October - AIDS Awareness Month

October is AIDS Awareness Month here is a brief update from UNAIDS - Joint United Nations Programme on HIV/AIDS.

UNAIDS recently published “Countdown to Zero: A Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive.” Leaders from 25 countries, 30 civil societies, private sector, networks of people living with HIV and international organizations met to discuss the AIDS pandemic and draft a plan to force a dramatic decrease in the transmission of AIDS from mother to child during childbirth.

The plan has the following Global Targets:

                Global Target #1: Reduce the number of new HIV infections among children by 90%

                Global Target #2: Reduce the number of AIDS-related maternal deaths by 50%.

And these four key principles for success:

1.       Women living with HIV are central and must remain a focus

2.       Countries must own responsibility for eliminating new HIV infections among children

3.       National plans must leverage synergies, linkages and integration for improved sustainability

4.       Responsibility is shared between families, communities and countries and accountability must be specific

There are many challenges that must be overcome for “Countdown to Zero” to reach its goal. Among them are the needs for excellent leadership, countries to remain in alignment with the plan, adequate finances, comprehensive and coordinated implementation of treatment for mother and child, human resources, and infrastructure to support the consistent transport of supplies.

(To access the full report, go to www.unaids.org.)

Fourteen Women Making a Major Impact

Several times a year, individuals climb Mt. Kilimanjaro, Tanzania, as a fundraiser for the American Foundation for Children with AIDS. On October 1^st, fourteen women are flying to Tanzania to hike Kilimanjaro’s 19,340 feet. Each climber raised a minimum of $8,000 for AFCA and their efforts have the following impact.

·       Medical supplies affecting 30,000 people in Papoli, Uganda

·       School supplies for 800 children in Papoli, Uganda

·       Medical supplies affecting 170,000 people in Kilembe Mines, Uganda

·       2,475,000 doses of antibiotics for children to keep full blown AIDS at bay in 35 clinics throughout Uganda

·       Porridge, milk, and oil for 1600 children (twice daily) for 4 months in Mombasa and Voi, Kenya

·       Nevirapine, an anti-retroviral drug for 500 children and mothers in Bulawayo, Zimbabwe

This list is truly amazing and we are extremely grateful to these women!

For more information about Climb Up: Kilimanjaro and other fundraising initiatives, or to make a donation that will build on the list above, go to www.AFCAids.org.

A Cheaper And More Accessible Blood Test

A new credit card sized and portable blood testing kit has been making its rounds in Rwanda with remarkable results. The mChip is much cheaper and just as reliable and accurate as hospital lab tests for detecting diseases such as syphilis and HIV. It was developed by Samuel Sia, a professor at Columbia University, and funded by the National Institute of Health and the Wallace Coulter Foundation. The mChip has been put through clinical trials in Rwanda where it reported nearly 100% accuracy (they tested patients already known to be HIV positive and only had one false result). This blood test will no doubt make a huge impact for those living in remote areas. Instead of having to wait for days for a blood test report from a hospital, a person can now have near instantaneous results. Developers have estimated its cost at only a couple of dollars per unit. Sia, the lead developer, hopes especially to use this to diagnose pregnant women in remote, poor areas who otherwise would not have access to a hospital for testing. If caught early HIV positive mothers could be prevented from transmitting the virus to their children. The next step is finding a company to manufacture and distribute within the next couple of years. If you'd like to read more you can check out these articles:
http://www.ibtimes.com/articles/190205/20110801/study-low-cost-disposable-blood-cards-to-offer-easy-hiv-and-syphilis-checks-in-developing-countries.htm
http://www.mnn.com/health/fitness-well-being/stories/hiv-testing-cheap-accurate-with-new-portable-blood-test-kit
http://www.bbc.co.uk/news/health-14361017

In Our Own Backyard

It's been one year since the National HIV/AIDS Strategy (NHAS) was unveiled by President Obama. The strategy addresses the needs of United States citizens with HIV/AIDS and presents steps to fighting the epidemic at the domestic level. HIV/AIDS is sometimes not thought of as a major problem for the United States. It's so often associated with poor third-world nations that it's not given enough attention here at home. The strategy addresses this problem and now after a year of the NHAS in action we can see how the epidemic has been confronted in the US. A review of the strategy showed a significant focus on HIV testing and anti-HIV/AIDS discrimination. The Department of Veterans Affairs increased the number of HIV tests administered to veterans. The Department of Labor held a roundtable discussion over employment discrimination for individuals with HIV and have distributed public education materials on the rights of employees with emphasis on those who are HIV positive. The Department of Health and Human Services is working to begin a program concerning viral hepatitis since up to thirty percent of HIV positive individuals are also infected with hepatitis. If you'd like to read more on the progress by NHAS you can see this report by an employee of the Department of Health and Human Services. The CDC has also blogged about the strategy and it's progress.

