Stigma and discrimination against people living with HIV is commonplace in the Amazon region of Brazil. In an effort to change attitudes and increase awareness about AIDS, people living with HIV in the heart of the Amazonian territory have come together to try to encourage people to learn about the epidemic and break down AIDS-related stigma.

Credit : UNDP/C. Goldgrub
RNP+ is providing support to native Amazonians living with HIV

“In the northern region of Brazil, living with HIV is very difficult,” said Laurinha Brelaz, who has been HIV-positive for 13 years. “It is hard to get information, to show our faces and be open about our HIV status. The afro-Brazilian, native indigenous and Amazonian river people living with HIV are in constant fear of discrimination and stigma,” she explained.

Mrs. Brelaz is a member of Rede Nacional de Pessoas Vivendo com HIV/AIDS (RNP+), a Brazilian network of people living with HIV, based in São Paulo. RNP+ was created more than ten years ago and began working in the Manaus area of the Amazon State last year. The network seeks to support people living with HIV and focus on HIV prevention projects for native Amazonians.

“We want to support the Brazilian government in building public health policies. In the Amazon State, many people living with HIV are mistreated by public health staff. There are many cases of discrimination, especially towards HIV-positive women who particularly suffer prejudice. If we raise awareness about HIV in public opinion, people living with HIV will be confident enough to show their faces as part of society,” affirmed Mrs Brelaz.

Credit : UNICEF/BRZ/J.Simões
Native Amazonians often live in remote areas with little or no access to health care systems

According to a Brazilian Health authorities report, AIDS incidence in Amazon State increased from 3.7 cases per 100,000 inhabitants in 1994 to 15.7 in 2004. “In the Northern states the biggest challenges are related to access to health services. This is mainly due to geographical obstacles, and the need to expand the structure of health services to treat the local population. In order to strengthen the response to AIDS in the region, we need to improve health care systems, and encourage the involvement of civil society organizations,” said Mrs. Mariangela Simão, Director of the Brazilian National Programme on Sexually Transmitted Diseases and AIDS.

 

Credit : UNICEF/BRZ/J.Simões
By 2004, AIDS incidence had grown to 15.7 cases per 100,000 inhabitants in the Amazon state

The response to AIDS in the Amazon also goes beyond health issues. Recently RNP+ Amazonas mobilized civil society to participate in a Workshop for Awareness of Social Actors on HIV/AIDS sponsored by UNAIDS and ILO. “In the Amazon, there is a great opportunity to scale-up access to services for people living with HIV. A successful response cannot be achieved without the full engagement and participation of people living with HIV,” said Dr. Laurent Zessler, UNAIDS Coordinator Brazil. This partnership aims to develop actions on HIV in the workplace, including support to workers living with HIV in the Amazon region. The participants received information and material on HIV from UNAIDS, ILO, the Brazilian National Programme and various NGOs. The project also received support from local and State governments and National Trade Unions in the region.

Credit : L. Brelaz
Laura Brelaz, member of the Brazilian network of people living with HIV - RNP+

Partnerships between domestic and international actors are becoming increasingly fundamental to working on AIDS issues in inland Brazil. Mrs. Laurinha Brelaz represents the network of people living with HIV in the UN Expanded Theme Group on AIDS. “In the beginning of the epidemic, people living with HIV used to feel very alone. Nobody knew what HIV or AIDS was. So, people living with HIV built-up this network. Today, we are known internationally,” she explained proudly. “Our goals are to fully participate in the decision making at all levels, including state and municipal health councils and AIDS commissions, in order to build health policies together, fight for a high quality public health system and restore our dignity,” she said.

The work, led by Brazilian civil society in the Amazon region, still depends on strengthening their financial sustainability. “Financial issues are still the main obstacle we need to overcome. We are receiving some resources from National and local governments, but we intend to approach international sponsors as well,” Mrs. Brelaz highlighted. When asked about plans for the future, Mrs. Brelaz answered, “In the Amazon we intend to implement the same standard of quality of life for people living with HIV as in other areas of Brazil.” Now RNP+ Amazonas are planning for the next annual meeting of people living with HIV in the region.

 

Ms Ulla Schmidt, Federal Minister of Health of Germany welcomes Dr Peter Piot, Executive Director of UNAIDS

The emerging epidemics in Eastern Europe and Germany’s commitment to increasing HIV awareness were one of several topics under discussion with German Health Minister Ms Ulla Schmidt and Dr Peter Piot the Executive Director of UNAIDS. On his recent trip to Germany he also met with the Health Committee of the German Federal Parliament, the State Secretary and Parliamentary State Secretary, the National AIDS Council. Dr Piot also met with the Minister for Cooperation and Development, Ms Wiezcorek-Zeul to talk about the importance of keeping AIDS high on the agenda during Germany’s presidency of the G8 in 2007.

