also deal with other key international lung health-related issues, such as tobacco control, child lung health and asthma.

It is particularly fitting that this year’s conference, with its emphasis on HIV and TB co-infection, is being held in South Africa, a country that is working to deal the medical, health, social and economic consequences of HIV and TB co-infection, in the face of resource constraints and other serious challenges.

The conference is organized by the International Union Against Tuberculosis and Lung Disease and runs through Monday 12 November.  Regular reports from the conference, developed in collaboration with Aidsmap, will be posted on the UNAIDS website.

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Links:

Visit the conference web site
Go to Aidsmap’s guide to TB and HIV
Visit WHO’s tuberculosis web site

“What do you want to do when you grow up?” “Play cricket for South Africa!” the six boys cried out in unison when asked about their future aspirations.

The group of 9- and 10-year-old ‘mini-cricketers’ from Alexander Township on the outskirts of Johannesburg, were at Wanderers to meet some of their heroes from the Bangladeshi cricket team, here to participate in the ICC World Twenty20 2007, taking place in South Africa from 11 to 24 September.

The youngsters are all involved in the sports programme of loveLife – South Africa’s national HIV prevention programme for young people. The programme aims to introduce sport and develop interest and skills of underprivileged children who may not otherwise have the opportunity to play organized sport and instead turn to ‘risky’ behaviours that make them vulnerable to HIV infection. As in all loveLife programmes, HIV prevention messages are integrated into the sporting activities.

“LoveLife focuses on the next generation of South Africans”, said Rudy Van Rensburg, the organization’s outreach coordinator. “Some 95 percent of 15-year-olds in South Africa are HIV-negative currently and it is our responsibility to keep them free of the virus. All of our programmes teach positive living, whether through sport or self-development, motivating them to reach their future potential.

”LoveLife, together with the ICC, UNAIDS, UNICEF and the Kaiser Family Foundation, have joined together in a unique partnership to highlight the situation of children and young people living with and affected by HIV through the global game of cricket.

The Bangladeshi cricket team is the youngest in the international test-playing league, with an average age of only 22. Yet, they have scored a number of impressive successes on the field – most notably the landslide win over top team South Africa at the World Cup 2007. Many put this down to the young age and fearlessness of the players.

“Yes, we are young and maybe fearless because of that,” said 19-year-old wicket keeper Mushfiqur Rahim. “But we’re also very professional and mature when we’re out on the pitch. We are very aware that have a responsibility to each other as teammates and to the nation to do our best.

”This sense of responsibility and leadership are lessons that they, as international cricket players and role models to millions of young people around the world, are keen to pass on to the next generation of ‘mini-cricketers’. They are also qualities fundamental to HIV prevention.

Although Bangladesh has a low HIV prevalence rate compared with other cricket-playing countries, the players are aware that effective HIV prevention is key to keeping the number down and it is particularly important to target children and young people to ensure an AIDS-free generation.

“Young cricket fans look up to us and we have a role to play in teaching them about HIV prevention and how to protect themselves from infection,” added Mashrafe Mortaza, at 24 the veteran of the team. A fast bowler, Mortaza was the world’s top wicket taker in ODIs in 2006. “We are young but take our responsibilities seriously and do what we can to support the HIV and young people awareness-raising campaign of the ICC”. When in India for the World Champion’s Trophy tournament earlier this year, some of the Bangladeshi cricketers filmed HIV prevention public service announcements, as they are doing again here in Johannesburg to be broadcast during the televised Twenty20 matches.

A number of top players from all 12 teams participating in the international tournament will feature in public services announcements for the ‘Unite for Children. Unite against AIDS’ global campaign bringing attention to the ways in which HIV is affecting the lives of children and young people everywhere.

Coming off the pitch, the Bangladeshi players stopped to greet the youngsters, asked about their bowling and batting skills, and happily posed for group photos with the excited boys. A few then joined in an impromptu game of catch, testing the professed skills of these future cricket stars.