Two Promising Studies

I had mentioned in a previous blog that there would be a conference on AIDS in Rome. It was a four day event held by the International AIDS Society. At the conference there was a presentation of the results of a trial regarding the spread of AIDS. The results showed that an HIV positive person taking antiretroviral drugs had a decreased chance of spreading the virus to others by nearly 97%. By forcing the virus to "retreat", ART keeps the virus out of the bloodstream and other bodily fluids through which it is normally transmitted. This news will hopefully be a big push for expanding and creating more ART programs across the world. UNAIDS predicts that around 9 million people who could benefit from ART are not receiving the drugs. The next conference won't be until 2013 in Malaysia. You can visit the conference's website here.

Another study revealed that male circumcision could reduce the risk of HIV infection by up to 60%. Rwanda is taking this study very seriously and has begun to perform non-surgical circumcisions by using a device called PrePex. Since December 2010 Rwanda has circumcised 5000 men and hope to have that number up to 2 million by 2012. This, it is believed, will bring the HIV prevalence rate from 3% to 1.5% in the country. For more on this see this article by the BBC.

The East African Crisis

The UN on Wednesday declared a famine in parts of southern Somalia and predicts a spread of famine to all of southern Somalia within two months unless action is taken immediately. Around $300 million in aid is predicted to be needed in the next several months to keep the famine from spreading. After the announcement, the United States gave an additional $28 million in funding. Hopefully the declaration of a famine and the United States' donation will inspire other countries to help. I think this article really helps explain the level of this catastrophe more than any statistic ever could. If you'd like to find out more ways to help you can look at this article from CNN.

Famine To Be Officially Declared

The UN is set to officially declare a famine in parts of southern Somalia. The drought and food crisis in the Horn of Africa up to this point has been categorized as an "emergency" which is one step behind a famine. There are five levels of food security classification ranging from "generally secure" to "catastrophe/famine". The last official famine to be declared was in Ethiopia in the mid 1980's. A famine is declared once death rates reach 2 per 10,000 per day and malnutrition rates are at or above 30%. The UN has called for $1.6 billion in aid but only half that has been met. The US has been especially reluctant to give aid to Somalia and has cut its funding by 88% due to the presence of insurgents linked to al-Qaeda. The US worries that the aid would fall into the wrong hands and benefit the terrorists. However the insurgents have declared an amnesty for aid deliveries. It will be interesting to see if the declaration of a famine will change any minds in Washington to increase funding. For more on the US position and its implications see this article. And for a visual reference of the drought and food crisis, this interactive map is a great resource. I'll definitely be blogging more about this situation and especially how the declaration of a famine affects aid to the countries so keep checking the blog!

Famine in the Horn of Africa

            You’ve seen the images hundreds of times: a desperate child with his belly protruding held up only by stick-like legs. But how much does that image affect you now? Thanks to the internet and television we are able to know about and see any and all devastation from around the world. But has that weakened the power of those images? Right now in the “horn of Africa” (northern Kenya, Ethiopia, and southern Somalia) there is what is being called the worst drought in nearly 60 years. That, combined with soaring world food prices is shaping up into a massive famine. But this famine was being predicted and warned about since last year. And yet international aid is nowhere near what it should be. One article warns against this “donor fatigue.” Another article questions whether time is an issue. When a natural disaster such as a hurricane or a flood occurs, aid seems to pour in from around the world. But something like a drought and the onset of a famine which occurs more slowly doesn’t seem to get the same urgent attention. This drought in the horn of Africa will have significant consequences for all those who are HIV positive. Even the slightest malnutrition can be devastating for an AIDS patient. I’ll blog more about this as it unfolds. For now here are some more articles if you’re interested: http://www.telegraph.co.uk/news/worldnews/africaandindianocean/ethiopia/8637978/The-forgotten-people-of-Africas-famine-cry-out-for-aid.html

http://www.abc.net.au/correspondents/content/2011/s3271036.htm

http://www.economist.com/node/18929467?story_id=18929467

News Updates

I thought I would use this post to update you readers on some news articles I've come across the past week. A lot of them had to do with finding a cure! It seems like the 30th anniversary of the discovery of HIV/AIDS has really ignited a fire in the medical community to focus on finding a cure. A research center in Seattle recently received a $5 million grant and is hoping to start human clinical trials in five years. Their main focus is on the "Berlin patient" incident which I had blogged about earlier. A man from Berlin who was both HIV positive and a leukemia patient received a bone marrow transplant from someone who had the rare delta 32 mutation which is immune to HIV. The patient is now both leukemia and HIV free. The Fred Hutchinson Cancer Research Center is hoping to find a way to replicate this mutation, modify stem cells and find a way to attack the HIV "reservoirs" which make this virus so complicated and difficult to cure. The "reservoirs" refer to the dormancy of the virus. Controlling the virus with ART does not eliminate it and "pockets" of the virus remain in the persons system. Researchers from Johns Hopkins are receiving $32 million in funding to find out more about these reservoirs of HIV. A conference by the International AIDS Society will take place in Rome next week and I hope to find out more about what is discussed and blog about it!

