Welcome to the Health Policy Project's HIV Policy Monitor, monthly compendium of analytical documents and news from around the world that focuses on the advancement, development, and analysis of policies and information related to HIV and AIDS. This newsletter will include innovative policy reporting on a wide range of topics including treatment, key populations, gender, HIV financing for policies and programs, and more. It is our hope that this information helps guide your work and continues to show the importance of policy advances, debates, advocacy, communication, and data analysis in improving the health and well-being of citizens. We look forward to your feedback and hope you share this resource with your friends and colleagues.  

 

If you would like to suggest an item to be included in the next issue, please send it to:  policyinfo@futuresgroup.com

 

Help us by taking this short survey and letting us know your thoughts about the HIV Policy Monitor:

https://www.surveymonkey.com/s/LTVHCT8

 

Sections:

News

Policy Analysis

New Resources: Models, Tools, and Publications

Contents

October 2013

 

News


Policy Analysis
newsNews
australia1AUSTRALIA: Fear States Will Go Own Way On AIDS
October 18, 2013

http://www.theaustralian.com.au/national-affairs/policy/fear-states-will-go-own-way-on-aids/story-fn59nokw-1226741997798

Documents obtained by The Australian under Freedom of Information laws reveal that the federal Health Department believes the current strategies, which expire at the end of the year, are in need of a major overhaul that may cause tensions between governments.

"There may be difficulty in gaining agreement across all jurisdictions for a set of targets, given each state's different experiences with the epidemic, varying approach and level of focus on each of the areas covered under the strategies," former health minister Tanya Plibersek was advised in March.
australia2AUSTRALIA: African activists welcome ACT bill
October 25, 2013

http://www.townsvillebulletin.com.au/news/breaking-news/african-activists-welcome-act-bill/story-fnjbnxoj-1226746668812

The press in Africa have run stories on the decision, with gay communities and their supporters warmly welcoming the move.

Speaking from Gambia, renowned gay and lesbian rights advocate Pepe Onziema said on Friday: "I celebrate with the gay community in Australia. I believe every adult should have the right and choice to marry who they love."

Burundi gay activist Stella Uwimana said: "It is great that lawmakers in Australia have at last seen light as far as same sex marriage is concerned. I salute them over that."
She urged legislators in Africa to follow suit and not only allow homosexual people to live freely, but let them marry one another if they so wish.

An activist in the Democratic Republic of Congo, Pierre Lovi, said: "If developed countries like Australia and others can allow same sex marriage, why do some African countries still regard the act as a terrible sin? They need to wake up."

"I hope those advocating for the anti-gay bill (in Uganda) to be passed into law have learnt something from Australia," said Ugandan, activist James Kajaga.
belgiumBELGIUM: Belgium Launches Robust National HIV Plan
October 16, 2013

http://www.unaids.org/en/resources/presscentre/featurestories/2013/october/20131016belgium/

The 2014-2019 strategic plan has three central pillars: HIV prevention; testing and treatment; and care and support. It addresses a context in which more than a thousand new HIV infections are being reported each year. The plan prioritizes most affected populations including men who have sex with men and migrant workers. Despite relatively low numbers of people living with HIV in Belgium-the AIDS epidemic remains a concern as the rate of new HIV infections has not declined in recent years.

Far-reaching, multi-year and multi-sectoral, the plan was developed through a highly consultative process with the engagement of a range of actors including people living with HIV, key populations, medical professionals, community activists and national authorities. UNAIDS was also involved in its development.
borneoBORNEO: Govt's High Commitment Helps Reduce HIV/AIDS Cases
October 29, 2013

The government's high commitment, including in introducing the premarital Human Immunodeficiency Virus (HIV) test for Muslim couples, has given significant contribution to the decline in the number of HIV/AIDS cases in the country, the Dewan Rakyat was told.

