Victim of terrorism - the common man

Victim of terrorism - the common man
Shobha Shukla

Recently I had the privilege to hear Mr. Ajit Sahi, the Editor-at-large of Tehelka, speak on the 'Myth Of Terrorist Organisations----SIMI fictions'.

His painstakingly collected and carefully analyzed information speaks of scores of innocent Indian Muslims languishing in the countries' prisons on false police accusations. He feels that it is a premeditated government (read Hindu) campaign to implicate and harass Muslim youth and demonise the Muslim community----all in the name of curbing terrorist activities. His findings indicate that in not a single case has it so far been conclusive that SIMI ( students' Islamic movement of India ) activists were involved in terrorist offences. Police have killed scores of innocent persons during the last several years, wrongly branding them as terrorists, whereas the the real culprits remain untouched. All this has helped to reinforce hatred against the Muslims who no longer feel safe in the country.

However they need not despair, as they are not alone in their fear and mistrust. It is the common ,hapless person on the street who is being hounded by the powers-that-be irrespective of her/his caste, creed or religion. How else do we explain the thrashing of the UPites and Biharis in Mumbai by the Shiv Sena and the Nav Nirman Sena in the name of purging Maharashtrian territory,( thus usurping the right of an Indian citizen to work in any part of the country), unleashing a wave of violence and hatred amongst members of the same religion.

Or the vandalism by the saffron brigade during a recent painting exhibition of artist Manjit Singh in New Delhi . They not only smashed his paintings but manhandled him too, as they thought his works of art to be against Hindu culture.

Or the barbaric burning to death of Rajni Majhi---a twenty year old Hindu girl in Orissa---whose only fault was that she was living in an orphanage run by Christian missionaries.

Or the police firings on the poor farmers who dared to protest against the acquisition of their farmlands at ridiculously low prices by the Government in the name of economic development.

Whether it is the heinous bomb blasts, or attacks on a particular minority community/ caste, or illegal coercion of farmers; the perpetrator is always the more powerful and the victim is the helpless poor. The new world order seems to have fuelled our brutal passion to tread upon the down trodden and to oppress the weak. It could be the State/executive against the minorities; the economically powerful industrialists against the poor farmers; the police excesses on the innocents. Everywhere it is the same blatant signature tune that I am racially/socially/economically superior to you.

A few months ago the son of my sister's domestic help was rounded by the police on a false complaint of theft, with no evidence whatsoever. When she approached a senior police officer, the charges against him were withdrawn, but his poor mother had to shell out a thousand rupees for his release. On top of it a police constable pestered him to name someone else for some other uncommitted crime, just to add numbers to the police record list. Even after his release, the boy and his mother are living in constant fear of the police. This is just one of the several cases which must be happening every day and we seem to have become immune to these indignities as long as they do not affect us directly.

Isn't the police terrorizing the common public with impunity and getting away with it?

Aren't the Bajrang Dal/ Shivsainiks/ political parties terrorizing the law abiding citizens and zealous missionaries and social activists( like Binayak Sen) for their narrow parochial gains?

Isn't the State machinery terrorizing us by usurping the fundamental rights of the common person by forcibly taking away his/her land and siphoning off funds earmarked for flood/ drought/ riot victims?

Isn't our army, deemed to be the custodians of law and order in troubled areas, violating the dignity of women and committing excesses against human rights?

How often have seen traffic rules being broken with impunity and no action taken against the culprits; cases of road rage resulting in deaths;women being subjugated and treated like dirt ( that is if they are allowed to be born) for bringing insufficient dowry/ not producing a male child / daring to exercise their choices.

All these are acts of terrorism unleashed on the weak and powerless by the strong and mighty. It is not just the Muslims, but about anyone and everyone without a political/ economic clout who are living in constant fear of the unbridled and brute force of the executive/ police/ judiciary. It is rare to find an influential person becoming a victim of any act of terrorism.

It is time for the oppressed to stand up in solidarity against all forms of terrorism, irrespective of their faith and affiliations.

The stupid (wo)man on the street ,who has been dumped by all, must stand up in non violent resistance and abide by the truth, ( just like the farmers of Jharkhand and villages adjoining New Delhi ).

We may be grateful to have survived bomb attacks but our spirit is dying and needs to be resurrected.

Shobha Shukla

The author teaches Physics at India's Loreto Convent and has been writing extensively in English and Hindi media. She serves as Editor of Citizen News Service (CNS).

Published in
Thai Indian News, Bangkok, Thailand
News Track India, Delhi
Scoop Independent News, New Zealand
Assam Times, Guwahati, Assam
Indo Asian News Service (IANS)
The Bangladesh Today, Dhaka, Bangladesh
Bihar and Jharkhand News Service
Central Chronicle, Madhya Pradesh and Chhattisgarh
Asian Tribune, Bangkok, Thailand
The Seoul Times, Seoul, South Korea

Regional Perspectives Successes and Challenges - Africa

Orphans and vulnerable children: Communities in need of support.

The Regional Psychosocial Support Initiative for Children Affected by HIV/AIDS (REPSSI) provided the regional perspective for East and Southern Africa during the Technical Consultation on Children and HIV/AIDS in London, 7-8 February, 2006. The initiative is a psychosocial support (PSS) network for children affected by HIV and AIDS. REPSSI operates in 13 countries and has a partner base of nearly 60 organisations in the region working to mainstream PSS into their activities and policies. Ms Noreen M Huni, speaking for the region, told participants that the family system has not collapsed, but is very overstretched. Communities are committed to caring for and supporting the children themselves; extended families, communities, faith-based and non-governmental organisations (NGO) provide the majority of care and support for orphans and vulnerable children (OVC) in the HIV/AIDS context.

In this region, OVC programming has recognised that cultural systems, practices and beliefs are a valuable entry point for successful and sustainable interventions. For example, Malawian initiation ceremonies have included HIV/AIDS prevention messages in their curriculum. The elderly are increasingly taking up this responsibility, yet their own material, physical, social, spiritual and emotional needs remain unmet. The overall capacity to responding is extremely inadequate. Knowledge, skills and resources are far from sufficient. Communities need resources and technical capacity enhancement to manage these resources.
The comprehensive care and support packages provided so far are physical, spiritual and material in nature, ignoring the psychosocial well-being of the children. Thus, there is a huge gap requiring unique interventions to strengthen the existing responses. Access to essential services has been agreed upon but tremendous barriers hinder access to these basics. Access to antiretroviral (ARV) drugs remains limited due to issues of affordability, accessibility and treatment literacy. Children are still not accessing ARVs, which as a priority are given to adults. Appropriate dosages and formulations for children are unavailable.

National Plans of Action are in place and most governments are attempting to address OVC needs with the necessary policies, for example the 'Free Education for All' campaign, although other barriers continue to hinder children from attending school. But there is no legislative review to support the Convention on the Rights of the Child; these rights remain inaccessible to most OVCs. Many OVC have no legal existence at national level due to lack of birth registration - therefore no resources are allocated for OVC. Most countries have no national social policy on OVC - leaving NGOs and faith-based organisations (FBOs) to take the lead in responding.

Government officials have begun to include the plight of orphans in their campaign and advocacy strategies. Schools are becoming centres of care and support. Hospitals are also being used as meeting places for support groups, counselling centres and provide information on the well-being of orphans. Certain print and broadcast media are taking a positive responsibility to educate and create awareness of issues pertaining to children within an HIV/AIDS context. There has also been a major increase in the number of NGOs focusing on OVC issues. But challenges remain - there are too many soldiers and no generals in this fight. It is not clear which ministries are mandated for OVC and what status these ministries have. The OVC challenge has a very low profile among the national governments. Noting that children constitute 50% of the population in most countries, isn't it time to create a special ministry for them?

International funding partners, UN agencies, regional and national political structures have all emphasised the seriousness of the problem. But the funding duration is usually less than 5 years, which ignores the fundamentals of child rights programming. Donors often arrive with pre-planned interventions, rather than supporting existing multi-sectoral responses - searching for 'quick results'. Some interventions are unrealistic, and do not take into account succession plans, such as exit strategies. A lack of coordinated donor activities is reported in most African countries and information-sharing is limited between funding partners and recipients. FBOs and CBOs often do not have the technical capacity to access available funds. An additional problem is that regional political structures (i.e. Pan African Parliamentarians, AU, SADC and NEPAD) have failed to mainstream OVC in regional HIV/AIDS, poverty reduction and budgeting and planning frameworks.