Here are the links to the articles if you'd like to read them in their entirety: http://seattletimes.nwsource.com/html/localnews/2015589038_hivcure13m.html
http://weblogs.baltimoresun.com/health/2011/07/hopkins_joins_group_looking_to.html
http://www.einnews.com/247pr/223806

Also--I will be picking up the medicine bottles tomorrow to get started on the Nelson Mandela Day Fundraiser. If you'd like to participate please let me know!!!

Do Something

July 18th is Nelson Mandela Day. It's a day of service where everyone is asked to go out and do something. It doesn't have to be a major event. This year I'd like to ask all of you to join me in collecting change for AFCA. It's simple: you get a medicine/prescription bottle and fill it with coins and then give it back to AFCA. I will be handing out these medicine bottles to various groups and organizations and then collecting them on the 18th to give back to AFCA. If anyone would like to participate in this (and if you know others that would want to get involved) please contact me by commenting on this or writing on our facebook page wall!

A Poll to Ponder and an Event to Plan

I came across this poll conducted recently by the Kaiser Family Foundation and want to share it with all you readers! Here's a link to a page on the website that will allow you to view the complete report of the poll findings: http://www.kff.org/kaiserpolls/8186.cfm. The report is 35 pages and highly interesting. What I found most intriguing was the part about the "declining sense of national urgency" which said fewer Americans name HIV as the top health problem for the US. This result is followed by the findings that people hear less about HIV through social media. Is that because of the declining sense of urgency? Or is it the other way around? Similarly, another one of the top findings showed that not many participants could name a national leader for the fight against HIV/AIDS. Regardless of how you look at it (the lack of urgency caused the lack of attention and focus, or the lack of coverage led to the decrease in urgency), the HIV problem is still huge and needs attention. July 18th is Nelson Mandela Day which is basically a day of service. I'd like to do something with AFCA to really get the word out there about HIV but I need your help! I've got a few ideas of my own but I welcome anyone to share their thoughts and ideas with me and maybe we could really pull something spectacular together! Comment on this with any ideas or questions. Hopefully I'll make some more concrete plans for the day and let everyone know soon!

Bringing the issue home

So even though AFCA only works in African countries and I’ve blogged a lot about developing nations, I want to bring the issue home a little. The United States is huge and industrialized and “modernized” but that hasn’t exempted us from this crisis. America has the highest rate of HIV infections of all the industrialized countries at 0.6%. Sure, 0.6% looks really small compared to the countries AFCA works in but think about what that means: about 1.2 million people are living with HIV in this country. Bringing it even closer to home, a total of approximately 31,220 Pennsylvania residents are living with HIV (according to a 2008 estimate). A lot of people see the HIV/AIDS issue as a problem for developing and third world nations. But recently there has been a significant amount of reports on the problem here in America and especially in urban areas. For instance, some cities have the same prevalence rate as a developing nation in Africa. Just a few years ago Washington, D.C. reported a 3% HIV prevalence rate which is on par with or even more than some developing countries (such as Ghana). D.C. has been making improvements since then but it just goes to show that HIV/AIDS is not a foreign issue.

            Here are some great sources if you want to learn more about HIV in the United States: http://aidsvu.org/states/PA (you can also view other state profiles), http://www.avert.org/usa-states-cities.htm (HIV incidences by state), http://www.aidsaction.org/communications/publications/statefactsheets/pdfs/2004/pennsylvania_2004.pdf (specific to PA), http://www.statehealthfacts.org/profileglance.jsp?rgn=40# (you can view other states and compare them to one another on a range of health issues!).

More from Tanya's trip

A road of red dirt, dotted by deep holes, as wide as the road, as long as a car, and deep – filled with water. Are these little lakes deep enough for fish?  I don’t ask this silly question, but it does cross my mind as the truck crosses yet another puddle, with the driver declaring in broken English ”that was a piece of cake”.  As laughter escapes my mouth, I wonder if I’ve heard correctly.  Before the question is spoken, Rachel tells me that Edison, our fearless driver, learned this phrase from other visitors.  I smile. My smile meets the fish question and it settles while my body continues to bounce.

