AIDS 2006 Youth Site
This entry is about: AIDS 2006 – XVI International AIDS Conference


I am very happy to welcome everyone to the AIDS 2006. This is the first time the International AIDS Conference has had a youth specific things component and our team is very excited about it! TakingITGlobal has been working very hard to get everything up and running so many thanks to their hard-working team.Youth should take this opporunity to make meaningful impact at the conference and after the conference.

Women and girl children, apart from being more vulnerable to HIV
infection, have to bear an additional burden when someone in the family is
infected with the disease. It is the girl child who is more likely to be
withdrawn from school to cope with household chores including caring
for the ill, a study on the Gender Impact of HIV and AIDS in India has
shown.
According to the National AIDS Control Organisation (NACO) estimates
for 2005, in India, women account for about two million of the
approximately 5.2 million estimated cases of HIV and AIDS, constituting 39 per
cent of all HIV infections. Of the 1,11,608 AIDS cases reported in the
country until July 31 last year, females accounted for nearly 30 per
cent.
The burden of caring for People Living with HIV and AIDS (PLWHA) is
also proportionately higher in the case of women, whether or not they
themselves are HIV positive. Of the 882 caregivers in the families
surveyed, 627 were women — 91 per cent of them in the age group 15-59. Twenty
per cent of the caregivers themselves were HIV positive, as against 16
per cent in the case of men.
Conducted by the National Council of Applied Economic Research
(NCAER) and supported by the NACO and the United Nations Development
Programme (UNDP), the study concludes that not only does women's workload at
home increase, but they are also required to take up employment to
supplement lost earnings.
In a clear indication of the gender gap in treatment seeking
behaviour, close to 9.7 per cent of the patients were left untreated in the
case of HIV/AIDS affected women, the study found, nearly double the case
of men. Also, women were more likely to get treated in health facilities
run by government or non-government organisations in comparison to a
greater proportion of men being treated at private nursing homes. Only
29.8 per cent of the women surveyed went to private health facilities for
non-hospitalised illnesses, against 41.3 per cent in the case of men. A
similar picture can be seen in the case of hospitalised illnesses.
While HIV and AIDS have a negative impact on children from affected
households, it is the girl child who is more likely to be withdrawn to
cope with household chores or to supplement the family income. All
PLHWAs face stigma and discrimination; the women face the worst forms of
discrimination. More women than men faced discrimination such as neglect,
isolation and verbal teasing in both urban and rural areas.
Households headed by HIV positive widows are also found to be
economically worse off than other HIV households, with the average at Rs.
32,993 in the case of women and Rs. 51,111 in the case of men. The average
per capita expenditure by HIV positive widow household was Rs. 790.
Moreover, the savings of HIV positive widow households was lower and
indebtedness higher than other HIV households.

Indeed the fact that the world does not care enough to address these
issues really expresses the degree of human degradation and this is
linked to humanity's ancient shame and fear based modes of existence. From
shame and fear and seeing the world as what it is NOT rather than what
it IS or the POTENTIAL that exists, we create a feast/famine duality
upon which one side has so much that they make themselves sick both
mentally and physically, while the other side suffers from a lack of even
the most basic resources.

What is missing from this equation is the realization that it is simply
not in humanity's interests to maintain such a dysfunctional pattern of
existence and the extremes we now see in the use of resources are not
historical norms. In the past, I believe the distance between rich and
poor was much less because of the practical limits to what technology
could do. With the loss of those natural limits to growth and technology
development, we see gross distortions between the haves and have-nots
globally. This trend if unchecked will threaten the stability of not
only globalization but the whole process of modernization itself as it
will lead not only to rising resentment but increasing impulses to strike
back at the powerful by any means necessary - terrorism.

Now in terms of your comments regarding the market system I agree but I
want to add what I see as was and is still missing in the traditional
left-right dialectic. First the left needs to accept the understanding
that liberalization is necessary but the problem is how to liberalize.
It is the difference between a development program based on rhetoric and
results driven actions involves transparency and such action oriented
development in my view involves the empowerment of local economic actors
at the grassroots.