Deputy Health Minister Datuk Seri Dr Hilmi Yahaya said the latest statistics showed that between January and June this year, only 1,702 new HIV cases (11.5 cases for every 100,000 population) were recorded compared to 6,978 cases (28.5/100,000) recorded in 2002.
canadaCANADA: Calls for improved HIV/AIDS care in Manitoba and Canada
October 22, 2013

http://www.themanitoban.com/2013/10/calls-improved-hivaids-care-manitoba-canada/17137/

The MHP is also asking for "provincially supported HIV tests," and uniform, provincially-funded medications for all Manitobans with HIV. According to the MHP, individuals with HIV currently pay a deductible to cover their care, and this "creates barriers for people living with HIV."

"Anywhere from 30 to 60 Manitobans per year have to stop taking their medications because they cannot afford it," explained Kasper, noting that this estimate may be low due to a lack of data on rural cases.

"We're asking the province to do what they did with cancer care, and have medication access for all Manitobans," continued Kasper, who, along with Montaner, was scheduled to meet with provincial government ministers later that day.
chinaCHINA: Outcry Over China Plan to Ban HIV Patients From Public Baths
October 14, 2013

http://www.bbc.co.uk/news/world-asia-24518447

The proposal orders public bathhouses to display signs prohibiting "people with sexually transmitted diseases, Aids and infectious skin diseases". It has been posted online for public consultation by China's State Council.

But Aids activists and ordinary users of Weibo, China's version of Twitter have strongly criticised the move. "There is no evidence that people can be infected with HIV in public bathhouses," Wu Hao, from the Beijing Research Centre on Sexually Transmitted Diseases and Aids, was quoted as saying by the Beijing Morning News.

The proposal has also been condemned by the United Nations' Aids agency. Hedia Belhadj, China country coordinator for UNAIDS, said it was concerned by the provision and called for it to be removed, the AFP news agency reports. She said that there was no risk of transmission of HIV in a spa or bathhouse setting.
gambiaGAMBIA: Gambian Gays Flee Persecution in Home Country Only to Face Discrimination in Senegal
October 24, 2013

http://www.foxnews.com/world/2013/10/24/gambian-gays-flee-persecution-in-home-country-only-to-face-discrimination-in/

Alhaji, a 21-year-old gay man, knew there was trouble when he heard that an uninvited guest was snapping photos in the middle of his poolside birthday party in Gambia's capital.

That photographer turned out to be a member of Gambia's feared National Intelligence Agency, and accused Alhaji of throwing "a gay party" in violation of Gambian law.
He and 17 other men were taken into custody that night. In the months that followed, he said they were interrogated, beaten and subjected to a very public trial that destroyed their reputations in a country where President Yahya Jammeh has called for sexual minorities to be decapitated.
indonesiaINDONESIA: Jakarta Lays on free, Confidential HIV Tests For All 
October 23, 2013
 
Seeing an increase in HIV cases in Jakarta, the city administration and the Jakarta chapter of the National AIDS Commission (KPAP Jakarta) are offering free, confidential HIV testing and counseling for a month from Tuesday to Nov. 21.

Teams manned by the Jakarta Health Agency and Commission staff as well as relevant NGOs will be deployed to provide a Voluntary Counseling and Testing (VCT) program in public places, including shopping malls, targeting a wider section of the populace in the city's five municipalities.
jamaica1JAMAICA: Church Rebuffs Gay Marriage
October 14, 2013

The position also appeared to be much softer on homosexuals than previously, noting: "While the council affirms the prophetic role of the church, it also affirms its pastoral role and so appeals to the church, as well as the wider religious community, not to speak or act in ways that could ostracise, incite violence or any other treatment of indignity towards persons who are homosexuals, as they too are bearers of the 'image of God' and for whom Christ died. The church must also be ready to support families who have to cope with the implications of homosexuality within...

"The council further affirms that all of humanity shares in a common human brokenness (Romans 8:22) and therefore deserves to receive the love and pastoral care of the Church that is modelled off the love, compassion and grace that Jesus Christ demonstrated in His earthly ministry."

"As a politically independent and sovereign state, we must resist such imposition and allow for our own people to determine what is in the best interest of Jamaica," the JCC said.