I listen to the Lingala flowing around me, picking out now-familiar works and making up the rest of the conversation in my head. Lingala is a trade language and is not a rich language, at that.  It would not be hard to learn this language, I decide silently, and I try to memorize words as I hear them.  Two hours pass quickly and I look up to see that we’ve arrived in Bwamongo.  Here, we are visiting the pharmacy where we get the medicine we donate to the clinics of the Tandala Health Zone (16 of them) and the Tandala Hospital.   I have been brought here by Rachel, Tony, Dr. Bienvenneu, and Edison. 

Since French is easier for me to understand, we conduct our business in that language, visiting the warehouse and making some small purchases for some doctors and the dentist at the hospital, who made requests when they knew we were coming here.  Soon, our business is over and we climb back into the back of the truck.  We settle our sore bums for another couple of hours of riding as we make it back to the hospital and I settle my brain to do some more listening and thinking.  My friends sing in the truck – lilting voices combining to make a gorgeous sound.  At least four parts in each song and is it simply amazing.

I let the sound wash over me and I look out the window and look at the women balancing heavy burdens on their heads.  Before we ever reach them, they move silently into the tall grasses that edge the road.  I quickly turn my head to see them through the back door window.  I am always surprised when one or two more people come out after our car moves on than the number I saw go into the grasses. I think how grateful I am that their disappearances are short-lived and that they are due to a peaceful car passing by.  Not long ago, women and children disappeared into tall grasses because they were running for their lives.  With soldiers ransacking, raping and killing, the grasses meant life.  Babies were hushed with soft singing and hands pressed over their mouths.  Mothers prayed and dragged children while looking out for water and edible leaves.  Soldiers walked by on the road and the lucky ones in the grass fled and counted the days until the soldiers went home.

More from Tanya and pictures!

The bathroom sink is black and it is moving.  Wait.  It is not moving, although movement is definitely present, as ants have taken over.  The bathroom is quite dark, so I can’t see clearly, but I can see enough to know that we have a problem – hundreds of ants.  I try not to keep the ants off me as I lean into the water barrel to get some water to dump over the ants, washing them down the drain and back to the earth.  I wonder if anyone cries for them?  Is there a mama ant out there, crying for her children?  At that moment, I don’t really care – all I want is to get those ants out of the sink which used to be white and is now black.

As the day progresses, I feel ants on me, in me and around me.  Sometimes, they are on me, but sometimes, they are just a thought, a feeling. 

As I walk from ward to ward at Tandala Hospital, talking to doctors and seeing first-hand what their needs are, my head swims with possibilities.  Everything needed is possible.  For a price.

Beds, birthing beds, mattresses, mattress covers, new floors, repaired windows, headlamps – all doable.  All available.  All out of reach without money.  God, give me wisdom.  Bless our work.  Help us help. Help us not do harm while helping.  The truth is that no child should have to spend the night in a dark hospital ward, all by themselves, scared and hurting.  No mother should lay on a metal bed without a mattress while waiting for the birth of her twins.

Twins. I hold a pair of day-old baby boys today and I felt full.  It was an especially sweet moment because both babies and their mama are doing well and they are healthy.  So soft and so new, these babies, yet uncounted.  Why count your babies, when they will likely die?  They’ll be counted once they turn five.  Until then, every day is a prayer. 

More from Tanya!

Here's some more from Tanya in the Congo!

Sunday June 19, 2011

I feel old time missionaries here.  Even though I can’t see them, I smell them as they walk by, fingers brushing their dusty books in the old bookshelves.  The books are well-loved and they are the books of my childhood, so I drink in their sight and sigh, knowing that those who lived here in the past are much like those who lived with me in Colombia as a child. The small fan in the corner, the one that needs non-existent electricity to function, sits by a cracked mirror, which, doubtless, saw many faces pass through this room.

The bottom bunk, wrapped under a mosquito net, is the perfect place to think and plan my day.  It is 5:00am.  How many others did that in this exact spot before me? After my quiet time is done and I have stretched out the kinks in my body and imagination, I search for my flashlight and sandals on to make my way to the kitchen.  It is still dark there, but I put a pot of water on the stove (thank God for gas!) to take the chill out of the morning bucket bath.  Nothing feels as good as that lukewarm water as I dump it over my head and it washes over my crouched body and my feet, which are protected by a pair of shared flip-flops.  After several house in a bouncing car to reach Tandala Hospital yesterday, this bath is glorious and I fell alive again.  I strive to only use ½ a bucket of water, knowing it is a precious commodity.  I am so grateful to have short hair.