UNICEF in collaboration with REPSSI and some African universities have started working on a 'Children at Risk' certificate level programme for child care and support service providers in response to the knowledge and skills gap. Children, families, communities, non-governmental and faith-based organisations are providing the majority of OVC with care and support. But there is an urgent need to make these interventions more visible and respected by the communities themselves, before trying out 'new' interventions. The programme for orphans and vulnerable children should be high on the international, regional and national agendas. The nature and duration of interventions should ensure there is no additional trauma by placing the child and family at the centre of the programmes.

Ishdeep Kohli-CNS

More ways to change...Same sex relationships and stigma

During the first plenary of the conference, Anandi Yuvaraj, from the Programme for Appropriate Technology in Health (PATH) in India, described the discrimination she personally faced from relatives - and also how she and her close family were able to shift their attitudes by showing open acceptance of her HIV status.

Stigma and discrimination was also the highlight of one of the following sessions, which focused on consulting community when addressing the needs of men who have sex with men (MSM) in China. Mr Xu Jie outlined some of the ways in which the government in China is now partnering with the MSM community. This is in stark contrast to a few years ago when the government did not even mention MSM. According to Edmund Settle, from UNDP in China, the government now sees the MSM community as a partner in AIDS programmes. This has led to increased funding for MSM groups at both the national and local levels.

In a presentation from Japan in the same session, Jane Koerner described the situation for young MSM in central Japan, where homosexuality is largely invisible in society - as a result, MSM groups in the country have not been mobilized and funds are in short supply.

As part of the discussion, the question arose of whether reducing stigma is the government or civil society's responsibility. Jan W De Lind, from UNESCO in Bangkok argued that society follows policy.

"If there is a legal policy in place then the society is expected to abide by it," de Lind commented. "Policy-makers should follow evidence; there is good data available now about the rising HIV rates in the MSM communities. Collaborating with MSM communities is a good way forward."

Participants had an active discussion, stressing that public health researchers should play a stronger role in pushing the government towards framing policies to reduce stigma and discrimination.

Ms Revati Chawla, the Sri Lankan co-chair, remarked that leadership at the community and government levels plays an important role in reducing stigma and discrimination. The other co-chair, Mr Aditya Bandyopadhyay from India, highlighted that same sex discriminating laws exist in India, Pakistan, Sri Lanka, Bangladesh, Malaysia and Nepal.

"Legal reforms should be the first step," he commented.

Some of the participants agreed that if international pressure on governments in these countries to reform the laws would be helpful. Collective measures across countries could play an important role in ensuring that governments repeal laws that discriminate and block interventions for HIV prevention work among same-sex communities.

Representatives from the MSM group Bandhu, from Bangladesh, argued that HIV is a good background to start mobilizing work with the MSM communities and partnering with governments. Even in India, which is in the process of drafting the anti-discrimination law, it is being suggested that the idea of a 'safe-area' of working with MSM groups as part of HIV prevention work is being accepted has been identified as part of the way forward.

Ishdeep Kohli-CNS

World Ozone Day (16 September) and our commitments

World Ozone Day (16 September) and our commitments
Vasu Shena Misra

September 16 every year is observed as "World Ozone Day". The celebration of this day is made to pay our homage to the ozone layer, that saves our earth from the harmful ultra-voilet radiation of the Sun.

The life on the Earth , depends on the energy provided by the Sun in the form of various radiations.

* Out of total energy received by the Earth, 35% will be reflected back to the space by the clouds, dust-particles and ice particles present in the atmosphere.
* 14% of the energy , which comes in the form of ultra violet radiation gets absorbed by the ozone layer, thus saving the earth from the harmful effects like over warming of the Earth or diseases like cancer
* 34% of the energy is radiated back from the Earth in the form of direct solar radiation and 17% radiated back from the Earth in the form of terrestrial radiation.

The part of the energy radiated back from the Earth unabsorbed is called "Albedo". Average Albedo ranges between 29% to 34%. Because of the artificial cover provided by the green house gases the Earth surface is unable to reflect the total energy thus gets heated. So lesser the Albedo more will be the temperature on the Earth and viceversa.

Besides this the tarnishing of ozone layer provides the way to ultra violet rays to enter in the Earth's atmosphere which can cause great destruction , catastrophies (famines ,droughts etc.) and diseases like cancer.

The fact that the density of ozone layer reduced considerably making the situation more horrified. (from 1956 to 1970 the density of the ozone layer was nearly 280 to 325 doveson which in 1994 got reduced to mere 94 doveson. The density has been on a decline since then.)

The gases which are responsible for increasing the Earth temperature artificially are called "green house gases " which includes:- carbon di-oxide, methane, chloro floro carbon (CFC), sulphur herxa-floride, nitrous oxide, perflorocarbon. These gases are called green house gases because they increase the temperature in the glass house made artificially to provide higher temperature in colder areas which in turn helps plants that are native to warmer climates, to grow in the hilly areas.

The gases like CFC, or carbon di-oxide have been used in the modern appliances like air-conditioners, refrigerators, fire extinguishers etc. So its looks like where there is more industrialisation there is greater chance of causing harm to the ozone layer.

But the reality is unbelievable and horrifying. Unbelievable because the ozone hole was discovered in the polar regions where there is negligible industrialisation and horrifying because this reality can cause more destruction in less time. The reason behind this reality is the polar stratosphere clouds provide basis for chlorine molecules (present in the CFC) to act freely in the colder regions ( as in polar regions) and in the presence of sunlight in the Antarctica region the chlorine molecules attacks on the ozone molecules (O3) and kill them in the process. More damaging fact is this molecule could have a life of 45 years to 250 years. This is also causing the glaciers to melt.

The recent report of the Inter-governmental Panel On Climate Change (IPCC) states that Earth's temperature has increased by 0.74% in the past hundred years. Its effects are disastrous like:

* Unexpected increase in the sea level that can submerge low lying regions including UK
* The melting of glaciers like Himadri in India, which will first result in floods and then a long lasting drought
* Exposure to ultra-violet rays can up the risk of cancers
* Unexpected climatic changes

USA which pretends itself as a global leader, is also the biggest producer of these harmful green-house gases (nearly 30%) but hasn't signed the "Kyoto Protocal" - a legally binding global treaty for reducing the emission of these gases.

To efficiently deal with this current fearsome situation, we have to take stringent steps. Some are:-
1. Save trees as they save life by inhaling harmful gas carbon-di-oxide.
2. more sustainable behaviour in our daily lives like saving energy at every step.
3. To use technologies which are environment-friendly, like bio-fertilizers.
4. The expansion of carbon trading by the developed countries from developing countries.
5. Globalize the technologies to the under developed nations that supports the climate.

Let us act now before it is too late.

Vasu Shena Misra
(The author is a development activist who did his post-graduation from University of Lucknow. He serves on the CNS board of writers)

Published in
Thai Indian, Bangkok, Thailand
News Track India, Delhi
Bihar and Jharkhand News Service (BJNS)
The Seoul Times, Seoul, South Korea
Khabar Express, Bikaner, Rajasthan
Pakistan Post, Karachi, Pakistan
Central Chronicle, Madhya Pradesh/ Chhattisgarh
My News, Delhi
Assam Times, Guwahati, Assam

Creating a national enabling environment for AIDS vaccine trials - China Interview with Dr Joan Kaufman

1. HDN: China is an important player in the global effort to find an AIDS vaccine. The second phase I AIDS vaccine trial was launched in 2005 in China. What lessons have been learnt and what have been the results of the trial?

JK: The trial was launched in Nanning, capital of Guangxi Zhuang Autonomous Region, in March 2005 in China. The clinical trial indicated that the vaccine is safe. But there will be further testing with this product to determine its immunological effect and ultimately its efficacy. The vaccine trial was conducted under the guidance of the local provincial CDC in Guangxi; this was a wholly owned Chinese venture. The trial created an understanding around issues relating to safety and recruiting of volunteers for AIDS vaccine trials in China.