UNAIDS Executive Director was in Germany from 26-28 September to participate in a range of meetings to discuss ways forward and continued commitment to the AIDS response.

The visit kicked off with a meal at the Kaffee Graefe, a café in Berlin run by people living with HIV. The café is part of a project to train people living with HIV, particularly migrants, to give them skill sets which will help them to integrate more easily into the workplace. As well as the café there is a successful catering business where people are trained in cookery and catering, waitering and waitressing, and small business management. Dr Piot was joined for the dinner by representatives from the German AIDS organisations Deutsche AIDS Hilfe, Aktionsbündnis AIDS, Seutsche Siftung Weltbevölkerung, Deutsche AIDS Siftung and Positive Aktion, to exchange views and discuss AIDS related issues and concerns.

(left to right): Mr Gernot Erler, Minister of State at the Federal Foreign Office, Germany; Dr Peter Piot, UNAIDS Executive Director; Dr Christoph Zöpel, President of the German United Nations Association, Deutsche Gesellschaft für die Vereinten Nationen DGVN at an event organized by the German United Nations Association and the Federal Foreign Office of Germany.

Highlighting UNAIDS as a test case for UN reform, Dr Piot presented at an evening event organised by the German United Nations Association and the Federal Foreign Office of Germany.

On the last day, Dr Piot met with the Head of the Office of the Federal President and the Committee for Economic Cooperation and Development. He wrapped up the visit with discussions on ways of building on existing partnerships in countries with the Managing Director of the German development agency GTZ and German development bank KfW.

Related links

View photographs from Executive Director's visit to Germany
Kaffee Graefe

When young housewife and mother Kiri* learned she and her young son had tested positive for HIV, she didn’t know where to turn. “I had so many problems hidden in my heart. I didn’t dare tell my problems to anyone. Keeping this secret from people made me so distressed that sometimes I wanted to kill myself to escape from this suffering,” she said.

But Kiri found strength and support by picking up the telephone. She dialled the special ‘Inthanou’ (the Khmer word for ‘Rainbow’) hotline – a unique free, anonymous and confidential telephone counselling service established by a local NGO in 2000 to provide vital HIV information, support, counselling and referral – and help was at hand.

“After contacting the Inthanou hotline, I felt relieved and much less distressed after discussing my long-hidden problems. Now I can express my feelings to someone without any fear because: Firstly: No one knows who I am. Secondly: The conversation is confidential. Thirdly: I can discuss issues concerning my personal health problems and receive good advice and encouragement,” she explained.

Kiri is one of many benefiting from the Inthanou hotline. Since its creation in August 2000, the initiative has reached almost 300,000 people, most of them aged between 15 and 24.

The hotline is the result of a partnership with a telephone company in Cambodia, which provides two free telephone lines that are available in all of the county’s provinces. Funded by UNAIDS Cosponsor organization UNICEF, the French Embassy and other donors, the hotline runs six days a week from 11:00 to 20:00 and receives an average of 200 calls per day. In 2005 the hotline received a total of 63,228 calls.

Inthanou employs nine trained counsellors who provide information on HIV and reproductive health and when necessary refer callers to Voluntary Counselling and Testing Centres, as well as other medical services including Sexually Transmitted Infection clinics, access to treatment and care, and networks of people living with AIDS for psychosocial support.

 “The hotline is not only providing information but it is also referring services that are available in the country. In this way the hotline is making a real impact on people’s lives, and is making a difference,” said Fabrice Laurentin, Project Officer for UNICEF Cambodia.

For Kiri, referrals from the hotline have led to her being able to access antiretroviral treatment from a local NGO.  For others, the hotline has had equally positive impacts such as referrals which have lead to people living with HIV being able to access small grant funding to set up businesses.
The hotline is regularly promoted through various media, particularly TV and radio as well as via advertisements in magazines, t-shirts, key-rings and pamphlets that are widely distributed. In 2004 a special poster campaign was conducted featuring some of the country’s top sporting stars. In August 2006, the National AIDS Authority and UNICEF launched another special poster campaign promoting greater awareness of HIV among young women and encouraging them to use the free Inthanou HIV hotline.