Now, with the 6am light of morning, I am ravenous.  Peanuts and a cup of tea will assuage my appetite, as soon, we’ll head for morning devotions at the hospital before starting a day of meetings, photos, handshakes, and smiles. The song is sweet and doesn’t over power or overtake the prayer.  It enshrouds us.  It covers us.  It makes us feel like one, thanking God for His goodness.

Updates from Tanya!

For those of you who don't know, Tanya is currently visiting the AFCA programs and children in the DRC and Zimbabwe. She managed to get access to the internet and sent me some entries to post on the blog:

Dem. Republic of Congo

June 15 - 18, 2011

Ken and I arrived in Kinshasa on June 16 and stayed at a semi-nasty hotel with no running water in Ken’s room, some running water in my room and cockroaches.  My room had water, but it came in spurts and water was not to be found coming out of the sink.  Instead, it came out through the water tubes running on the side of the wall, flooding the tile bathroom.  This was a bit of a pain, especially when the electricity ran out and I thought I’d fall and break my neck on the slippery floor.  I managed to bathe using a bucket of water while diligently keeping my eyes focused away from the spider on the wall.  I figured if I gave him a wide berth, he’d leave me alone in gratitude for his life.  It worked well and we both slept in different rooms, that spider and I.

While in Kishasa, we spent time with Pastor Alenge, who is a great driver in a sea of mad drivers and casual walkers with a death wish. We ate tasty dinners at his home, cooked and served by his wife Betty and spend the day in his car, driving from place to place.  We went to the airlines office to deposit our suitcases which would forwarded to Gemena, to the bank to exchange money, to the church where the pastor lives and works, and to the grocery store.  All of these tips should have been doable in a couple of hours, but the traffic was so dense that it took us all day to complete these four tasks.

On Saturday, we flew to Gemena, where the air was thick with humidity and where sweat started pouring down my shirt and into my pants, finally finding its way to my ankles.  We arrived at the mission station where we were greeted by children who receive medicine from AFCA and who were holding a banner thanking AFCA for the hope they have received.  The children had t-shirts on which said “AFCA, thanks for giving us hope” and which almost made me cry.  Had I not been the only woman in the whole bunch of people, I would have cried, I am sure.  But, I held it together and really enjoyed the short but touching ceremony carried out by the various leaders of CECU and PEASIT.  Rachel arrived in time to translate the ceremony for Ken and me and it was a beautiful service.  The music was my favorite part, with different voices joining in to form a hymn that I recognized in my own language.  The music had a distinct African sound to it, with harmonies and clapping forming sounds and feelings that make me swell up inside – it is a sound that makes me smile and that makes me sorrowful, at all once.  It leaves my soul feel full and I know I am in Africa once again.

Now, on the 18^th of June, we sit in a small guesthouse  while Rachel cooks up some Ramen Noodles for dinner and we wait for the internet to work so we can write our loved ones back home.  The generator is working, so we are able to charge our cameras, phones and laptops, but we can’t get hooked up to the V-Sat quite yet. 

I am trying not to drink too much liquid at this time of night because I don’t want to have to use the outhouse unless my kidneys just can’t take it anymore.  I don’t like it when my flashlight catches shadows made by giant spiders or cockroaches.  I don’t like having to set my flashlight down in order to fetch water to pour into the toilet that doesn’t flush.  So – little water and soup for me tonight.

Outside, the dark is dark.  It is gorgeous and smells fresh due to the storm that passed this way, washing away the humidity and leaving behind the clean, earthy smell and cool temperatures that promises good sleep tonight.  I am told that this is not normal and that tomorrow, we might swelter as we sleep.  But, for now, I am looking forward to a great night of sleep, as last night was lost to a cacophony of noise outside our hotel windows.  Tonight, all I hear is the croaking of frogs, the chirping of insects, and the sound of chickens sleeping. I feel peaceful, which is such a welcome feeling after the oppressive, dirty, and sad feel from Kinshasa.  I’d be happy not to pass through that city again, but I know I must.  Next time, I will come through Bangui in Central African Republic.

Democratic Republic of Congo

The final country that AFCA works in that I’ll briefly introduce is the Democratic Republic of Congo. The DRC has been riddled with violence ever since its independence in 1960 (originally Congo, the country was renamed Zaire in the 1970’s and then became the DRC in 1997). Refugees from the Rwandan genocide flooded into the country and eventually the DRC found itself in the midst of a five year war that has been referred to as ‘Africa’s World War’. The violence is still present and rape has been a major issue. Last year a UN official actually called the DRC the ‘rape capital of the world.’ The adult HIV prevalence rate is around 1.3% and many studies suggest that this number is on the rise. The effects of the conflict in the region are mostly apparent in the poverty and lack of access to proper resources. USAID says that approximately 70% of the population does not have adequate access to health care. Women have been disproportionately affected due to the sexual violence that has occurred. Additionally there is a big orphan population in the country (around 8.2 million) who could be at risk for contracting the virus and according to a study done in 2009 in the DRC around one million of these children have been orphaned due to AIDS (see the USAID document for more on this). 