The normally chatty Molefe Makubela, one of the six lucky boys, was almost without words following this close encounter with the cricket stars. All he could say, over and over again, was “It was very nice, it was very nice’ - a big grin on his freckled face.

 

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Links:

Read more on the ICC Twenty20 World Championships
Read more on Unite for Children: Unite against AIDS

Neil McCullum wears two caps – star cricketer for Scotland on the pitch as well as a physical education teacher.
     
Squeezing in training sessions and international cricket play when his day job allows, Neil also manages to make time in his busy schedule to support the ICC’s HIV awareness programme by visiting children infected with or affected by the illness.
     
In Nairobi earlier this year to face for the ICC World Cricket League, Neil together with a number of his team mates paid a visit to a local school for children living with HIV to coach a chosen few in the art of cricket.
     
The visit was part of the ICC’s partnership with UNAIDS and UNICEF to raise awareness and reduce stigma around HIV and the impact of AIDS on children and young people through the global campaign ‘Unite for children, United against AIDS’.
     
“We started with a group of six,” related Neil. “But soon more and more children joined in until the entire student body of 60 boys and girls surrounded us, clamouring for our help with their bowling and batting technique!”
     
Smiling at the memory of the visit, Neil then became thoughtful. “My visit that day was a massive eye-opener to the situation of these children,’ he said. “I was touched by their positive spirit and terrific enthusiasm.” He added: “It was a very moving experience and will remain a lasting memory.”
     
When he returns to his own students in Scotland, Neil makes a point of sharing his experiences with them to increase their awareness of HIV and to help reduce the stigma often associated with AIDS.
     
“It is important that young people at home are aware of the disease and of the situation of young people in other parts of the world who may be less fortunate,” explained Neil. “It is important that we come together around this issue and tackle it as a global community. The world must unite against AIDS.”
     
In South Africa to play in the inaugural ICC World Twenty20 2007, being held from 11 to 24 September, Neil, his teammates and all players of the 12 competing teams will be wearing red ribbons to show their support for children and young people infected with or affected by HIV in nine games of the tournament, including the final, to be televised around the world: ‘Uniting the world against HIV and AIDS.

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Links:

Read more on the ICC Twenty20 World Championships
Read more on Unite for Children: Unite against AIDS

The Proteas skipper Graeme Smith is not only upbeat about victory in the ICC 2007 World Twenty20 but also optimistic about how cricket can add to combating HIV among children and young people.

Talking tough to the opponents, Smith, who joins an array of leading cricket icons to aid the “Unite for Children, Unite Against AIDS” global campaign, couldn’t ignore the attention he was getting from scores of children and young admirers during a training session at Johannesburg’s Wanderers Stadium.

“HIV and AIDS are relevant and pressing subjects here in South Africa. As cricketers we command the attention of the public and the media, and we want to use that to try and better the situation for the children and young people,” he said.

He added: “We have an important role to ensure that the message that says children’s rights and needs take prominence in the fight against AIDS reaches all the relevant people.

”Fielding coach Jonty Rhodes joined the skipper in a short coaching clinic for the children. The smiles on the children and how they treasured the autographed miniature bats by the cricket stars left an impression that cricket has touched them in more ways than one.

The “Unite for Children, Unite Against AIDS” campaign stresses the unacceptable levels of HIV prevalence among children and young people. It also makes a call to action to de-stigmatize the AIDS epidemic and shows how the values of cricket are applicable responses to AIDS while giving greater visibility to children living with and affected by AIDS.

The campaign recognizes the power of world class cricket as a platform to raise awareness of HIV and AIDS, especially among children and young people. The ICC World Twenty20 2007, taking place in South Africa in September, is expected to add impetus to the campaign.

The South African cricketers have also recorded video footage, amplifying key messages overarching the “Unite for Children, Unite Against AIDS” campaign as part of the ongoing awareness programme.

The backdrop to the campaign is the staggering numbers of than 1000 children under 15 dying from AIDS-related diseases every 24 hours. So, far more than 15 million children have lost one or both parents to AIDS.

 

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Links:

Read more on the ICC Twenty20 World Championships
Read more on Unite for Children: Unite against AIDS

Nathan Bracken and Brad Hodge took time out of their preparations for the ICC World Twenty20 2007 to visit a project as part of the ICC’s work with UNAIDS and UNICEF to raise awareness on AIDS.

They visited the loveLife Orange Farm Y-Centre, part of South Africa's national HIV prevention program for youth, to meet young people who both volunteer and attend the project.

Nathan Bracken said: "By visiting projects to raise AIDS awareness, hopefully we can play a role in the ICC's partnership with UNAIDS and UNICEF to reduce stigma around HIV. It is important that projects like loveLife provide opportunities for young people to make informed choices about the way they live their lives and help halt the spread of HIV.

"loveLife Y Centres provide hubs for regional networks of franchise holders, adolescent friendly clinics and outreach programs. They serve as best-practice sites for youth leadership development and adolescent clinical services; training venues for groundBREAKER and loveLifestyle programs; and provide trained facilitators to support the loveLife Games and other outreach programs.

Brad Hodge: "Sport is a great way of inspiring young people and teaching them skills which they can use in all areas of their life. It has been very moving to see how loveLife provides opportunities for young people to develop their confidence by taking part in a range of team sports."

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Links:

Read more on the ICC Twenty20 World Championships
Read more on Unite for Children: Unite against AIDS

Bats flashing. Balls flying. The three young boys, their fingers intertwined in the links

of the wire-mesh fence, watched mesmerized as some of their cricket idols trained on a pitch just outside of Johannesburg in South Africa.

 

The Pakistan cricket team had invited the youngsters from loveLife – the national HIV prevention programme for young people in South Africa – to their training session in support of the International Cricket Council’s partnership with UNAIDS and UNICEF to bring attention to the situation of children and young people living with or affected by HIV.

 

The Pakistan cricket team is among 12 world teams currently gathered in South Africa to play in the inaugural ICC World Twenty20 2007, which is being held at various locations throughout the country from 11 to 24 September.

 

Coming off the pitch after their practice session, the cricketers took time to sign commemorative bats, take photos – and talk to the young boys about the importance of HIV prevention.

 

“Be safe. Be strong. Love life!” said Shoaib Akhtar, arguably the fastest cricket bowler in the world and a clear favourite of the young fans.

 

“AIDS is a challenge for all countries in the world, and especially for cricket-playing countries, which are among the most affected by HIV,” added Kamran Akmal. As the AIDS Ambassador for the Pakistani team, Kamran devotes much of his time to HIV-related activities in his home country, spreading the ‘Play safe’ message. “It must be our common goal to defeat HIV.”

 

Some 40 million people in the world are infected with HIV – nearly 15 million of them living in cricket-playing countries.

 

Pakistani captain Shoaib Malik was the first player to arrive for the training session and the last to leave – a reflection of his responsibility as team leader. “Being the captain of the team is a difficult job. It means giving 110 percent. But strong leadership is important to the performance of any team. It is also important that we show leadership as role models for young people through the world and we are proud to be part of the ICC partnership with UNAIDS and UNICEF.”

 

Pakistan stars and other top players, including South African captain Graeme Smith, Kuman Sangakkara of Sri Lanka and India’s Yuvraj Singh will feature in public service announcements for the ‘Unite for Children, United against AIDS’ global campaign highlighting how HIV impacts on the lives of young people. These will be made available to broadcasters in 105 countries across the world as well as being watched by fans on the big screens at the 27 matches during the tournament.

 

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Links:

Read more on the ICC Twenty20 World Championships
Read more on Unite for Children: Unite against AIDS