“I really hope that this campaign will reduce women’s shyness about AIDS-related issues and encourage them to call the hotline,” said Dr. Loun Monyl, Inthanou Coordinator.

Inthanou also has a web site (www.inthanou.org) which provides online information on HIV and prevention and treatment services, as well as useful advice and testimonies of people living with HIV and other members of the public who have accessed the hotline for more information and assistance.

One young man tells his story on the web site: “I have had sex with my closest friend and I rarely thought about using condoms. I believed that having sex with a man was safe,” he explained.

One day as he was reading a magazine he came across Inthanou’s hotline number, advertising that the hotline provides anonymous and confidential information related to HIV and STDs. He called the hotline and counsellors advised him that having unprotected sex with a male partner, is a high risk behaviour for transmission of HIV and STDs. The counsellor gave him helpful advice about how to reduce the risk of HIV infection. Having consulted the hotline, he acknowledges that the hotline counsellor gave him important information about HIV. “I am now interested in finding out more about issues related to health and HIV. I often call Inthanou counsellors when I have questions,” he said.

“Ithanou is reaching out to all sectors of the population. Its anonymous and confidential service makes it easier for people to start talking about issues that are often taboo. In this way it is encouraging dialogue on issues of HIV and STIs and is helping break down stigma and discrimination,” said Jane Batte, Social Mobilization and Partnerships Advisor, UNAIDS Cambodia.

"You can protecty yourself against HIV, use condoms... If you want to know more about HIV and AIDS, please call 012 999 008/012 999 009" - Poster from the 2004 campaign uses famous Cambodian boxing star to raise awareness.

The hotline aims to build on its current service and, with additional funding, hopes to continue to answer tens of thousands of calls and refer at least 12,000 callers to appropriate government and NGOs medical and non-medical facilities every year.

“We want to reach out and make a difference to as many people as possible. With Inthanou, help is just a phone call away,” said hotline Coordinator Dr Monyl.

According to the UNAIDS Global Report 2006, at 1.6%, adult national HIV prevalence in Cambodia was one-third lower in 2005 than in the late 1990s—due mainly to a combination of rising mortality rates and HIV prevention efforts that helped reduce unprotected paid sex. However, the country is still burdened with one of the worst epidemics in Asia with women constituting a growing share of people living with HIV – an estimated 47% in 2003, compared with 37% in 1998.

*names have been changed to protect identity
Testimonials used in this story appeared first on the Inthanou web site – http://www.inthanou.org

Related links
http://www.inthanou.org
http://www.unicef.org

	"Do you know how to protect your baby from HIV? If you want to know call 012 999 009" Poster from the 2006 UNICEF / National AIDS Authority poster campaign targets pregnant women.
	"Be part of the winning team against HIV/AIDS... If you want more information about HIV/AIDS, please call 012 999 009/012 999 008"   Poster from the 2004 campaign uses a famous Cambodian football player to raise awareness.
	"Someone with HIV can swim with me...If you want to know more about HIV and AIDS, please call 012 999 008/012 999 009" Poster from the 2004 campaign uses a famous Cambodian swimmer to raise awareness.
	“Where to access care and support related to HIV and AIDS? If you want to know, please call 012 999 009” Poster from the 2006 UNICEF / National AIDS Authority poster campaign targets farm worker
	"Run faster than AIDS, use condoms... If you want more information about HIV/AIDS, please call 012 999 009/012 999 008" Poster from the 2004 campaign uses a famous Cambodian runner to raise awareness.
	“Where to do an HIV test? If you want to know, call 012 999 009” Poster from the 2006 UNICEF / National AIDS Authority poster campaign targets female workers

Despite evidence establishing male-to-male sex as one of the driving forces of HIV transmission in Asia and the Pacific, only a few HIV interventions are strategically focusing on prevention, treatment, care and support for men who have sex with men in the region.

The need to build and strengthen programmes for men who have sex with men was addressed at the Male Sexual Health and HIV in Asia and the Pacific International Consultation, held in New Delhi from September 23 to 26, 2006.

The theme of the Consultation ‘’Risks & Responsibilities’’, signifies the increased risks that men who have sex with men face through sexual practices and cultural vulnerabilities, and the risks of not addressing these with adequate, appropriate and sufficiently funded HIV prevention, treatment care and support interventions. This also flags the responsibilities of men for protecting themselves and their partners, and the responsibilities of governments, donors and other stakeholders in ensuring resources and environments that enable good-quality HIV programmes and services for prevention, treatment, care and support.