It added that as a non-negotiable, the JCC strongly believed that the practice of homosexuality must never be promoted as a normal and natural way of life and on par with heterosexual lifestyle; and that every effort must be made to protect children from being lured or forced into sexual activities, whether homosexual or heterosexual.
jamaica2JAMAICA: Employers Could Face Sanctions for HIV-Related Discrimination Under New Bill 
October 18, 2013

http://www.jamaicaobserver.com/news/Employers-could-face-sanctions-for-HIV-related-discrimination-under-new-bill

He said it is imperative that discrimination and stigma against these people be eliminated, as they pose no harm in the general work environment

The OSH Bill, which is being drafted, and is expected to be passed by April 2014, will set the groundwork for the protection of all workers in all spheres of economic activities, and will comprehensively address all occupational hazards
japanJAPAN: Japan's Gay Community Asks For Better Living Conditions 
October 17, 2013

http://www.tokyotimes.com/2013/japans-gay-community-asks-for-better-living-conditions/

Japan does not have an anti-gay law or legal protections for homosexuals. Some in the gay community are actively seeking legislation to guarantee their rights, but others, especially those who remain in the closet, prefer a more gradual approach by striving to solve problems they face in their daily lives, activists say, according to Kyodo news agency.
Kaito Akechi, 36, a gay activist who has been lobbying for a "partnership law" in Japan to provide legal protections for same-sex couples, said his group aims to raise the status of homosexual couples so that they can be treated the same way as heterosexual couples in common-law marriages.

Japan situates itself in the middle when it comes to gay marriage. While it does not obviously discriminate sexual minorities, it does not show too much support either for recognizing or legalizing unions between same-sex couples.
kenyaKENYA: Mombasa County to Budget for HIV-AIDS War
October 16, 2013

http://www.the-star.co.ke/news/article-139788/mombasa-county-budget-hiv-aids-war

MOMBASA county government will include HIV/Aids funding in its budgetary process to help fight the spread of disease in the county. County health executive Job Tumbo yesterday said the funds will be an addition to the county's partnership with different stakeholders to curb the virus.

He said HIV/Aids is still a priority in the county as it is still among the high prevalence areas in the country. He was speaking at a Mombasa hotel during the Mombasa county meeting on persons living with HIV and the new WHO treatment guidelines.

"We are ready to work with partners to curb the spread of HIV/Aids.Mombasa county will emphasize the fight against HIV and budget for the campaign against Aids," said Tumbo.

He said the National Aids and STI Control Program (NASCOP) has not yet released the WHO recommendations, the county is willing to implement them once the resources are available. Aids Healthcare Foundation Mombasa county coordinator Mary Nyaguthi urged residents to join the fight.
laosLAOS: Compulsory Detention For Drug Use Undermines Treatment in Laos 
October 11, 2013

"People who use drugs are treated first and primarily as criminals, with their health needs often not properly addressed with evidence-based interventions," said Robert Gray, a technical expert on harm reduction for Population Services International (PSI), a nonprofit global health organization headquartered in Washington, DC.

"We need to help local and national-level authorities - especially law enforcement agencies - to develop a more accurate understanding of what drug dependence really is and how it is linked to things like the risk of contracting HIV/AIDS," said Juana Tomás-Rosselló, a medical doctor and project coordinator with UNODC in the Asia-Pacific, who is based in Bangkok.
NigeriaNIGERIA: 80 Million to Undergo HIV Test in Presidential Response Plan
October 8, 2013

About 80 million Nigerians could undergo testing for HIV virus in the next two years, in efforts to enable them know their status, according to the new President's Comprehensive Response Plan for HIV/AIDS backed by National Agency for Control of AIDS, NACA.