2: HDN: Community Advisory Boards (CABs) play a significant role in linking communities and researchers to help facilitate the introduction of education and prevention programs. What is the role of the CAB in China to inform and educate volunteers, and to link the community and science?

JK: The development of AIDS vaccines depends on community participation and advocacy. There is a general enthusiasm for activities such as developing vaccine education materials, organizing ethics committees, and CAB development. While the concept is similar, CABs in China are not necessarily constructed in the same way that CABs are constructed in other countries.

IAVI is in the process of working with its partners in China to foster a more meaningful CAB process. IAVI plans to conduct a CAB assessment in some of the key sites for AIDS vaccine trials. We also plan to hold a workshop later this year regarding CAB efforts in China.

3. HDN: There may be concerns about ethical issues in AIDS vaccine research, such as standards of care, informed consent, risks and benefits to participants and communities, and issues relating to women, adolescents and other vulnerable groups. What steps are in place to ensure that the trials are conducted in an ethical manner and how is the community informed?

JK: We have played a role in vaccine preparedness program in China and we are working with local partners to introduce state of the art international understanding of ethics in AIDS vaccine research to the Chinese research community. We are doing this through a number of different mechanisms. We have translated IAVI's AIDS vaccine literacy materials into Chinese. A number of other publications focusing on ethics in AIDS vaccine research has been translated and widely disseminated to our partner organizations.

A one day satellite meeting on ethics in AIDS vaccine clinical research was held in 2006 at the International Bio-Ethics conference in Beijing, during which we translated a great deal of material for. Chinese speakers.

International experts including Ruth Macklin from Albert Einstein College of Medicine, Ezekiel Emmanuel from the US NIH, and Solomon Benatar from South Africa, discussed issues around the conduct of ethical research related to AIDS vaccines internationally and in China, standards of care and adequate volunteer protection. The report of that meeting will be published shortly.

4. HDN: What is the role of the national government in vaccine research and development? Are there specific political commitments laid out in the by the Chinese government for AIDS vaccine research? Is the level of co-ordination between local governments and healthcare providers satisfactory?

JK: The Chinese government is very committed to AIDS vaccines and they are putting significant resources into research. For example, the new 15 year science and technology development plan includes a large provision for AIDS vaccine research. Some of the provincial governments, such as the Guangdong province, have invested heavily in attracting leading Chinese AIDS vaccine researchers to work locally in state-of-the-art labs

Regarding the link between government and healthcare providers, it is too preliminary right now to say whether it is satisfactory. I can tell you that one identified need in AIDS vaccine clinical trials is for a higher level of understanding among the local healthcare providers. Given the strengthening of the government's response, it seems the link to healthcare providers should be a priority.

5. HDN: The draft blueprint for AIDS Vaccine Preparedness was generated by participants of the CAMS-IAVI AIDS Vaccine Network Meeting in Beijing in February 2006. What are the priority areas of action laid out in the blueprint?

JK: We drafted the blueprint based on the input of the participants in the Network meeting, which included the scientific community members and others working on AIDS vaccine research and vaccine preparedness issues in China.

Based on consensus of the discussion, we laid out an action plan of priority activities. Activities were proposed in five key areas: Community Relations; Stakeholder Outreach; Ethical Issues including Standards of Care; Policy Advocacy; Communicating and Networking. This was made widely available to all the stakeholders, and IAVI is now trying to interest other stakeholders to take on board the recommendations from the blueprint.

There are a number of science groups working on different vaccine candidates, and IAVI has been taking the lead in pushing preparedness issues for the field, such as the CAB process and the national ethics symposium described previously, and a follow-up meeting to provide scientific updates.

IAVI is also supporting a website to provide updates on AIDS vaccine trials in China, and is facilitating translation and dissemination of vaccine literary materials.

Ishdeep Kohli-CNS

Youth Leadership on Sexual and Reproductive Health Issues

Nearly half of the world’s population is currently under the age of 25 and across the globe young people face unique challenges that increase their risk of sexual and reproductive health morbidity and mortality. Young people aged 15-24 account for an estimated 45% of new HIV infections world wide and approximately 6000 people are infected with HIV everyday according to the UNAIDS 2008 report on the global AIDS epidemic. The largest proportion of STIs is believed to occur in young people below the age of 25 years. The Youth Forum at the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) Pre-Congress Activity, Bali, Indonesia focused on meaningful and active youth participation to robust Youth Leadership on Sexual and Reproductive Health issues among Asia and the Pacific region.

The Youth Forum being very vibrant and energetic aimed to strengthen the networks of youth organizations and independent youth activists in Asia and the Pacific. The participants identified and exchanged views on key and emerging issues of concern related to young people. Knowledge, experience and skills were shared among the youth forum delegates. Discussions included better ways to manage and implement youth programs in the future. The forum ensured that young people’s voices, needs and issues will be heard in the Congress and followed after it. These deliberations among the participants will be presented as comprehensive recommendations for governments, UN agencies, non-governmental and international organizations. Skills building training were provided for the youth to be empowered from each others diversity and similarity.

It becomes critical to address the sexual and reproductive health and rights (SRHR) of young people in order to achieve universal access to reproductive health (RH). This being target 5.B of the Millennium Development Goals (MDGs), which is: “Achieve by 2015, universal access to reproductive health”. Access to sexual and reproductive health is a human right, it is a right that all people, including young people are entitled to. The four official indicators for MDG Target 5.B are contraceptive prevalence, adolescent birth rate, antenatal care coverage and unmet need for family planning. These are all important factors, but achieving universal access to RH for young people requires a broader more comprehensive approach to address social, economic, political, environmental and biological determinants of SRH.

Some other important aspects of Universal Access to young people are ensuring access to youth friendly SRH services that include prevention, diagnosis and treatment of HIV and STIs. Comprehensive sexuality education to be provided in formal and informal educational settings that include medically accurate information about sexuality, reproductive, human development, contraceptive methods, STIs and HIV, relationships, decision-making, skills-building to resist social/peer pressure, sexual orientation, body-image and gender relations. Ensuring that youth have access to a variety of modern contraceptive methods and safe abortion services Elimination of harmful practices and gender based violence through policies, programmes and laws that address the social, economic and cultural practices that lead to these practices. Making modifications to the health systems to facilitate the integration SRH, family planning, HIV and STI services. Providing services in a non-discriminatory way to marginalized young people, including YPLWHA, sex workers, injecting drug users, refugees, internally displaced people and undocumented migrants. Young people need to meaningfully participate in the design, delivery and evaluation of SRH interventions.

To achieve Universal Access for sexual and reproductive health and rights to young people it is necessary to foster an enabling environment, with sustaining commitment from governments, community leaders, young people and donors. The right to SRH is clearly articulated in the International Conference on Population and Development (ICPD) Programme of Action (PoA), which was endorsed by 179 UN member states in 1994. The ICPD PoA remains just as relevant today as it did 15 years ago. The PoA’s focus on a rights-based approach to population, health, environment and development issues is pre-requisite to achieve the broader goals outlined in the MDG framework.

Ishdeep Kohli-CNS

Effective Community Involvement in HIV/AIDS Response

Nearly five million people are living with HIV in Asia with 440,000 people acquiring the infection in 2007 and 300,000 dying from AIDS related illness in the same year. If the current rate of transmission continues an additional eight million people will become newly infected by 2020, costing the region $ 2 billion annually and pushing 6 million people into poverty. HIV could emerge as the leading cause of death among 15 to 44 year olds. However Asian nations could avert increases in infections and death and save millions of people from poverty with high-impact interventions, such as HIV prevention programmes focused on key populations and increased antiretroviral treatment. These were among the findings of the "Redefining AIDS in Asia – Crafting an Effective Response" report published by the Commission on AIDS in Asia (CAA). The report believes that governments in Asia have the potential to make the ambitious international targets – 2001 Declaration of Commitment on HIV/AIDS as well as Millennium Development Goal 6 to halt and reverse the epidemic by 2015 a reality if they take the decisive steps set out in this new report.