The International Consultation brought together governments, policy-makers, donors, researchers, grassroots and community based organisations across Asia and the Pacific to provide a space for dialogue and learning, to enable expansion, strengthening and scaling up of strategies addressing male sexual health and related HIV vulnerabilities. In addition, the consultation will provide an opportunity to inform and develop strategic advocacy initiatives and deliberate on key policies related to these issues.

 Visit the "Masculinity in India" website by Jason Taylor (flash, 491Kb)

Speeches

23 September 2006
Inaugural Statement to Male Sexual Health in Asia and the Pacific International Consultation: “Risks and Responsibilities” by Dr. Nafis Sadik Special Adviser to the United Nations Secretary-General and Special Envoy for HIV and AIDS in Asia and the Pacific

23 September 2006 
Statement by Most Reverend Desmond Tutu, Anglican Archbishop Emeritus of Cape Town  

23 September 2006
Speech by Purnima Mane, Director, Policy, Evidence and Partnerships UNAIDS  

23 September 2006 
Opening speech by JVR Prasada Rao, Director, Regional Support Team UNAIDS  

Related links:

Risks and Responsibilities , Male Sexual Health and HIV in Asia and the Pacific International Consultation 

For many years, the international community has been looking for new tools to ensure sustainable financing for development and the fight against hunger and poverty. In this spirit, Brazil, Chile, France, Norway and the United Kingdom have taken the initiative in creating UNITAID, an international drug purchase facility, which will help scale up access to drugs and diagnostics to fight AIDS, malaria and tuberculosis for people who need them most in developing countries. This new initiative is funded primarily by innovative financing mechanisms such as the tax contribution on air tickets.

UNITAID was officially launched on Tuesday 19 September on the day of the opening of the 61st session of the General Assembly of the United Nations. The event was opened with a statement by UN Secretary-General Kofi Annan, followed by a series of statements by Brazilian President Luiz Inacio Lula da Silva, French President Jacques Chirac, Norwegian Prime Minister Jens Stolenberg, Chilean Foreign Minister Alejandro Foxley Rioseco and British Minister for Development Gareth Thomas. Congolese President Sassou N’GUESSO spoke in his capacity as Chairman of the African Union.

“UNITAID is a model of its kind for many reasons. It is an approach that can be made to work rapidly. It is flexible, in that more countries can easily join the original members. And it is a lean mechanism which complements the existing global architecture for health, inside and outside the UN system,” said the UN Secretary General at the opening.

UNITAID is the culmination of long efforts on the part of the international community to mobilize a portion of resources generated by globalization to benefit development.

In 2004, over a hundred countries acceded to the New York Declaration on Action against Hunger and Poverty and 79 countries endorsed the Declaration on Innovative Sources of Financing for Development that was adopted on 14 September 2005 at the United Nations in New York.

The Paris Conference, held on 28 February and 1 March 2006, resulted in the establishment of a pilot group of 44 countries that committed to work on implementing such financing. It was at the end of the Paris Conference that France proposed to create the international drug purchase facility.

“New innovative sources of financing are absolutely necessary,” said UNAIDS Executive Director Dr. Peter Piot on the occasion of the Paris meeting. “The demand for ARVs will constantly rise in the next few years. More and more people will get sick and more and more people will know they have HIV. That’s why it’s so important that we develop long term sustainable funding mechanisms which will allow us to continue treating people in 20 or 40 years,” he said.

At the High Level Meeting on AIDS that took place at the UN Headquarters in New York on 2 June 2006, Brazil, Chile, France and Norway drafted a Joint Declaration on UNITAID outlining its mission, key principles and objectives. Since then, the founding countries and partner organizations have identified priority activities for each disease and determined the way in which UNITAID is to operate.

As of today, 19 of the 44 pilot group countries have taken initial steps to introduce an air-ticket solidarity levy: Brazil, Chile, Cambodia, Cameroon, Congo, Côte d’Ivoire, Cyprus, France, Gabon, Guinea, Jordan, Luxembourg, Madagascar, Mauritius, Mali, Nicaragua, Norway, South Korea and the United Kingdom.

Chile, Côte d’Ivoire, France, Gabon and Mauritius are already implementing a voluntary contribution mechanism. Other countries are preparing to join the UNITAID effort.

The United Nations system is working closely with UNITAID to support the initiative as it moves forward. UNAIDS’ Cosponsor the World Health Organization will host the Fund and the Secretariat of UNITAID.

At its last meeting in June 2006, UNAIDS’ governing body expressed its support for UNITAID as an example of innovative financing. UNAIDS has provided advice and support throughout the conception and development of the initiative and will continue to work with UNITAID, particularly on facilitating relations within the UN system.

Related links
Read the Secretary General’s opening statement
Read the document describing the UNITAID initiative
Visit the UNITAID web site
WHO statement: WHO welcomes launch of UNITAID
February 2006: Feature story - ‘Innovative AIDS funding takes off’

Marcela Romero became a woman in heart, soul and body at the age of 17. This decision changed her life completely. No longer would ‘Marcelo’ (her name at birth) be the favourite uncle or pride of the family. Instead Marcela faced scorn and rejection.

“Knowing that your family wishes you had never existed or listening to the constant question what did I do to have a person like this in the family is very painful,” Marcela explained.

After having to drop out from school in Argentina due to reaction to her new appearance, Marcela was forced to sell sex to survive financially. During this time, Marcela became HIV positive.

Marcela’s experiences are typical of transsexuals in Latin America and other parts of the world as they face rejection from their families, marginalization within wider society and other forms of stigma and discrimination.

Marcela Romero (right of photograph), Coordinator of the Latin American Transsexual Network (REDLACTRANS)

“This is the reality of the gay, lesbian and transsexual population in Latin America. We are permanently treated as fascinating objects for investigation or contempt and not as individuals with rights,” said Marcela, explaining that despite her wish to be considered a woman, she is still obliged to carry and present her male identification papers to keep within the country’s law.  In Latin America, stigma and discrimination of sexual minorities often goes hand in hand with HIV-related discrimination.

“Sexual violence is a reality for many sexual minorities and often sex work is the only viable option to make a living for transgender and transsexual people who are marginalized in mainstream society. Unless HIV prevention and stigma eradication programmes are designed by and for these communities they will continue to be more vulnerable to HIV,” said UNAIDS Head of Civil Society Partnerships, Andy Seale.

Marcela is working hard with others in the same situation as her to respond to and reduce the kind of stigma and discrimination she faces every day. As coordinator of the Latin American Transsexual Network (REDLACTRANS), she recently took part in a meeting in Brazil, in which other representatives from more than 20 Latin American countries gathered to address the issue of discrimination against sexual minorities and its effects on the AIDS response.

(right to left): Dr Pedro Chequer, UNAIDS Country Coordinator for Argentina, Chile, Uruguay and Paraguay; Marcela Romero, Coordinator of the Latin American Transsexual Network (REDLACTRANS)

Within the discussions at the meeting, a strategic guidebook to help fight discrimination against sexual minorities, and reduce its impact on HIV, was presented for discussion. “This guidebook will be a useful instrument for countries, especially those that lack on legislations and laws that ensure the basic human rights to these important populations,” said Pedro Chequer, UNAIDS Country Coordinator for Argentina, Chile, Uruguay and Paraguay. More than 80 countries around the world, especially in Asia, Africa, Central America and the Caribbean, currently punish homosexuality as a crime.

The meeting was an initiative of the Horizontal Technical Cooperation Group (HTCG), that comprises more than 21 Latin American countries, and the UNAIDS Regional Support Team for Latin America.  The guidebook is expected to be ready for distribution later this year.

“We are committed to stopping the crimes and abuses against gay, lesbian and transsexual populations which can lead to a higher HIV risk. This goal can only be achieved through public policies that respect sexual orientation and human rights,” said Carlos Passarelli, HTCG’s Joint Director.

Arturo Diaz, from the Mexican non-governmental organization, Letra S, stated that this type of discrimination “affects the daily lives of the gay, lesbian and transsexual populations in personal, emotional and professional aspects, as well as health”.

As stated in the Declaration of Commitment on AIDS, UNAIDS is working on initiatives to join efforts with governments, civil society and the media of all the Latin American countries to fight stigma and discrimination through coordinated action as part of a wide response to the AIDS epidemic.

The path ahead is long, but as Marcela has seen, stigma and discrimination can be broken down gradually, moving towards the ultimate goal of total eradication. “Before only my best friend would accept me, now my Mum has started to come around as well,” she said. “Things are changing – it’s little by little, but they are changing for the better.”

Related links

Horizontal Technical Cooperation Group of Latin America and the Caribbean on HIV/AIDS
Letra S

PAHO - HIV/AIDS-Related Stigma and Discrimination in the Health Sector
PAHO - Estigma y Discriminación por el VIH/SIDA en el Sector Salud

PAHO - Time to Stop Homophobic Crimes in Latin America and the Caribbean
PAHO - Es hora de poner fin a los crímenes homofóbicos en América Latina y el Caribe

“Every person living with HIV should have access to the treatments made available by medical science and churches must advocate for this to happen,” was the powerful declaration that came out of the first meeting of the current Central Committee of the World Council of Churches (WCC).

The declaration was part of a ‘Statement on churches’ compassionate response to HIV and AIDS,’ which was adopted by the Central Committee (the main decision-making body of the WCC) in Geneva at the beginning of September. The Statement on AIDS is the third of its kind to be issued by the Committee since 1986.

“It is commendable that the Central Committee has produced such a strong statement on churches’ response to HIV,” said Calle Almedal, UNAIDS Senior Adviser, Partnerships Development. “The statement is substantive and will encourage dialogue within the Church on many difficult AIDS-related issues.”

The ecumenical movement has been engaged in the AIDS response for over 20 years.  As early as 1986 the executive committee of the WCC cautioned, “Churches as institutions have been slow to speak and to act, that many Christians have been quick to judge and condemn many of the people who have fallen prey to [HIV]; and that through their silence, many churches share responsibility for the fear that has swept our world more quickly than the virus itself.”

In the newly adopted Statement, the Committee calls on churches and Christians to promote greater involvement of people living with HIV in churches’ response to the epidemic and to adopt inclusive workplace policies for people living with HIV. It also acknowledges that, “Many of us (churches) have been complicit in stigmatizing and marginalizing people living with HIV by their silence, their words and their deeds.”

The statement also recognises that churches need to promote open discussions on issues related to sexuality, gender-based violence and intravenous drug use. It also focuses on areas of churches’ response to AIDS where there is continual disagreement and called for reflection on churches’ response to those who engage in high risk sexual activity or drug use including the appropriate means of prevention.

Photo credit: World Council of Churches.
Rev. Samuel Kobia addressing the Indigenous Peoples'
pre-Assembly meeting, February 2006

“Churches in particular need to correct the flawed theology and practices that equate sin with disease and that put morality over compassion," said Reverend Dr Samuel Kobia, WCC general secretary.

UNAIDS supports churches’ efforts to reach out to their own membership to make all churches safe places for people living with HIV to talk openly without fear of stigma and discrimination. UNAIDS also supports churches in their outreach efforts in comprehensive prevention, care and support for all affected groups and recognizes that their vision on working with AIDS is with a very long term perspective. Furthermore UNAIDS gives technical assistance on AIDS to, and collaborates with, churches working on HIV related theology, and sees this as sustainable development in the AIDS response.

In an effort to encourage churches to be more inclusive of people living with HIV, the WCC recently teamed-up with key partners in the AIDS response including the African Network of Religious Partners living with or personally affected by HIV, the Global Network of People Living with HIV and the International Community of Women Living with HIV on a campaign to provide guidance to churches in encouraging the active participation of people living with HIV in church life.

The WCC's Ecumenical HIV/AIDS Initiative in Africa (EHAIA), launched in 2002 has been encouraging churches to become ‘HIV competent’ in order to; indicate clearly that stigma and discrimination against people living with HIV is against the will of God; understand fully the severity of the AIDS epidemic in Africa; take into consideration pastoral, cultural and gender issues; and use its resources and structures to provide care, counselling and support for those affected. 

Dr Manoj Kurian, the WCC programme executive for health and healing, said “The EHAIA is responding to the burning needs of people. Through its five EHAIA offices the WCC is making it possible for church leaders and their congregations to speak honestly about AIDS, formulate relevant liturgy and theology, and to act practically in response.”

The World Council of Churches brings together more than 340 churches, denominations and church fellowships in over 100 countries and territories throughout the world and represents more than 560 million Christians. For more information visit http://www.oikoumene.org/

Related links:
The Central Committee of the World Council of Churches "Statement on churches' compassionate response to HIV and AIDS"

While the AIDS epidemic in Eastern Europe and Central Asia continues to grow and is affecting more and more societies in this region, the epidemics in Tajikistan and Kyrgyzstan have remained relatively small.

In 2005 UNAIDS estimated that 4,900 people were living with HIV in Tajikistan and 4,000 in Kyrgyzstan. That same year, it was estimated that AIDS claimed less than 100 lives in each country.

During her visit to the region in July 2006, the UN Secretary General’s Special Envoy on HIV/AIDS in Asia and the Pacific Dr. Nafis Sadik, congratulated both countries for their efforts to prevent the spread of HIV, saying that with continued national leadership and international assistance Tajikistan and Kyrgyzstan had a real possibility getting ahead of the epidemic.

However, despite the relatively low numbers of people living with HIV and of AIDS-related deaths in both countries, recent surveys show evidence of growing numbers of HIV infections among injecting drug users, prisoners and sex workers.

(left to right): Dr Amanullo Gaibov, Secretary of National Coordination Committee on HIV/AIDS, Tuberculosis and Malaria of the Republic of Tajikistan; Dr Zievuddin Avgonov, Deputy Minister of Health of the Republic of Tajikistan; Dr Rano Abdurakhmanova, Director of Department on Social, Health, Women and Family Affairs, President’s Office of the Republic of Tajikistan; Dr Nafis Sadik, UN Secretary General’s Special Envoy on HIV/AIDS in Asia and the Pacific; Dr Nusratullo Faizulloyev, Minister of Health of the Republic of Tajikistan (Chair of the Partnership Forum)

“This data is very alarming, since there are many factors that contribute to the spread of the HIV epidemic,” said the Minister of Health, Dr. Faisullaev during a presentation of the country’s National Plan on AIDS. “If we continue the way we do the HIV epidemic will become generalized,” he added.

Underlining her call for continued comprehensive efforts to curb the epidemic, Dr. Sadik stressed that HIV prevention must be the mainstay of the national response, and urged both governments to commit to ensuring that a wide range of prevention programmes are made available to the general population through high-level advocacy and education at the national and regional level. “To be successful, HIV prevention must make use of all approaches known to be effective, not implementing exclusively one or a few select actions in isolation,” said Dr. Sadik.

Dr Sadik also emphasized that all stakeholders must be involved in the response to AIDS, especially with regard to prevention activities. In Tajikistan she met with a group of women’s NGOs and with a group of people living with HIV to learn more about their situation, what they need and how they can contribute to the AIDS response.  

Acknowledging that faith based organizations have a critical role to play, Dr Sadik also met with the rector of the Tajik Islamic University to advocate for greater involvement of faith based organizations. She also discussed with him the importance of preventing and reducing the stigmatization of people living with HIV, promoting tolerant attitudes, the protection of women’s rights in reproductive health and the prevention of sexually transmitted diseases.

(left to right): Dr Nafis Sadik, UN Secretary General’s Special Envoy on HIV/AIDS in Asia and the Pacific and Mr Felix Kulov, Prime-Minister of Kyrgyz Republic.

“Tajikistan and Kyrgyzstan provide living examples that prevention works to contain the epidemic,” said Dr Sergei Furgal from UNAIDS European Regional Support Team in Geneva. “Their efforts should be acknowledged and some countries may find lessons to draw from their experience with HIV,” he added.

Related links
More on Tajikistan
More on Kyrgyzstan

In 2008, top athletes from around the world will gather in China to attempt to run, jump, swim and pole-vault themselves into the records book at the XXIX Olympic Games. And as China warms up to host the games, building of stadiums and amenities across the country, a parallel initiative is taking place to raise awareness about HIV among the thousands of construction workers involved in preparing Beijing for the Olympics.

More than 200 workers gathered at one such awareness raising activity held recently at a construction site in Beijing. Through exhibitions and the distribution of AIDS-related pamphlets, posters, playing cards and condoms, workers were able to find out information about HIV and how to protect themselves and others. A special question and answer session, informative entertainment and other awareness raising activities were conducted.

Organized by the China AIDS/STD Prevention and Control Foundation and the Beijing Health Bureau, the event involved special presentations by UNAIDS Executive Director Peter Piot, the Beijing Construction Commission, a worker on one of the sites and the China AIDS Prevention Foundation.

“Targeting workers involved in the construction of Olympic venues as well as workers at the many other building sites all over China is an extremely important and big task. Migrant workers are often particularly vulnerable and at risk as they are away from their families for very long periods of time and can lack the information and skills necessary to protect themselves from HIV,” said Mr. Joel Rehnstrom, UNAIDS Country Coordinator in China.

The initiative for raising awareness among migrant workers was launched in 2005 by the State Council AIDS Working Committee office together with 12 government ministries. The initiative is being rolled out over 20 Olympic sites over the next six months. With many construction workers coming from different parts of China specifically to build the facilities, the events aim to reach out to as many people as possible from a wide variety of communities and backgrounds and to highlight sport as a key arena for promoting HIV prevention activities, particularly among young people.

In 2004, UNAIDS signed a Memorandum of Understanding with the International Olympics Committee, combining efforts to enhance the role of sports organisations in the fight against AIDS at community and national levels, and to organize AIDS awareness activities with coaches, athletes and sports personalities.

Photo credit: UNAIDS/Li Mingfang

Related links
UNAIDS Executive Director visits China 7-12 September
UNAIDS China website

The guidebooks call it ‘remote’, ‘undiscovered’ – China’s south-western province of Guizhou is home to some examples of extreme natural beauty including China’s largest waterfall, the ‘Huangguoshu’ and the Zhijin Caves, famous for their massive-scale stalagmite stone pillars.

But despite its remote location and idyllic surroundings, the province, like every other in China, is increasingly affected by HIV. From a few individual reported cases in 1993, it is currently estimated that about 37,000 people in Guizhou are living with HIV. There are signs of the epidemic becoming progressively generalized and increasingly women are becoming infected.

With hope and help – A self-help group for people living with HIV in Guizhou

A joint HIV prevention and care project, run by Guizhou provincial authorities, and UNAIDS` Cosponsor UNICEF is making some headway towards tackling the growing figures and at the same time involving people and groups from all sectors in the AIDS response. Established in 2001, the project focuses particularly on young people, tackling the often difficult issue of injecting drug use and its crossover with HIV, as well as providing care and support for people living with HIV.

“The initiative contains three key areas – development of a strategic plan on AIDS involving high-level advocacy and media mobilization; HIV prevention among children and young people in and out of school and within drug rehabilitation centres; and care and support to children living with HIV and their families,” said Christian Voumard, UNICEF Representative and chairman of the UN theme group on AIDS in China.

The project aims to build and involve all key officials and provincial groups in the AIDS response. Vice Provincial Governor of Guizhou Wu Jiafu underlines how the initiative has helped bring people together. “As government officials, we now know how we can work together with multiple sectors to confront AIDS and support people living with and affected by HIV. This network is now implementing the national policies and local policies to support young people, people living with HIV and their families to fight against the disease and its social impact,” he said. 

“Though the resources here are very limited, we’re confident that we can get ahead of the HIV epidemic with the participation of all these young people and people infected and affected,” he added.

Results so far have been extremely encouraging. Provincial policies on HIV have been put in place and training sessions with authorities and project managers are already underway. Since the project’s inception, 45 high schools have developed curriculum on HIV and drug use prevention in eight of the province’s prefectures, reaching more than 70,000 children and young people.

Voluntary testing and counselling services have been set up within seven drug rehabilitation centres across the province. 

“By knowing my HIV status and with all the knowledge of prevention of HIV, I will stop sharing needles with my friends and engaging in high risk sex,” said one young man at the Tongren prefecture drug rehabilitation centre.

Through the initiative, gradually people living with HIV are being brought to the forefront of the response in the province. A number of self-help groups of people living with HIV have been developed with the participation of 50 people living with HIV. More than 100 family members and 26 children and their families participated in care and support campaigns in the prefectures of Guiyang and Tongren, receiving community based care for family life and schooling.

“I never imagined it could be possible that authorities and big organizations would care about us –people living with HIV—and our children,” said one man living with HIV from Tongren prefecture who has been involved in the programme. “I lost my hope because of the pain of disease, social discrimination and poverty, but this is helping to restore the hope by supporting me and my children.”

UNICEF was the first major donor on AIDS in Guizhou province and provided some of the ground work for other donors’ work in the area. Programmes supported by the US Center for Disease Control and the Global Fund to Fight AIDS, TB and Malaria (Round 4) have since benefited from this in their support to Guizhou.

UNICEF will continue to support the project in their new 2006-2010 programme and activities will be expanded to include prevention of mother to child transmission of HIV (PMTCT) and increasing care and support for children affected by AIDS.

The joint project in Guizhou is focusing particularly on young people

“This programme has been an example of bringing together a variety of different groups within the AIDS response – and crucially invovles young people and people living with HIV,” said UNAIDS Country Coordinator for China, Joel Rehnstrom.

“We are seeing the project help reduce numbers of new infections, as well as break down the barriers and taboos of involving people living with HIV – which in turn is breaking down stigma and discrimination related to HIV.”

UNAIDS Executive Director Peter Piot is visiting China from 7 – 12 September to encourage continued leadership and commitment and to mobilize a truly multi-sectoral response to AIDS in China. As part of his visit, Dr Piot is participating in a three-day mission to Guizhou, visiting the Hui Long community and Zhijing County. Dr Piot will meet with representatives of provincial government and city leaders and visit various key sites that focusing on HIV and drug use.

Related links
UNICEF China website
More on China