The tests, said to have commenced in four states, comes as more than 40% of people already living with the virus do not know their HIV status, said NACA director-general Prof John Idoko at a sensitisation workshop in Abuja for the presidential plan
RussiaRUSSIA: European Physicians Condemn Impact of Russian Anti-Gay Law on HIV Prevention and Care 
October 16, 2013

http://www.aidsmap.com/European-physicians-condemn-impact-of-Russian-anti-gay-law-on-HIV-prevention-and-care/page/2780967/

"We are concerned that these provisions not only affect basic human rights, but also result in harmful public health policy since they add to the already-existing barriers related to HIV prevention, diagnosis, access and retention in care", EACS stated. "The legal framework in States should do everything to reduce stigmatisation."
Russian politicians have been extremely resistant to lobbying from foreign politicians on questions of human rights, not least on recent legislation and rhetoric which seeks to stigmatise and marginalise alternative sexualities. In a recent interview, President Putin insisted that no discrimination against gay people existed in Russia
scotlandSCOTLAND: AIDS Fear Over Condom Ban in Edinburgh's Sex Saunas as Police Launch Major Crackdown in the City
October 23, 2013

http://www.dailyrecord.co.uk/news/scottish-news/aids-fear-over-condom-ban-2482411#ixzz2jFsg3ke5

A POLICE demand to ban condoms in Edinburgh's sex saunas could put lives at risk, campaigners claimed yesterday.

Police Scotland, who are accused of cracking down on the saunas, want a new rule that "no items of a sexual nature will be permitted".

But AIDS charity the Terence Higgins Trust said: "Taking away condoms will not stop people having sex. It will result in unprotected sex and increased rates of HIV and sexually transmitted diseases."
And Scot-Pep, who campaign for rights for sex workers, said: "This is a return to the dark days of the 80s, when an HIV epidemic swept through the city."

Lothians MSP Margo MacDonald, a strong critic of police on the saunas issue, said of the proposed condom ban: "I don't know what their intention is, but this would completely destroy the safer sex message that has been delivered to the sex industry and wider community over the last 30 years.
southafricaSOUTH AFRICA: PEPFAR in Transition - Implications for HIV Care in South Africa
October 10, 2013 
 
http://www.nejm.org/doi/full/10.1056/NEJMp1310982

South Africa receives more than $500 million annually from PEPFAR but is also the only PEPFAR-funded country that has underwritten most of its own HIV budget for the past 5 years. As the government transitions to independence, it has begun closing many of the specialized HIV-treatment centers created by PEPFAR, moving patients into government-run, community-based health care centers, where long waiting times and medication shortages are common. Some observers worry that this shift will threaten the tremendous gains PEPFAR has brought. "We are working closely with the government of South Africa to decide how we can successfully shift many of the services that PEPFAR provided and decide what is essential for HIV care," said the U.S. Global AIDS Coordinator, Ambassador Eric Goosby. "The tension is determining how to continue to provide state-of-the art treatment and care at affordable prices."
tanzaniaTANZANIA: MPs Hail PPF Efforts in Fight Against HIV 
October 26, 2013 

 
http://allafrica.com/stories/201310270188.html

Deliberate efforts by the PPF Pensions Fund to support the government initiative in fighting HIV/Aids has won the accolades by members of the Parliamentary Committee, Aids and Drug Control who visited PPF Headquarters in Dar es Salaam on Friday.

Speaking at the opening of discussion whereby the legislators made their contributions in the struggle to prevent new HIV/Aids infections, the Director General of PPF Pensions Fund, Mr William Erio said 100m/- had been set aside this year in support of the national initiative.

"PPF continues to reach out the community through Peer Group Educators particularly from this office. PPF formed HIV/Aids Committee. Workers and their family members are informed about preventive measures through fliers, pamphlets and seminars," Erio explained.
thailandTHAILAND: Cabinet Approves Strategy to Stop HIV/AIDS
October 9, 2013

http://www.pattayamail.com/news/cabinet-approves-strategy-to-stop-hiv-aids-30937

The strategy set a goal for 2016 targeting the reduction by two-thirds the number of new HIV/AIDS patients in order that the infection ratio in new-born babies can fall be less than two per cent. Patients will also be socially protected and provided equal access to qualified treatment, while the number of AIDS-related deaths should drop by more than half.