The independent Commission on AIDS in Asia was created in June 2006 to give an opportunity to look at the unfolding realities of the HIV epidemic in Asia from a wide socioeconomic perspective reaching beyond the public health context. In order to deliver on this mandate, nine leading economists, scientists, civil society representatives and policy makers from across the region were appointed to the Commission, led by Professor C. Rangarajan, Chief Economic Adviser to the Prime Minister of India. While recognizing that epidemics vary considerably from country to country across Asia, the report highlights certain shared characteristics. Epidemics centre mainly around behaviours of unprotected paid sex, use of contaminated needles and syringes by people who inject drugs, and unprotected sex between men. By pragmatically focusing prevention programmes on key populations – commercial sex workers and their clients, intravenous drug users and men having sex with other men, the commission suggested a considerable impact could be made by governments in halting and reversing the number of new infections across this region.

Noting that stigma against HIV patients remains a major issue in Asia’s health care systems, the commission recommended a more meaningful role for civil society and community-based initiatives. Community organizations of Injecting drug users, sex workers, MSM populations and HIV positive people should be involved and engaged in planning and service delivery. National HIV responses tend to be strengthened when community based organizations are able to participate in policy development, programme planning, and implementation. Community participation is essential for reaching people involved in risky behavior with information and services they are likely to trust. Community participation is the key to understand and influence the contexts in which risk occurs, and to help create supportive environments for risk reduction. This is vital in understanding the issues that affect these populations, and to achieve overall transparency and accountability in the HIV response. Enabling environments need to be created to facilitate services and remove obstacles for most at risk groups.

The report called for political, religious, business and local community leaders to speak out against discrimination, repeal laws that discriminated against men who have sex with men, support HIV-prevention services for sex workers and decriminalize intravenous drug use. Interventions should incorporate elements that address some of the other pressing, subjective needs of beneficiaries such as child care for sex workers, legal support for dealing with police harassment, safe spaces that offer shelter against violence, hygiene and medical facilities for street-based sex workers and IDUs. Further vast social security networks must be created with special attention on vulnerable groups, such as women, children and orphans. Necessary support should be provided for setting up and running local community organizations. National programme budgets must include funding for these activities.

The commission stressed that existing resources are not only inadequate but are currently not being spent on priority interventions that produce an impact. At present, donors provided the lion’s share of funding for such programmes, but Governments really needed to invest more. A focused prevention package between 2008 and 2020 will raise condom use among sex workers to over 80%; halve needle sharing among IDUs; a reduction in cumulative infections by 5 million, a reduction in the number of people living with HIV in 2020 by 3.1 million and a reduction in the number of AIDS related deaths by 40%.

Countries in Asia have the resources, technology and organizational capacity to vastly scale up their response, but strong political will, Government leadership and active community involvement of key populations are lacking. Community and civil society involvement should be ensured at all stages of policy, programme design, implementation and monitoring and evaluation. Communities and non-governmental organizations must take the Commission’s report to their respective Governments to demand the legal protection, policy space and the action necessary to stem the epidemic.

Ishdeep Kohli-CNS

South Asia Regional Workshop On the Prevention of HIV Related to Drug Use

Photo by sassenfrazz17th-18th, March 09 - Kathmandu, Nepal

Response Beyond Borders – Over 100 delegates present from the SAARC countries, Iran and Afghanistan are attending the South Asian Workshop on poverty, drug use and HIV. The aim of the South Asian workshop is to bring together parliamentarians, civil society organisations and affected populations (including drug users) to review the challenges to be faced in affecting policy change, reducing stigma and ensuring effective action and interventions to address the gaps in HIV Prevention among risk populations. “HIV does not respect borders so we need to build alliances which go beyond country perimeters”, said Tariq Zafar, the Chair of the workshop. The action plans developed will build on current capacity, identify gaps and respond co-operatively across borders.

With its young democracies and political turbulence the region is all the more vulnerable due to its proximity to the drug-producing Golden Triangle and Golden Crescent regions. Added to this the existing HIV epidemic is adding pressure to the already overburdened health systems. The responses to HIV have seen significant involvement of affected communities, with the notable exception of drug users who are both marginalised and stigmatised. “The position of women drug users is especially neglected, we are a forgotten people”, says Parina Subba, Programme Director of Dristi Nepal. If societies do not address the concentrated epidemic among drug users, the burden of disease will reach breaking point.

This workshop is a follow-up to The First Asian Consultation on the prevention of HIV related to Drug Use, which was held in Goa, India in January 2008. The Goa Consultation recommended that in order to respond effectively to the HIV epidemic, policies that effectively address the health risks associated with drug use should be introduced in all countries. Measures that reduce the stigma and discrimination experienced by drug users and people affected by HIV, should also be taken, to enable provision of effective treatment.

As an outcome of the Goa consultation, three workshops are organised to develop more detailed action plans for specific regions – South, Central and South Eastern Asia. The South East Asia workshop was held in Phnom Penh Cambodia on 8-9, October 2008. The Central Asian workshop takes place in early summer 2009.

The South Asia workshop will focus on the following:

1. Highlight the Continuum of Care and Services and identify capacity, gaps and opportunities for collaborative growth across the region.

2. Identify, review and respond to challenges faced in providing services to emerging populations i.e. wives of drug users, women drug users and young people.

3. Identify, discuss and develop an action plan to ameliorate the criminalisation and incarceration of Drug Users in prisons and custodial settings.

4. Effectively respond to the hepatitis C co-infection epidemic among drug users in Asia.

5. Support parliamentarians in their leadership in introducing enabling policies and achieving a balance between human rights, access to health and law enforcement in Asia and provide parliamentarians and activists with evidence to support their campaigns for change.

Ishdeep Kohli-CNS

Living with the HIV Virus - Challenges for Children

Photo by blmurchAmong the estimated 2.5 million people in India living with HIV/AIDS, 70,000 are children under 15 years old (UNAIDS 2007). Every year about 21,000 children are infected through mother to child transmission and thousands of children are affected because their parents are HIV positive.

Children continue to be ignored and discriminated against in India's fight against HIV. A study carried out by the Population Council of India in collaboration with the Social Awareness Services Organization (SASO), Asha Foundation and Freedom Foundation in three high prevalence states Manipur, Karnataka and Andhra Pradesh, found that less than a fifth of the children had been diagnosed with HIV infection before 18 months of age. The study found that most of the children are diagnosed for HIV when they are 30 months or older thus creating a barrier to accessing care and treatment for HIV infected children. Many children are often tested when one or both parents report positive.

Among the key findings of the study were the difficulties faced by a third of the caregivers in getting a confirmed HIV diagnosis and getting referred to the treatment centres. The study also states that disclosure of HIV status to children is low and the reasons for not informing the children varied from ‘the child being too young to understand’ to ‘fear that the child would tell others in the community leading to stigma and discrimination by society.’

The late diagnosis of the positive status of children indicates a delay in treatment. Late testing also means delayed initiation of co-trimoxazole prophylaxis which prevents life threatening opportunistic infections in infancy. It also means there is a gap with regard to PPTCT (prevention of parent to child transmission) as an entry point for diagnosis and access to treatment. Even the 21,000 children that are born with HIV each year through mother-to-child transmission is due to lack of services including access to preventive medication. Without treatment, these newborns stand an estimated thirty percent chance of becoming infected during the mother’s pregnancy, labor or through breastfeeding after six months. There is effective treatment available, but this is not reaching all women and children who need it. Dr Vaswani, consultant UNICEF, MDACS (Mumbai District AIDS Society), states that even for those children accessing treatment difficulties exist for the caregivers in getting transport to the ART centres across the city for treatment and care.

HIV positive children face discrimination in their everyday life. This stigma and discrimination practiced by the general public against the HIV positive children denies their access to education, health and many other crucial government provided services. Caregivers at the Ashray center for children in Mumbai mentioned that stigma and discrimination continue to be the major challenge in obtaining school admissions for HIV infected and affected children. It is clear from various studies in India, that HIV positive children who are being denied an education based on their HIV status are due to lack of knowledge or awareness about how HIV/AIDS spreads in the general population.

The number of children who are positive and affected by HIV and AIDS, including those who have to head households, care for infected parents and siblings and lose their childhood, is increasing. With every passing day the number of street children and those sold into the sex trade is also increasing, making these children more susceptible to HIV. Now with a large number of perinatally infected children approaching adolescence, issues of adherence, substance use, sexuality, secrecy, peer relationships, vocational training and guidance and planning for the future have become increasingly important.

Children have the right to love, care, affection and protection against exploitation. Providing care and support for those who are infected results in realization of protecting their rights – which is enshrined in India’s ratification of the UN Convention on the Rights of the Child. HIV/AIDS affected children have many of the same needs as other children – good nutrition, exercise, education, love and affection. Beyond these, affected children whether orphaned or not, may have special needs such as counseling, medical treatment, vocational training and encouragement of self-reliance. Legal support may be required in fighting discrimination in schools and medical care settings, also to help with guardianship issues and inheritance disputes. A child’s development is dependent on all of these needs and each must be adequately addressed.

What we need to understand is that -- HIV is a problem for the whole society and the solutions must have the involvement, support and effort of the whole community. Children affected by AIDS need adults (each and every one of us) to voice and protect their rights. Multiple partnerships and collaborations are needed at all levels, with Governments and NGOs, to International Agencies and Donors working together with Health care providers, Nurses, Pediatricians, Religious leaders, Faith communities, Pharmaceutical companies, Industrial houses, Child Advocates, Academic and Research institutions, Media, and legal and human rights activists. Coordination and cooperation through an Intersectoral approach with government commitment at the highest level.

For Children affected and infected by HIV/AIDS the approach is of an emergency. We must put care and protection of these children high on the national HIV/AIDS agenda.

Ishdeep Kohli-CNS

We need to act now on HIV, says Netherlands ambassador

Ishdeep Kohli, CNS (Citizen News Service)

I interviewed Paul Bekkers, the HIV and AIDS Ambassador of the Netherlands, during the first Asian Consultation on the Prevention of HIV Related to Drug Use on 29 January 2008. Bekkers is also the Director of the Netherlands Social and Institutional Development Department under the Ministry of Foreign Affairs and has served the ministry for more than 15 years. He was named Ambassador for HIV and AIDS in 2005.

Forum on Women’s Health and Rights Opens

Forum on Women’s Health and Rights Opens With Claim on Economic Stimulus Funds:

More than 400 delegates to the Global Partners in Action: Non‐Governmental Forum on Sexual and Reproductive Health and Development began three days of meetings at the Estrel Conference Center to evaluate 15 years of work on those issues since the International Conference on Population and Development (ICPD) issued its landmark Programme of Action in Cairo.

“An additional dollar invested in voluntary family planning comes back at least four times in saved expenses,” said Thoraya Ahmed Obaid, executive director of UNFPA, the United Nations Population Fund, which is co‐sponsoring the Forum with the German government. “It would cost the world only US$23 billion per year to stop women from having unintended pregnancies and dying in childbirth, and to save millions of newborns—less than 10 days of the world’s military spending.”

Gill Greer, Director‐General of the International Planned Parenthood Federation, called on conference participants to demand renewed action from their governments. “By insisting that governments keep their promises of 15 years ago, and by showing that sexual and reproductive health is a cost‐effective long‐term investment, we are playing an essential role in this process,” she said.

“The challenges today are perhaps greater than those of 1994,” said Greer. “These include a world financial crisis, climate change, the HIV/AIDS pandemic, increasing conservatism and fragmented health systems.” A woman dies every minute from complications of pregnancy and childbirth—more than half a million deaths per year—and another 10 million suffer injury or disability.

Greer noted that more than 200 million women now want but have no access to modern methods of family planning while demand for contraception and condoms is expected to increase 40 percent by 2050, in part because of HIV/AIDS.
Read source article...

Ishdeep Kohli-CNS

Sex, rights, and politics—from Cairo to Berlin

Sex happens: 125 million times each and every day. So how is it that in the 21st century this precious element of human existence is still taboo? We are used to seeing sexualised images, yet the reality of sex and reproduction seems as secret as ever. In the political and religious skirmish over sex and morality, we often lose sight of the critical contribution that a realistic approach to sexual and reproductive health makes to our lives. Read source article...

Ishdeep Kohli-CNS

TEMPLES OF LEARNING OR OF RELIGIOUS BIGOTRY

Temples of learning or of religious bigotry

Shobha Shukla

It has become fashionable and customary for our political parties fanatics to give a religious colour to one and everything and revel in creating communal disharmony for narrow partisan gains. It is so easy to whip up sentiments of hatred in the name of religion and so very difficult to douse the fire of fanatic violence.

This is what seems to have happened at St. Xavier’s School ( one of the oldest and most reputed school of Jaipur), whose principal Father Jose Jacob rightly suspended seven students of class XII for misconduct and indisciplined behaviour. These students were reportedly caught offering a mock puja to a poster of Lord Ganesha in their classroom, on the occasion of Ganesha Chaturthi, with the entire class joining in the revelry, shouting and laughing. They thus undermined the sanctity of their own religious festival by treating a sacred ceremony in a derogatory manner. It amounted to disrespecting Lord Ganesha, who is venerated by all as Vighna Harta—solver of all problems.

But the blue eyed activists of Bhartiya Janata Yuva Morcha (BJYM) thought otherwise. They ransacked the school premises and accused the principal of hurting the religious sentiments of the Hindus. The city president of BJYM was naïve enough to demand the arrest of the principal.

It is common knowledge that our schools and universities have become dens of antisocial activities where learning has taken a backseat. Our political parties and dubious religious outfits are abetting the moral degeneration of the country’s youth.

It is high time for all right minded people to help teach our children some discipline and the real meaning of being religious. They need to learn to respect authority and not cock a snook at them .s Classrooms should be treated with respect and venerated as temples of learning and not vandalized at one’s free will. Students should not be applauded for taking the law in their hands. The parent of one of the students indirectly admitted to the wrong doing of his ward. He thought that instead of suspending the students, the principal should have taken a milder action.

If the behaviour of the BJYM activists is condoned it would send wrong signals to honest and upright principals of schools who are struggling to keep their schools free from the vitiated atmosphere of insolent and wayward behaviour, so rampant amongst our youth today. Communal frenzy needs to be stopped immediately, irrespective of the caste and the creed of perpetrator and the victim.

Shobha Shukla

The author teaches Physics at India's Loreto Convent and has been writing in English and Hindi newspapers since past 30 years. She serves as Editor of Citizen News Service (CNS).

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TEACHERS' DAY: THE SACRIFICIAL GOAT

Teachers' Day: The Sacrificial Goat
Shobha Shukla

Once again the nation will gather dutifully this year on the 5th of September to pay tribute to the hard work put by the teachers all year long. Once again teachers will be exhorted to show exemplary competence, dedicated hard work and unwavering commitment in their onerous task of nation building.

Indian tradition compares a teacher to God. So like any other god she is installed on a pedestal and then best forgotten. Hers is a life meant only for selfless service to others. A good teacher should be able to stand high above her students and yet be on their level; she should be able to do 101 things other than teach her subject well; she needs to be tough and soft at the same time.

And God forbid if she expects anything in return---not even the respect/goodwill of the students( as the guru-shishya parampara has given way to the student being her paymaster), not even a modestly comfortable life style ( as that is not for godly beings like her).
The Kothari Commission had long recognized that there is nothing more important for a healthy educational system than having a sufficient number of highly qualified and motivated teachers. Yet education has remained the most neglected of subjects by central and state governments alike. Gone are the days when teachers commanded respect in society.

Teaching has now become a much denigrated profession with slow upward mobility and poor financial rewards. This has resulted in a dearth of quality teachers at all levels (especially at the middle school level in the science/maths streams.. A recent survey has revealed that less than 10% of the teaching work force is there for the sheer love of it. Even premier institutes like the IITs and IIMs are facing serious faculty crunch, what to talk of the primary and secondary education level schools. The condition of private school teachers ( including those of Christian missionary schools) is even more pathetic. These schools are like ‘education shops’. The teachers here have no access to government scales/facilities (which have improved recently, albeit marginally).

They are supposed to survive on salaries worse than that of an unskilled labourer and yet mould the character of their pupils with uncanny precision. They do not enjoy any medical/ pension benefits. The Pay Commission bonanzas are not for them. So teaching has become the last refuge of the incompetent. Talented youngsters are distancing themselves from this noble profession. They would rather join a call centre job given a choice.

All this does not auger well for a country which is poised to become a knowledge economy. It is the teachers who are to be credited with the academic progress which India has made and it is high time they get due recognition for their valuable services. I agree that there are a few black sheep/wolves( like politicians/businessmen owners of private institutes) who have made education a ‘sweat shop’ commodity. But by far and large, we teachers have only sacrificial goats in our fold.

In this age of money, economy and private enterprise , it is foolish to expect that teachers alone should rise above the spirits of time. Let there be sincere efforts to improve their dismal social status, frustrated hopes, poor salaries and deplorable working conditions, before expecting them to fulfil their noble duties. Till then, they will have to remain happy with the cards/ flowers/ prayer services and, perhaps, a lunch offered to them by children/ school authorities on this day.

A Very Happy Teachers’Day to all of us teachers.

( incidentally, Christian missionary schools have been directed not to celebrate Teachers' Day this year, in protest against the violence in Orissa against their community).

Shobha Shukla

The author teaches Physics at India's Loreto Convent and has been writing in English and Hindi newspapers since past 30 years. She serves as Editor of Citizen News Service (CNS).

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News Blaze, USA
Media for freedom, Kathmandu, Nepal
Pakistan Post, Karachi, Pakistan
News Track India, Delhi
My News, Delhi
Assam Times, Guwahati, Assam

Central Chronicle, Madhya Pradesh/ Chhattisgarh

The Seoul Times, Seoul, South Korea
Khabar Express, Bikaner, Rajasthan
Bihar Times, Patna, Bihar

Oxfam ups the response to Bihar floods

Oxfam ups the response to Bihar floods

Amit Dwivedi

Senior Rashtriya Janta Dal (RJD) leader and Union Minister of State for Water Resources Jaiprakash Narayan Yadav accused the Bihar government of massive flood in the state by being "totally negligent" in taking preventive measures.

According to a media briefing on 3 Septemer 2008, Yadav alleged that Bihar State Water Resources Department, till August 17, kept on giving reports from the flood control cell that all the embankments under its jurisdiction were safe. However, when a breach in the east Kosi embankment at Kusaha in Nepal occurred on August 18, Yadav said, the Bihar Government came up with a report that erosions were taking place at the Kosi dam in Upper Nepal on Bahothan embankment for the past several days.

"This is how the government played with its own report to steer clear of its responsibility. This is not a hearsay disclosure but facts based on documents," Yadav said showing the copies of the Bihar Government reports to the reporters.

Regardless of who-so-ever may get the blame, the severity with which one of the worst floods in Bihar has devastated the lives of millions of people, will not diminish. Enormous rehabilitation and relief work, needs to be done. Many civil society organizations are rushing in to contribute towards the relief and rehabilitation work. One of them is Oxfam India. Oxfam has been working in India since the 1952 famine in Bihar and also undertakes long-term development work.

Oxfam India issued an appeal on Monday (1 September 2008) for funds to support its rescue and relief work in flood-hit Bihar. The money will be spent on delivering emergency shelter, food, hygiene items, clean drinking water and safe sanitation.

Oxfam and its local partner organisations have been rescuing people and responding to the crisis since August 18, when waters rushed into six eastern districts of Bihar from a 3 Km breach in River Kosi on the Nepal-India border. The worsening floods, with more rains predicted by the meteorological department, have already affected over 30 lakh people in 16 north-eastern districts of Bihar. The Prime Minister has declared the floods a national catastrophe.

Oxfam is using its motorboats to rescue stranded men, women and children from Supaul, the worst affected district. Contingency stocks of tarpaulin shelter sheets, water purification kits, buckets and Oral Rehydration Sachets (ORS), kept in readiness in flood prone districts, have also been moved to provide preliminary support to the affected. Staffers from Oxfam and two local organisations, Bihar Sewa Samiti and Abhigyan Disha, as well as trained volunteers, are working round the clock in Supaul.

"Oxfam is preparing to reach out, to being with atleast 20,000 families in Basantpur and Pratapganj, two of the worst affected blocks of Supaul," said Nisha Agrawal, CEO, Oxfam India. "We are scaling up our response on temporary shelter, food, water and sanitation. Women and children are particularly facing the brunt in cramped camps or are exposed to heat and the rains under the open sky. Pregnant and lactating mothers are not getting safe water and are forced to defecate in floodwaters. The need for hygiene and sanitation is imminent to prevent the spread of any water-borne epidemic."

Oxfam rapid assessment team toured the worst affected areas in the first few days and has recommended shelter, food and public health as the key needs. Oxfam is also coordinating from the start with other aid agencies and the government through the state-level Inter-Agency Coordination Group to ensure there is no duplication in response and that relief reaches all the needy people.

The public can donate to Oxfam by calling in on +91 11 46538000 or by sending a check in the name of Oxfam Trust, addressed to Oxfam India, Plot Number 1, 2nd Floor(above Sujan Mohinder Hospital), New Friends Colony, New Delhi - 110065 (www.oxfam.org).

A donation of Rs 2000 would give a shelter kit for a family; Rs 850 would give a hygiene kit for 5 families; and Rs 1000 would give a safe latrine to 2 families.

The hope that efforts of organizations like Oxfam will help the most affected communities, lives on.

Amit Dwivedi

(The author is a Special Correspondent to Citizen News Service (CNS) and can be contacted at: amit@citizen-news.org, website: www.citizen-news.org).

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Bihar Times, Patna, Bihar

Scoop Independent News, New Zealand

Media for Freedom, Kathmandu, Nepal

Assam Times, Guwahati, Assam

Thai Indian News, Bangkok, Thailand

My News, Delhi

The Seoul Times, South Korea

Bihar and Jharkhand News Service (BJNS)
News Track India, Delhi
News Blaze, USA
Pakistan Post, Karachi, Pakistan

Central Chronicle, Madhya Pradesh/ Chhattisgarh

Oxfam India issues appeal; scales up response to Bihar floods

Oxfam India issues appeal:

Scales up response to Bihar floods

Oxfam India issued an appeal on Monday (1 September 2008) for funds to support its rescue and relief work in flood-hit Bihar. The money will be spent on delivering emergency shelter, food, hygiene items, clean drinking water and safe sanitation.

Oxfam and its local partner organisations have been rescuing people and responding to the crisis since August 18, when waters rushed into six eastern districts of Bihar from a 3 Km breach in River Kosi on the Nepal-India border. The worsening floods, with more rains predicted by the meteorological department, have already affected over 30 lakh people in 16 north-eastern districts of Bihar. The Prime Minister has declared the floods a national catastrophe.

Oxfam is using its motorboats to rescue stranded men, women and children from Supaul, the worst affected district. Contingency stocks of tarpaulin shelter sheets, water purification kits, buckets and Oral Rehydration Sachets (ORS), kept in readiness in flood prone districts, have also been moved to provide preliminary support to the affected. Staffers from Oxfam and two local organisations, Bihar Sewa Samiti and Abhigyan Disha, as well as trained volunteers, are working round the clock in Supaul.

“Oxfam is preparing to reach out, to being with atleast 20,000 families in Basantpur and Pratapganj, two of the worst affected blocks of Supaul,” said Nisha Agrawal, CEO, Oxfam India. “We are scaling up our response on temporary shelter, food, water and sanitation. Women and children are particularly facing the brunt in cramped camps or are exposed to heat and the rains under the open sky. Pregnant and lactating mothers are not getting safe water and are forced to defecate in floodwaters. The need for hygiene and sanitation is imminent to prevent the spread of any water-borne epidemic.”

Oxfam rapid assessment team toured the worst affected areas in the first few days and has recommended shelter, food and public health as the key needs. Oxfam is also coordinating from the start with other aid agencies and the government through the state-level Inter-Agency Coordination Group to ensure there is no duplication in response and that relief reaches all the needy people.

The public can donate to Oxfam by calling in on +91 11 46538000 or by sending a check in the name of Oxfam Trust, addressed to Oxfam India, Plot Number 1, 2nd Floor(above Sujan Mohinder Hospital), New Friends Colony, New Delhi – 110065 (www.oxfam.org).