I’d recommend the BBC website for basic information on the conflict in the region (http://www.bbc.co.uk/news/world-africa-11108589) and USAID and UNAIDS for information on the HIV/AIDS problem in the region (http://www.usaid.gov/our_work/global_health/aids/Countries/africa/congo_profile.pdf) (http://www.unaids.org/en/regionscountries/countries/democraticrepublicofthecongo/).

Improvement in Ghana

As I was sifting through the news today I saw an article that immediately caught my eye. It read “How Ghana Has More Than Halved Its HIV/AIDS Rate.” The prevalence rate has apparently gone down from four percent to one and a half percent thanks to a national strategy plan and AIDS commission. This is clearly something to be excited about. But as I kept reading I noticed that there was no mention of homosexuality in the country. I’ve been doing quite a bit of research on Ghanaian culture in preparation for my trip and I’ve found that homosexuality is actually illegal and very much seen in a negative light. So I found it a little strange that the article mentioned reducing the stigma attached to HIV but nothing about homosexuality. In fact I sort of started questioning whether that 1.5% prevalence rate was really accurate. I looked up a little more on homosexuals living in Ghana and most of them are afraid to come out and instead make up this sort of secret society in the country. I think this article just about sums up the perception of homosexuality in Ghana: http://www.ghanaweb.com/GhanaHomePage/NewsArchive/artikel.php?ID=211415. I’m certainly not denying the great achievement of the Ghanaian government in reducing the HIV/AIDS prevalence rate nor am I saying that these statistics are deliberately misleading or anything of the sort. But I do wonder how many people in that 1.5% that have HIV are gay and how many others are living HIV positive but are not reported. It’s just a thought. What do you think? Feel free to comment!

 Here’s the article on the Ghanaian governments success: http://www.npr.org/2011/06/20/137298597/ghana-vp-explains-how-country-has-more-than-halved-hiv-aids-rate. This should no doubt be used as a great role model for other countries on how to successfully curb HIV transmission.

Zimbabwe

There are currently about 1.2 million people living with HIV in Zimbabwe which is nearly one tenth of the population. 150,000 of those are under the age of 14 and half of all child deaths (ages 5 and under) are due to HIV/AIDS. Similar to Kenya, the government of Zimbabwe was slow to respond at first. However, the response has still been slow mostly in part to a series of devastating social and political issues. The government of Zimbabwe, run by President Mugabe, has been subjected to scrutiny from the international world for years which has hindered many HIV/AIDS efforts. Some foreign donors have been reluctant to get involved in the country due to its political turmoil. Other socioeconomic issues such as inflation, land resettlement, unemployment and food shortages have exacerbated the HIV problem. Despite this grim picture, the prevalence rate of HIV in the country has been on the decline. However, the political, social and economic issues of Zimbabwe stunted its ability to make substantial progress regarding HIV/AIDS and the country still has a long way to go.

            Zimbabwe’s history and issues are very interesting and a simple search of “Mugabe” produces an incredible amount of biographies and memoirs of people living under his rule in Zimbabwe. As usual I recommend UNAIDS website (http://www.unaids.org/en/regionscountries/countries/zimbabwe/), the CIA World Factbook (https://www.cia.gov/library/publications/the-world-factbook/geos/zi.html) and this article which addresses the connection between the political and social issues in the country and the HIV epidemic (http://www.prb.org/Articles/2004/ZimbabwesPoliticalandEconomicProblemsHinderEffectiveResponsetoAIDS.aspx).

UN Meeting on AIDS Sets High Goals for 2015

The UN General Assembly High Level Meeting on AIDS finished up on the 10^th. Some of the goals set by world leaders included halving the infection rate among IV drug users, eliminating new HIV infections among children and reducing sexual transmission by 2015 and also achieving the Millennium Development Goal 6 which aspires to halt and reverse the spread of HIV by 2015. As mentioned in my last blog, pediatric AIDS was given a significant amount of attention as well at the meeting with particular focus on gender inequalities and its impact on HIV transmission and treatment. A panel discussion centered on females and HIV brought up the issue of the unequal access to HIV treatment for women in many countries which has a significant effect on the pediatric AIDS issue. The meeting chose to focus on equal access to treatment for women as a means of combating mother-to-child transmission. The meeting did not set up any concrete plans or programs and only served to set goals for the UN member states to aspire to regarding HIV/AIDS. The goals are incredibly ambitious in my opinion and it will be very interesting to see the results in 2015 and which member states really commit to achieving the goals.

            If you would like to read more about the goals set forth and the discussions you can go to www.unaids.org. There is also an official website for the meeting at: http://www.un.org/en/ga/aidsmeeting2011/ where you can read the final declaration that was adopted titled “Political Declaration on HIV/AIDS: Intensifying Our Efforts to Eliminate HIV/AIDS”.

Kenya

            HIV in Kenya first began to spread through its sex workers (mainly in Nairobi). Presently, women are disproportionately affected with prevalence rates nearly twice that of males. Kenya was accused of not initially responding as aggressively to the HIV problem as its neighbor country, Uganda. However, since 2000 Kenya has made significant strides in prevention and care. Prevalence has decreased from its peak rate of 13.4% in 2000 to 6.9% as of 2006. Around 20,000 children are reported as HIV+ each year in Kenya which is decreased from the rate in 2000 at around 40,000. However, according to the Kenyan newspaper Business Daily, these figures are not accurate and many more children are infected but not reported (http://www.businessdailyafrica.com/-/539444/1176552/-/122i2bbz/-/). This lack of information has hindered the ability to implement effective pediatric programs according to the article. Additionally, Kenya has a very low number of pediatricians that are mostly concentrated in urban areas which poses major problems for children living in rural areas to get treatment.

On a related note: the UN is currently holding a High Level Meeting on AIDS and First Ladies from around the world have put forth pediatric AIDS and gender inequality as top priorities. I will be following the UN meeting and writing more on the issues that are presented and focused on. If you would like to read more on it as well you can go to www.unaids.org.   

Prepping for Africa

In preparation for my study abroad this upcoming fall to Ghana I, unfortunately, had to get six shots and order anti-malarial pills on Wednesday. But the shots didn’t phase me nor did the daunting task of taking those malaria pills every single day the whole time I’m in Africa. What truly affected me during the nearly-two-hour session was the way in which Ghana was perceived by the nurse. I know she certainly didn’t mean any harm by it but I also got the feeling that she had never been to Africa. As she was giving me precautionary advice she kept referring to the Ghanaians as “them” and was telling me not to trust their police or hospitals or water or anything for that matter. I was informed that I absolutely should not get tap water in my mouth nor should I eat anything that has not been cooked. I should not use their hospitals unless absolutely necessary since their doctors are not up to par with American standards. I should remember that their police are not to be trusted and have no interest in helping foreigners. And as she kept listing what I should and should not do all I could think was “Do you expect me to stay holed up in my dorm room the entire time?” There’s no need to fear going to a country in Africa (or any country for that matter). Yet, this is what she seemed to want—she wanted me to fear all the diseases and parasites and dirty food and unsanitary water that I would be exposed to. She had this strange perception of Africa as this dangerous and dirty place and it really bothered me. I’d love to hear from people who have been to Africa—have you experienced this perception from others?

A Cure?

This week marks the 30 year anniversary of the discovery of AIDS. There still has been no cure but an article on Reuters does provide some hope.  A man in Berlin was, in fact, “cured” of AIDS. There is a genetic mutation that is well-known to be resistant to the virus. The CCR5 delta 32 mutation has been found in a (very) small proportion of people. Timothy Ray Brown was both HIV positive and sick with leukemia. He needed a bone marrow transplant and his doctor suggested a transplant from someone with the genetic mutation. Miraculously it worked and Brown survived and has since not had any signs of the virus replicating and his doctor does not believe he will have any problems with HIV ever again. Obviously a very risky procedure such as this could not be implemented on all HIV+ patients and, in fact, this could be the only success story of its kind.

This story does brings hope that a cure could be found in the near future but it has also sparked a debate, or, rather, reignited the debate over whether money and attention should be focused on prevention or finding a cure. Some believe that research for a cure would detract from the immediate need for stemming the transmission of HIV. It’s an interesting debate and I still don’t know where I truly stand on it. What is your view? Feel free to share your thoughts on this subject or on anything else!

Here’s the link for the article: http://www.reuters.com/article/2011/06/01/us-aids-idUSTRE75030I20110601

Uganda

I’d like to take a little time to introduce the four separate countries that AFCA works in and hopefully make it clear why those countries need this aid. So here’s just a brief picture of the HIV/AIDS problem in Uganda. For starters, the CIA World Factbook states underneath its population estimate for the country (a little over 34 million) that this estimate takes into account the effect of AIDS on the population and the resulting increased mortality rate (it doesn’t do this for every country). As of 2009, 1.2 million people are living with HIV in the country setting the HIV prevalence rate at 6.5%. Orphanage due to HIV/AIDS is a significant problem in Uganda. Uganda has the highest proportion of orphaned children due to HIV/AIDS in the world with 2.3 million orphans attributed to the disease. While HIV/AIDS is still a serious issue in Uganda, there has been some progress since the disease first became known in 1980’s. The disease spread rapidly and peaked in the 1990’s but has since declined and prevalence has stabilized at around 6% (in the 1990’s it was as high as 18% in rural areas and 30% in urban areas!). AFCA provides medical supplies for three different hospitals and clinics in Uganda (more on that can be found at http://www.afcaids.org/about/impact).  HIV weakens the immune system and increases the lethality of infections that would not necessarily be fatal so these medical supplies are needed to treat both HIV and any other common infections or illnesses. These are just some statistics for you to think about and hopefully help you understand why AFCA works in Uganda. If you want to learn more about the country I recommend the CIA World Factbook as a good starting place (https://www.cia.gov/library/publications/the-world-factbook/geos/ug.html) and the UNAIDS website which has a “country factsheet” for Uganda (http://www.unaidsrstesa.org/regional-country-profiles-home/country-profiles/uganda).

Statistics, statistics, statistics

Sub-Saharan Africa is the hardest hit area for HIV infections. This is the area that AFCA works in (specifically in the four countries of Kenya, Uganda, Zimbabwe and the DRC). Over 22 million people in sub-Saharan Africa are living with HIV and 14 million children have been orphaned as a result.  We’ve all seen the pictures, heard the stories, read the statistics like the ones I just gave you. But what about the treatments? The progress? The success stories? You can’t just focus on the death and despair or you won’t have any hope for the future. This also works the other way around though too: don’t just look at the progress and success stories or you may begin to downplay how serious this disease is.

Looking at HIV/AIDS statistics can be overwhelming. And often, the statistics people tend to focus on are the negative ones. For example, when I looked at the first page of this UNAIDS report (http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/factsheet/2009/20091124_fs_global_en.pdf) I saw the numbers representing the millions of people living with HIV, the deaths, the orphans as a result of the disease and all I wanted to do was click out of the document. It was depressing, overwhelming. But I kept reading and amid those depressing statistics were numbers on the increase in people receiving treatment and drugs. Through some of my preliminary research I’ve been excited by the progress that’s been made. For example, just last week a news report was issued stating that the mortality rate in China for those infected has decreased by 60% since 2003 thanks to the free access to antiretroviral drugs (http://www.nytimes.com/2011/05/19/health/19aids.html). And organizations like AFCA have made a significant impact on the lives of those affected with this disease. You certainly can’t overlook those gruesome statistics, but don’t forget about the progress that has been made in the past few decades. And I’ll make sure to continue to post about both.

A Brief Introduction

First I’d like to introduce myself: I’m Hannah Snyder, the new intern here at AFCA. Last semester at Goucher College I took a class titled “HIV/AIDS: Tearing the Social Fabric.” It really challenged me to see the disease as not only medically complex but also socially complex. I was required to teach and lead the class discussion with two other girls one day on the macroeconomic impact of AIDS.  We had the class do a role play in which they saw how AIDS spreads and impacts mobile groups (for this example we had them role play as truckers). Some were HIV-positive, others were not but all had to end up with the same basic necessities of life by the end through whatever means necessary. The class remarked how difficult it was to get everything they needed to survive the game: money, medicine, food etc. For me, that just about sums up HIV/AIDS. It’s confusing. How do we help those who are HIV-positive? What if they’re in poverty? How do we tackle this issue in third world countries? There are so many aspects that need to be taken into account. That’s why I took this internship, because I wanted to understand the disease and its impact a little more and see how an organization can help those affected.

            I’d like this blog to be an informal, yet still informative, discussion on the nature and impact of this disease as well as on Africa in general. I will share with you my research on the countries that AFCA works with (Kenya, Uganda, Zimbabwe and the DRC), how HIV has impacted those countries, and the progress in HIV/AIDS research across the globe. I’d also love to hear from the readers. If there is a topic you’d like me to cover in the blog let me know!

Want to do some good with change?

How much money did you spend today? Maybe you got a cup of coffee for $3.50, bought lunch for $11.34 and then picked up a new pair of shoes on the way home for $58.60. What if you could round up each of those purcahses to the nearest dollar, and donate the spare change to American Foundation for Children with AIDS?


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