The spokeswoman said a budget for the project is expected next year at Bt11.2 billion, rising to Bt11.8 billion for 2015 and Bt12.5 billion for 2016 for continued protection and solutions to the problem and to achieve the United Nations' 'Getting to Zero' campaign.
ukUNITED KINGDOM: Theresa May NHS Immigration Proposals Could Cost Millions and Help Spread HIV  
October 10, 2013  

http://www.mirror.co.uk/news/uk-news/theresa-nhs-immigration-proposals-could-2359159


"Many studies highlight that more than half of new HIV infections are passed on by people who are undiagnosed; and encouraging GPs to carry out immigration checks sends out entirely the wrong message, and could be counterproductive.

"The Government must listen to concerns from health professionals and HIV experts, as this Bill could have a grave effect on tackling the numbers of late diagnoses in migrant communities - leading to potentially disastrous implications for public health."
uzUZBEKISTAN: UNAIDS Applauds Uzbekistan for Removing Restrictions on Entry, Stay and Residence for People Living With HIV
October 21, 2013

http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/october/20131021travel/

"I welcome this important milestone in Uzbekistan and I hope this will encourage other countries to take similar action towards a world with zero HIV-related stigma and discrimination," said the Executive Director of UNAIDS, Michel Sidibé.

UNAIDS advocates for the right to equal freedom of movement-regardless of HIV status. There is no evidence that restrictions on the entry, stay or residence of people living with HIV protect the public's health.

As part of its on-going dialogue with countries on this issue, in July 2013, UNAIDS sent official communications to all countries, territories and areas that appeared to have HIV-related entry, stay and residence restrictions. Through this exercise, new information was received from Andorra and the Slovak Republic, indicating that there are no HIV-related restrictions in these countries.
policyPolicy Analysis
bargainA Bargain Too! Analysis Shows Early HIV Treatment Provides Good Economic Value, Along With Health and Transmission Prevention
Science Speaks: HIV &TB News

http://sciencespeaksblog.org/2013/10/31/a-bargain-too-analysis-shows-early-hiv-treatment-provides-good-economic-value-along-with-health-and-transmission-prevention/

The landmark HPTN 052 study, which proved in 2011 that treating HIV also prevents transmission of the virus, continues to be the gift that keeps on giving, with data from the multi-site trial now showing that early treatment is cost-effective as well, results of a just-released analysis reported in the New England Journal of Medicine says.

Dr. Rochelle Walensky, corresponding author of the NEJM report, called the conclusions exciting, noting that recently updated World Health Organization guidelines recommending earlier antiretroviral treatment initiation have not been widely adopted, and that evidence the move can be cost effective can help inform decisions. 
questionA Question of Quality: Why Retention Matters for AIDS Treatment Mead Over
Center for Global Development

http://www.cgdev.org/blog/question-quality-why-retention-matters-aids-treatment

Counting the number of patients on treatment is no longer enough. For years even the friendliest critics of the global struggle against AIDS have pointed out that this metric unfairly neglects the people who are not put on treatment and then die, largely because their deaths are uncounted except in so far as they increase the treatment "coverage rate." This diverts attention from the challenge of assuring that patients are retained on treatment and remain alive and healthy, rather than failing treatment and dying, sometimes after only a few months.
LALA HLPP-New HIV Law and Policy Collaborative Launches October 2, 2013
Lauri Gavel, UCLA School of Law

http://www.law.ucla.edu/news-media/Pages/News.aspx?NewsID=2518

The Los Angeles HIV Law and Policy Project (LA HLPP)-a new collaborative partnership of the Disability Rights Legal Center (DRLC), the Los Angeles County Bar Association (LACBA), Inner City Law Center (ICLC) and UCLA School of Law-will launch on October 2, 2013 at The Edison, in downtown Los Angeles.