A donation of Rs 2000 would give a shelter kit for a family; Rs 850 would give a hygiene kit for 5 families; and Rs 1000 would give a safe latrine to 2 families.

For further information and to make a donation please contact:
Pamela Srivastava( for donations) : 0091-11-465380000(extension 118)
Aditi Kapoor (for media enquiries): 0091-11-465380000, 9810306200 or aditi@oxfamindia.org; akapoor@oxfam.org.uk

Notes to editors:
Oxfam India is an Indian organisation with an Indian Board and is part of the larger Oxfam International family (www.oxfam.org). Oxfam has been working in India since the 1952 famine in Bihar and also undertakes long-term development work. Oxfam believes in equality and justice for all and works by empowering communities to fight for their rights.

Sex Trafficked Girls at High Risk of HIV Infection

Women and girls trafficked into the sex industry in Southeast Asia are at greater risk of contracting sexually transmitted infections (STIs) including HIV than other groups of female sex workers. Titled “Sex Trafficking and STI/HIV in Southeast Asia: Connections between Sexual Exploitation, Violence and Sexual risk”, a new independent regional research study by the Harvard School of Public Health and UNDP, was released at the International Congress on AIDS in Asia and the Pacific, in Bali, Indonesia.

The study reveals the extent of sexual exploitation, physical, sexual and psychological violence experienced by trafficked women and girls. Trafficking victims, many of them under 17 years of age, are raped, locked up, denied food, water and medical care and/or forced to take narcotics and alcohol. Girls who are trafficked into sex work suffer different levels of sexual risk as compared with non-trafficked sex workers, and are less likely to be reached by HIV prevention programmes. The report includes studies covering Thailand, Cambodia and Indonesia.

In Thailand, trafficked Female Sex Workers (FSWs) reported higher number of male clients and greater incidence of anal sex encounters that increased their risk to HIV infection. Women who reported having been trafficked were far less knowledgeable regarding HIV transmission. Trafficked women were three times as likely to experience violence at initiation to sex work as compared to non-trafficked women and girls, as well as being more likely to report recent violence or mistreatment in the context of sex work.

The prevalence of HIV among those trafficked within Indonesia was found to be 5.4%. 1 in 7 trafficking survivors tested for at least one of 4 sexually transmitted infections, including HIV, were infected. 75% of trafficked women and girls experienced sexual violence. Conditions and treatment were oppressive and most survivors were denied all movement, many were forced to use drugs or alcohol. Notably a substantial number experienced trafficking for sexual exploitation at very young ages, with approximately one quarter of survivors trafficked under 15 years of age. Malaysia being the destination for the majority of those trafficked across national borders.

In Cambodia, 73 percent of women and girls who were rescued tested positive for sexually transmitted infections. That number increased to 90 percent among those rescued after less than two months, indicating tremendous exposure to STIs during initiation into sex work. The majority of female sex trafficking survivors identified were under the age of 17 at the time of trafficking. Sexual violence was prevalent, with 1 in 4 reporting forced sex acts in the context of trafficking and sex work.

The study demonstrates that denial of the most basic elements of human dignity, health and wellbeing are associated with the trafficking of women and girls for sexual exploitation. According to Jeff O’ Malley, Director, HIV/AIDS Practice, UNDP, New York, “It calls for a rights-based approach rather than an inappropriate law enforcement approach, which can result in victimising trafficked women, driving sex work underground, and making it even more difficult to reach sex workers and trafficked women to protect their rights and health.”

Mr. Hakan Bjorkman, Country Director, UNDP, Indonesia, said, “Women in the sex industry are already highly at risk of HIV. But women who are sex trafficked experience even more extreme levels of HIV risk, abuse and violence. This screams out for action.”

There is an urgency of creating a space for dialogue across partners, Caitlin Wiesen, Regional HIV/AIDS Team Leader and Programme Coordinator for Asia-Pacific at UNDP Regional Centre in Colombo said, “Partnerships across these communities, that engage Ministries of Justice, Health, Interior, are indispensable to preventing HIV and protecting the rights and health of women who have been trafficked as well as the rights of women in sex work.”

The study calls for an integrated approach to prevent trafficking and HIV in the context of sex work. Dr. Jay Silverman, Director of Violence Against Women Prevention Research at the Harvard School of Public Health and lead author of the study, said “This work further confirms the high risks for HIV infection faced by those coerced or forced into sex work. To confront this reality, anti-trafficking and HIV prevention professionals must work together to develop programs that can both reduce HIV risk among all those involved in sex work and assist women and girls trapped in these settings.”

Ishdeep Kohli-CNS

Pictorial warnings on tobacco products in India from 30 November

Pictorial warnings on tobacco products in India from 30 November

All tobacco products will display approved pictorial warnings from 30 November 2008, as per a notification issued by the Indian Ministry of Health and Family Welfare (dated 27 August 2008), in accordance with the Cigarettes and Other Tobacco Products (Prohibition of advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003.

Grim images of diseased lungs will appear on cigarette, bidi and gutkha packets, as per the notification, covering 40 per cent of the surface area of the tobacco packets, with the message: 'Tobacco kills/Smoking kills'.

The warnings were finally approved by a Group of Ministers (GoM), including the Union External Affairs Minister - Pranab Mukherjee, the Union Information and Broadcasting Minister - PR Dasmunsi, the Minister of State for Labour and Employment - Oscar Fernandes the Union Minister for Commerce and Industry -Kamal Nath, Union Minister for Culture and Urban Development -Jaipal Reddy and Union Health and Family Welfare Minister Anbumani Ramadoss.

Now, the tobacco industry has been given three months time to put up the pictorial warnings

The implementation of pictorial warnings on tobacco products in India was initially planned for February 2007, but got deferred four times thereon.

The GoM formed in 2007 by the Government of India was tasked to review the pictorial warnings on tobacco products. This GoM decided earlier this year (February 2008) to go for mild pictorial warnings on tobacco products. This GoM declined to accept the pictorial warnings (skull and bones) on tobacco products that surveys conducted in India had shown to work towards tobacco control, rather picked up weaker warnings. The GOM in an earlier meeting this year headed by India's External Affairs Minister Mr Pranab Mukherjee had agreed for two mild images of a scorpion signal depicting cancer or an x-ray plate of a man suffering from lung cancer as pictorial warning to deter people from smoking.

Not only this is in compliance with the Cigarettes and other Tobacco Products Act, 2003, but also with the provisions of the global tobacco treaty. On 5 February 2004, India had signed and ratified World's first corporate accountability and public health treaty - the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Article 11 of the FCTC states that warning messages should cover at least 50% of the principal display areas of the package (i.e. both the front and back), but at a minimum must cover at least 30% of the principal display areas. In India, these warnings will cover 40% of the principal display area of tobacco packets.

Several nations have implemented strong health warning label requirements. Examples include:
- Canada, whose health minister recently proposed enlarging the labels from 30% of the package face to 60%;
- Thailand, which has added the message "SMOKING CAUSES IMPOTENCE" to its list of required warnings; and
- Australia, which was the first nation to require that "how to quit" information be printed on every pack.
- South Africa, Singapore and Poland also require strong warning labels.

These pictorial warnings provide smokers with helpful information on the health effects. Most smokers want this information, and certainly want their children to have this information too. The tobacco industry is continuing its decades-long strategy of trying to minimize the effectiveness of package warnings. The tobacco industry is no friend of smokers - and ironically it's true that 'the tobacco industry kills its best customers'. The Indian Council of Medical Research (ICMR) says tobacco use causes 10 lakh deaths (a million) in India every year.

Also package warnings on tobacco products are a good public health strategy because the cost of package warnings is paid for by tobacco companies, not government. Also this should not be looked upon as an isolated initiative rather has to be supported by comprehensive healthcare, legislations and education programmes to attain long-run public health gains. Hopefully this time, these pictorial warnings will get enforced from November 30, and not deferred any further.

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Media for Freedom, Kathmandu, Nepal
Bihar and Jharkhand News Service, Bihar and Jharkhand
Scoop Independent News, New Zealand
Pakistan Post, Karachi, Pakistan

Women in Asia Risk HIV Transmission from their Intimate Partners

The evidence from almost all the countries in Asia indicates that women are acquiring HIV not because of their own sexual behaviours but because of the unsafe behaviours that their partners engage in. The intimate partners of men who have sex with men, injecting drug users or clients of sex workers constitute the largest vulnerable population in Asia. The report ‘HIV Transmission in Intimate Partner Relationships in Asia’, by UNAIDS, its Cosponsors and civil society partners, released at the 9th International Congress on AIDS in Asia and the Pacific in Bali, examines the issue of married or in long-term relationships women who are at risk of HIV infection due to their partners’ high-risk behaviours.

It is estimated that more than 90% of the 1.7 million living with HIV in the Asia became infected from their husbands and partners while in long-term relationships. These women are often percieved as ‘low risk’. At least 75 million men regularly buy sex from sex workers in Asia, and a further 20 million men have sex with other men or are injecting drug users. Many of these men are in steady relationships. As noted by the Report of the Commission on AID in Asia (2008), about 50 million women in Asia are at risk of infection from their partners who engage in risky sexual behaviours.

Dr Prasada Rao, Director, UNAIDS Regional Support Team Asia and the Pacific stressed, “HIV prevention programmes targetting the female partners of men with high-risk behaviours have yet to be developed in Asia, but are clearly essential”. It must be ensured that the health care infrastructure that many countries have built to take care of the reproductive health needs of women also provide information on sexual health and rights and render services to protect women from getting infected with HIV. The report calls for strong horizontal integration of reproductive health services and AIDS programmes at the grass roots level.

The report discusses the myriad issues that are at the root of the problem. The strong patriarchal culture in the countries of Asia, intimate partner violence, including sexual violence, delayed partner notification, disabling socio-cultural and gender norms, the large-scale migration and mobility of populations in Asia and HIV-related stigma and discrimination all play a role in the vulnerability of women to HIV.

Research from several Asian countries indicates that between 15% and 65% of women experience physical and/or sexual violence in intimate partner relationships, placing them at increased risk of HIV infection. According to studies in Bangladesh, India and Nepal, women exposed to intimate partner violence from husbands infected with HIV through unprotected sex with multiple partners were seven times more likely to acquire HIV compared to women not exposed to violence and whose husband did not have sex with multiple partners.

The strong patriarchal culture in Asian countries severely limits a woman’s ability to negotiate sex in intimate partner relationships, according to the report. While there is a societal toleration of extramarital sex and multiple partners for men, women are generally expected to refrain sex until marriage and remain monogamous thereafter.

“Discrimination and violence against women and girls, endemic to our social fabric, are both the cause and consequence of AIDS,” said Dr Jean D’Cunha, Regional Director, UNIFEM South Asia. “Striking at the root of gender inequalities and striving to transform male behaviors are key to effectively addressing the pandemic.”

To prevent HIV transmission among intimate partner relationships, the report outlines four key recommendations:

1. HIV prevention interventions must be scaled-up for men who have sex with men, injecting drug users, and clients of female sex workers and should emphasize the importance of protecting their regular female partners.

2. Structural interventions should be initiated to address the needs of vulnerable women and their male sexual partners. This includes expanding reproductive health programs to include services for male sexual health.

3. HIV prevention interventions among mobile populations and migrants must be scaled-up and include components to protect intimate partners.

4. Operational research must be conducted to obtain a better understanding of the dynamics of HIV transmission among intimate partners.

The report has been inspired by the ground breaking recommendations of the Commission on AIDS in Asia and developed through an extensive collaborative process between UNAIDS and it’s cosponsors UNDP, UNIFEM, UNFPA, WHO, WAPN+ and ICW.

Critical policy and programme action are urgently needed at scale to reduce intimate partner transmission. The challenge of addressing the vulnerability of the 50 million women at risk of intimate partner transmission of HIV calls for bold collective action. It calls for working with communities, joining the tremendous power of the women movements, need to rethink gender norms and engaging men in the response.

Ishdeep Kohli-CNS

Integrating Nutrition and Food Security into HIV Care Support and Treatment

Nutrition and food security are an integral part of the overall response to HIV at all levels. It is vital to address food security and nutrition in all settings to achieve the goal of universal access to HIV prevention, treatment, care and support by 2010, to which all Member States of the United Nations have committed themselves.

At a 9th ICAAP session, ‘Integrating Nutrition and Food Security into HIV Care Support and Treatment: Opportunities and Challenges’, Dr Martin W Bloem, Chief, Nutrition and HIV/AIDS Policy World Food Programme (WFP) discussed that, “Governments need to ensure the integration of food and nutritional support as part of the comprehensive care, support and treatment package for all people living with HIV ( PLHIV)”. Professor Praphan Phanuphak at the Thai-Australian Collaboration in HIV Nutrition (TACHIN) project, highlighted the impact of HIV on nutrition and food security in the Asia-Pacific region, he stated that “HIV affects metabolism and increases the need for nutrients and energy, good nutrition is of paramount importance for those with HIV, nutrition care should be a component of holistic care approach for PLHIV”. Nutrition and Food security form an integral part of Universal Access.

Food security refers to people's ability to access food, either by growing their own or buying food. HIV and AIDS have a significant impact on food security as HIV increases people's need to sell assets in return for food and medication. “Hunger can lead women to sell or exchange sex”, remarked Dr Angela Kelly, team leader Papua New Guinea Institute of Medical Research discussing the ‘Art of Living’ programme in PNG. Lack of food security constrains people’s choices about work and education, and child feeding and rearing, and can lead to increased mobility for work. Mobility and limited options for earning an income in turn can lead to high-risk behaviours such as engaging in sex for food or money.

Good nutrition plays an important role in maintaining the health of people living with HIV. Adequate nutrition is essential to maintain a person’s immune system, to sustain healthy levels of physical activity, and for quality of life. Adequate nutrition is also necessary for optimal benefits from antiretroviral therapy. Ms Kaniz Fatima, project officer WFP Bangladesh, “Large proportion of PLHIV are from the Most at Risk Populations (MARP), who also experience chronic malnutrition”. HIV impairs nutritional status by undermining the immune system, as well as nutrient intake, absorption and use. Malnutrition can exacerbate the effects of HIV and hasten AIDS-related illnesses in people living with HIV. Adults living with HIV have 10−30% higher energy requirements than a healthy adult without HIV, and children living with HIV 50−100% higher than normal requirements. Food availability and good nutrition are thus essential for keeping people living with HIV healthy for longer. A stronger, healthier body can better resist the opportunistic infections that affect people living with HIV.

Adequate dietary intake and absorption are essential for achieving the full benefits of antiretroviral therapy, and there is emerging evidence that patients who begin therapy without adequate nutrition have lower survival rates. Antiretroviral therapy itself may increase appetite and it is possible to reduce some side-effects and promote adherence if some of the medicines are taken with food.

Women are biologically, socially and economically more vulnerable than men to HIV. People without access to adequate food, income and land, especially women and girls, are more likely to be forced into situations that place them at risk of HIV infection such as mobility for work, transactional or commercial sex, or staying in abusive sexual relationships due to economic dependency. Women are usually involved in producing, purchasing and preparing food. Women are also primary caregivers. Most HIV positive children contract the virus from their mother during pregnancy, delivery or breastfeeding. Inadequate nutritional status may increase the risk of vertical HIV transmission. HIV positive mothers need access to appropriate information and replacement feeding options, in order to minimize the risk of transmission during breastfeeding.

Nutrition education and dietary counseling are currently underfunded; there is a current need for evidence to convince funding agencies like GFTAM and PEPFAR, that nutrition intervention can make a significant difference. It is important that issues of nutrition and food security are not trivialized and addressed immediately.

Nutrition should become an integral part of the countries response to HIV. It is recommended to strengthen the political commitment to nutrition and HIV within the national and global health agenda by reinforcing nutrition components in HIV policies and programmes. UNAIDS, WHO, WFP, FAO, World Bank, UNDP, GFTAM, PEPFAR, all these agencies need to collaborate and come up with an integrated Nutrition Food Security and HIV policy and programme applicable for all stages of HIV care support and treatment.

Ishdeep Kohli-CNS