In Africa there are many famous stories of national leaders who started
out driven by noble and idealistic visions and descended into
corruption and dictatorship and civil war. In Tanzania my understanding was that
collectivist approach inspired by Marx was a failure. Yet this does not
mean that we should or do not need to be more collective in our
approach. However, such strategies would in my view best designed as hybrid,
market driven social enterprises. This includes in my view a community
based development strategy that focuses on building a open society and
encourages local innovation in moving away from top down development
models that disregard the needs of local people while propping up the
political legitimacy of Western as well as local elites.

Also key is the rise of clever appropriate technologies and approaches
that bring people together in a multisectorial approach to development.
For example, considering a lack of adequate food supply as a key health
issue in Africa, we might consider the development of new Integrated
Farming/sustainable agriculture systems that: requires little land; is
highly productive; requires minimal inputs (mechanization, fertilizer and
pesticides); and regenerates the soil. Today the small farmer dominated
agricultural system in Africa is dependent on western agricultural
development model that benefits the western agribusiness industries more
than the people in Africa and this is the root of Africa's ills. And it
is not just the corporations selling this corrupt system but it is
western governments, academia and even most of the mainline NGO community.
And I think the reasons for this are obvious - everyone (the established
players) gets a piece of the development action.

Because most African societies are still agricultural and rural based,
we need to look at this issue deeply. Any health care solution in
Africa is not sustainable, if there is no sustainable economy for the
grassroots. And most importantly we need to provide systems for providing
healthy food for local people that does not degrade the environment to
complement any serious approach to the many health issues discussed here.
My suggestion is that the West needs to re-evaluate its role in
creating the structural deficiencies in Africa and other developing regions
and to see the key role its big business sectors play in this. If the
West is going to claim to help Africa with its situation, we need to be
serious about it and not actually do more harm than good, perpetuating
our dysfunctional role in exacerbating Africa's problem that began with
colonialism.

For example something is wrong with a system that exports coffee,
fruits and other tropical products desired by temperate affluent regions of
the world, while the people in these regions working the fields and
playing other supportive roles in sustaining this infrastructure do not
themselves have enough food to eat. We are all complicit in this
dysfunctional system and we need to take responsibility for our complicity by
doing more to support an alternative development model that promotes
sustainable agricultural solutions that focus on local needs first.

The prices of desirable commodities produced in emerging markets would
be based on a global tax as part of the WTO regime to ensure the cost
of shipping these products to western markets:
1. Credible scientific evidence that fossil fuels contribute to global
warming
2. Impact of primarily western owned plantations in terms of degrading
the soil
3. Removal of biomass from tropical regions that ends up perversely in
landfills in affluent nations and finally the reality.
4. Exploitation of the workers
5. Consideration of the fact that precious lands are being used to
export foods in regions of the world where large sections of the local
populations do not have their caloric and nutritional needs met.

The proceeds of this tax would go towards the funding of a
comprehensive sustainable development plan that would ensure that local farmers
promoting more sustainable agricultural practices could sustain themselves
and that their production if necessary would in effect be subsidized so
that more local people could afford to buy their products. This would
have the effect of inducing more balanced agricultural development
strategies so that the need to create foreign exchange through the export of
commodities was balanced with the immediate needs of local people to
adequately provide food, shelter, clothing, health care clean drinking
water and proper sanitation to themselves and their families.

"We encourage governments around the world to consider eliminating
import tariffs and non-tariff barriers on medicines... as a measure to
reduce further the cost of healthcare for the poor," G8 leaders, meeting in
Saint Petersburg in Russia, said in a statement Sunday.

They highlighted the fact that infectious diseases remain the leading
cause of death in the world and said "vigorous" action to counter this
was essential to global development and the well-being of the world's
population.

"The situation is especially acute in least developed countries,
particularly in Africa where governments and their people face limited access
to prevention and essential healthcare information," the G8 leaders
said.

They said "immediate attention" was required on bird flu, which could
become a human pandemic, and called for "effective, coordinated and
comprehensive action" to combat all infectious diseases.

The leaders said they were determined to achieve "tangible progress" in
six general areas, including keeping earlier promises on countering
major infectious diseases, monitoring their spread and working on cures.

They said that confronting the HIV/AIDS epidemic had been a top G8
priority for years and promised to continue efforts to check its spread and
that of other diseases such as tuberculosis and malaria that cause
millions of preventable deaths each year.

The leaders noted that HIV/AIDS, tuberculosis and malaria continued to
have a particularly severe impact on Africa, "where these three deadly
diseases exist side-by-side with a plethora of other deadly, endemic
infections."

"We reaffirm our partnership with African nations and with the African
Union, and will continue to work with them... to improve health systems
overall and to fight infectious diseases," the G8 leaders said.

The Group of Eight (G8) comprises Britain, Canada, France, Germany,
Italy, Japan, Russia and the United States.

In the world of malaria infection the children suffer most and it is making the generation to reduce because the government ,stakeholder,private bodies are not pay attendation to this issues.

I would like to follow up on a message that Chris White sent last
September about Mosquito/Malaria Control. Chris made the point that
interventions that are used in the United States are wrong for Africa ... but
in all honesty, I don't think he made a strong case for this.

The discussion had talked about the use of aerial spraying in the USA
in the aftermath of the Katrina hurricane ... and he correctly pointed
out that this was not spraying against malaria, but against various
other mosquito borne diseases (yellow fever, dengue and west nile virus).
Since malaria has not been a problem in the area since around 1950,
spraying against malaria is not done ... which seems to make sense! My
conclusion is that aerial spraying is a very appropriate and cost effective
way of delivering anti-mosquito pesticide, especially with modern
understanding of pesticide and the use of ultra low volume (ULV) technology.
I have made some cost estimates for aerial treatment and it is very low
cost per acre ... and depending on population density can be very low
cost per capita of human population.

Chris talks about the mosquito (specifically anopheles gambiae s.s.)
breeding in all sorts of small, transient rain-fed pools ... and how it
is unrealistic and uneconomic to expect that larvaciding can be
effective. I am not at all sure that Chris is right. From a practical
scientific point of view, larvaciding works ... though it is difficult to
organize over a big area. I don't think this problem is insurmountable,
though it must not be ignored. Arguably cleaning up the environment and
larvaciding is the best way to break the cycle of mosquito population
rebuilding. Building the Panama Canal 100 years ago was done in the face of
virulent malaria, in large part by cleaning up the environment where
the work was going on and where workers were living. Spatial information
seems to suggest that not all water has the same breeding performance.

I have not been able to find much cost and result information that
convinces me that insecticide treated bednets is the best way to go for
effective mosquito malaria control interventions. While an individual
seems to get less malaria when they use a bednet ... the cumulative
experience in the community does not seem to change very much. This may not be
the right conclusion, because the information available is not very
clear. Rather than having a focus on costs and results (as measured by
reduction in the prevalence of malaria in the community), much of the cost
performance information relates to merely the cost and the scale of
distribution of bednets into the community ... an interesting metric, but
not a metric that helps determine the effectiveness of bednets as an
anti-malaria intervention. I think it is fair to conclude that bednets on
their own do not make much of a difference, even when they are widely
distributed. I would love to know more about costs and reduction in
malaria parasite prevalence using the bednet approach.

There seems to be a lot of information that shows that interior
residual spraying (IRS) does have a significant impact on the prevalence of
malaria in the community ... and especially when DDT is used as the
pesticide. The cost of a large scale IRS program is substantial, but the
results seem to justify the expenditure, especially if DDT is permitted.
Sadly use of DDT in a country has the possibility of creating trade
issues with Europe, not so much because of prevailing legislation but
because of corporate environmental sensitivities and concern that there
might be adverse consumer impact.

The role of medical interventions is not insignificant. Remove the
parasite from the human host and malaria transmission will be reduced ...
though it is not easy to get the reduction in malaria transmission low
enough so that the parasite population gets reduced. It can be done ...
but it is not the norm for Africa at the moment.

Clearly resistance is an issue in any chemical intervention ... whether
against the mosquito or the malaria parasite. A modern management
information system for any intervention should take this into consideration
and collect appropriate data and use it to manage the interventions.

Lastly ... the information I have been able to collect seems to suggest
that a variety of interventions going on together and coordinated gives
the best results at least cost. A data driven program, including
spatial information about all the interventions and all the results can be
used to keep costs down and to deliver better than "average" results. But
in order for data to be useful, they must be organized as "management
information" for decision making and not merely to satisfy academic
criteria.