LA HLPP will provide access to legal services and policy research support for the more than 60,000 people living with HIV and AIDS in Los Angeles previously left without any system of centralized legal support. The collaboration is designed to utilize the resources of pro bono attorneys from LACBA's AIDS Legal Services Project, law students and public policy research from UCLA and staff attorneys from DRLC and ICLC to create a new major service resource for Angelinos living with HIV and struggling to receive care.

newpublicationNew Publication Addresses Human Rights Challenges in the Caribbean
UNAIDS

http://www.unaids.org/en/resources/presscentre/featurestories/2013/october/20131023caribbean/

A book exploring the challenges and legal stumbling blocks to overcoming stigma and discrimination in the Caribbean was launched on 22 October in Port-of-Spain, the capital of Trinidad and Tobago. Legal and Policy Perspectives on HIV and Human Rights in the Caribbean was co-edited by former United Nations Special Envoy on HIV for the Caribbean, Sir George Alleyne and law professor, Rose-Marie Belle Antoine. The publication includes contributions from a range of experts who participated in a high-level symposium convened by UNAIDS, the Pan Caribbean Partnership against HIV and AIDS (PANCAP) and the University of the West Indies (UWI) in 2010.
advancingAdvancing HIV Justice: A Progress Report on Achievements and Challenges in Global Advocacy Against HIV Criminalization 
Global Network of People Living With HIV, HIV Justice Network

Ever since the HIV epidemic began, there have been those who want to address HIV - and people living with HIV - with punitive approaches. One of these approaches has been the application of criminal laws against people living with HIV for non-disclosure, exposure and transmission. Most of these laws, and the prosecutions under them, have been overly broad. That is, they disregard scientific evidence about HIV and/or ignore critical criminal law principles, including foreseeability, intent, causality, proportionality, defence and proof. For those prosecuted and convicted, these laws result in miscarriages of justice and lives ruined. For the HIV epidemic, these prosecutions send out misleading and discriminatory messages, undermining proven public health strategies.

This document scans the current situation, the good developments and the bad; details the many initiatives by independent experts, governments, the United Nations and civil society; describes the latest research and its findings in terms of prosecutions and convictions and the social impact of these on the HIV response and people's behaviour. Most importantly, it powerfully demonstrates that civil society advocacy on this issue is not only alive - it goes from strength to strength.
resourcesNew Resources: Models, Tools, and Publications
POLICYPolicy Analysis and Advocacy Decision Model for HIV-Related Services 
Health Policy Project
 
People Who Inject Drugs 

Males Who Have Sex with Males, Transgender People, and Sex Workers

Designed to help country stakeholders build a public policy foundation that supports access to and implementation and scale-up of evidence-informed services for key populations, the Decision Model helps to clearly identify and address policy barriers to services. Its policy inventory and analysis tools draw from the extensive body of international laws, agreements, standards, and best practices related to key population services, allowing the assessment of a specific country policy environment in relation to these standards. This customizable, in-depth, and standardized approach will build stakeholders' capacity to identify incremental, feasible, near-term opportunities to improve the legal environment and the resulting quality of and access to services for key populations while long-term human rights strategies are implemented.
tacklingTacking HIV/AIDS Among Key Populations: Essential to Achieving an AIDS-Free Generation
amfAR

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has embarked on a historic effort to ensure an AIDS-free generation. This visionary initiative aligns with broader international efforts that aim to lay the foundation for the eventual end of HIV/AIDS.

However, ending the AIDS epidemic will not be possible without greatly increased efforts to reduce new infections and prevent AIDS-related deaths among key populations at highest risk of HIV acquisition and transmission. This issue brief focuses on four such populations- sex workers, people who inject drugs, men who have sex with men (MSM), and transgender individuals-and demonstrates why equitable attention to the HIV-related needs of these groups is essential to future progress on AIDS and why current efforts are failing to get the job done. In light of growing evidence that antiretroviral therapy dramatically reduces the risk of HIV transmission,3,4 ensuring access to competent HIV testing and treatment services is a particular priority for these key populations and for the broader AIDS response.

Join Our Mailing List
Logo Bar: USAID/PEPFAR/HPP  
About the Health Policy Project   

The Health Policy Project is a five-year cooperative agreement funded by the United States Agency for International Development (USAID) under Cooperative Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. The project's HIV-related activities are supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with CEDPA (part of Plan International USA), Futures Institute, Partners in Population and Development Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA).