April 2015
NewsNews

Africa and the Middle East

Asia and the Pacific

PHILIPPINES -- UN Exec Urges PH to Invest vs HIV/AIDS

 

AUSTRALIA -- HIV: Rapid Testing, Preventative Drugs Used in Fight Against Queensland's Rising Infection Rate

Europe and Eurasia

HIV/AIDS and Drug Use on the Rise in Ukraine

 

More People in the UK Are Starting HIV Treatment Early, in Order to Reduce Their Risk of Transmission

Latin America and the Caribbean

TB Still a Major Health Priority for the Caribbean

North America

UNITED STATES -- Indiana Races to Fight HIV Surge Tied to Drug Abuse

 

UNITED STATES -- Half of Atlanta's Newly Diagnosed HIV Patients Have AIDS, Grady Testing Finds

 

We Can Beat AIDS in Canada. Here's How. 

Global

UNAIDS Calls for Integration of Services to End the Dual Epidemics of Tuberculosis and HIV
AdvocateAdvocate Focus
Photo courtesy of Francois Xavier Karangwa

Francois Xavier Karangwa

 

Executive Director at the Umbrella of Organizations of Persons with Disabilities in the Fight Against HIV and AIDS and in Health Promotion (UPHLS), Kigali, Rwanda

 

"When you examine the historical treatment of persons with disabilities (PWDs) in Rwanda, we have come a long way ... Today, every Rwandan knows that PWDs have a right to live with dignity and respect; international conventions, such as the UN Convention on the Rights of Persons with Disabilities, further affirm this." -- Francois Xavier Karangwa

 

Francois Xavier Karangwa is the executive director of UPHLS, a nongovernmental organization involved in health promotion and advocacy for persons with disabilities fighting against HIV and AIDS. UPHLS was founded on September 21, 2006, and is composed of eight major disabled persons' organizations (DPOs), ranging from organizations serving veterans of the Rwandan genocide to those that serve children with disabilities or survivors of psychological trauma. The HIV Policy and Advocacy Monitor spoke to Francois about his work and the needs of persons living with disabilities in Rwanda. 

 
PolicyPolicy Analysis

The Impact of PEPFAR Abstinence and Faithfulness Funding Upon HIV Risk Behaviors in Sub-Saharan Africa

2015 Conference on Retroviruses and Opportunistic Infections, conference paper

 

http://www.croiconference.org/sessions/impact-pepfar-abstinence-and-faithfulness-funding-upon-hiv-risk-behaviors-sub-saharan  

 

Stanford University researchers used Demographic and Health Survey data for 22 sub-Saharan African countries to examine the relationship between PEPFAR-supported abstinence and faithfulness programs and changes in high-risk sexual behavior. Findings suggest no relative behavior change in countries receiving this support, compared to non-funded countries. The author suggests a re-examination of PEPFAR's funding priorities to improve HIV prevention in the region.  

Responding to the Public Health Consequences of the Ukraine Crisis: An Opportunity for Global Health Diplomacy

Journal of the International AIDS Society

 

http://www.jiasociety.org/index.php/jias/article/view/19410/html  

 

Ongoing conflict and a ban on opioid substitution therapy have increased both injection drug use and HIV prevalence in Crimea. The Ukrainian conflict may also reverse previous public health gains, and the convergence of HIV, injection drug use, and other infectious diseases is a major concern. However, the crisis may offer a platform for global health diplomacy stakeholders to engage multilaterally, both to improve the region's stability and to prioritize public health in foreign policy making. 

TB/HIV Research Frontiers Meeting in Conjunction with the 22nd Conference on Retroviruses and Opportunistic Infections (CROI 2015)

World Health Organization, CROI 2015 meeting report

 

http://www.who.int/tb/challenges/hiv/croi2015_main/en/  

 

Stakeholders from the WHO, the UN, and several universities discussed high-level scientific interchange on ongoing clinical trials for empirical tuberculosis (TB) treatment in people living with HIV (PLHIV), as well as the policy impacts of that research. Attendees also discussed TB prevention in low-resource settings with high TB and HIV prevalence, and expressed concern about scaling up TB prevention among PLHIV. 

ResourcesNew Resources: Models, Tools, and Research 

Borrowing for the Cure: Debt Financing of Breakthrough Treatments

RAND Corporation

 

http://www.rand.org/pubs/perspectives/PE141.html  

 

Until recently, concerns about high-priced breakthrough pharmaceutical treatments were subordinated to the overall goal of saving lives, but medical and government officials increasingly believe that this approach is unsustainable. The authors find that further increases in pharmaceutical costs are likely in the short term, and propose a debt-financing model to combat short-term budget constraints and enable investments with greater long-term benefits.  

Poor Quality Drugs and Global Trade: A Pilot Study

The National Bureau of Economic Research (NBER)

 

http://www.nber.org/papers/w20469  

 

NBER's working paper addresses some pharmaceutical experts' belief that Indian drug manufacturers produce substandard drugs for countries with insufficient regulatory oversight, especially in Africa. Nearly 11 percent of the antibiotics and tuberculosis drugs examined in the study were found to be substandard. These products were more likely to be distributed in Africa than other markets. 

Increasing Capacity in GBV Programming from Program Integration to Community Perceptions

Health Policy Project

 

http://www.healthpolicyproject.com/index.cfm?ID=publications&get=pubID&pubID=565  

 

This report assesses efforts by the USAID- and PEPFAR-funded Health Policy Project to integrate gender-based violence (GBV) prevention activities into existing HIV programs in Mozambique. The assessment documents the extent to which local program staff responded to GBV trainings, implemented gender- and GBV-integrated program design, and executed prevention and response mechanisms. It also reports on community members' attitudes and knowledge regarding gender equality and GBV. 

AdvocacyAdvocacy

Economic Rationale for Advocating for Sexual Minorities: Lessons Learned from Uganda

Kuria Foundation for Social Enterprise

 

http://www.kuriafoundation.or.ke/Economic_Rationale_for_Advocating_for_Sexual%20_Minorities_final%20.pdf 

 

The Kuria Foundation's report details possible economic consequences for Kenya if it were to adopt a series of anti-homosexuality laws modeled on Uganda's Anti-Homosexuality Act 2014, which led to currency devaluation and donor and trade consequences.  

Corruption and Averting AIDS Deaths -- Working Paper 395

Center for Global Development

 

http://www.cgdev.org/publication/corruption-and-averting-aids-deaths-working-paper-395  

 

Willa Friedman's paper examines the impact of corruption on antiretroviral effectiveness in reducing HIV- and AIDS-related mortality. Compared to countries with less corruption, highly corrupt countries see little to no reduction in mortality from the same expenditure on treatment. Further research on corruption mechanisms that limit the effectiveness of health spending can help identify solutions. 

Politicians Need to Get Over their Squeamishness About Needle Exchange Programs

The Washington Post

 

http://www.washingtonpost.com/blogs/wonkblog/wp/2015/03/31/politicians-need-to-get-over-their-squeamishness-about-needle-exchange-programs/  

 

Christopher Ingraham's blog post examines political opposition to needle exchange programs in the context of rural Indiana's recent HIV outbreak. Ingraham highlights the belief that these programs encourage drug use, which has led to bans on the practice in 24 states and congressional prohibition of federal funding. Scientific evidence has shown these programs to be effective in preventing HIV without encouraging drug use. 

InterviewInterview with Francois Xavier Karangwa

 

HIV Policy and Advocacy Monitor: Tell us about your organization's mission and its focus on HIV policy and advocacy work.

 

UPHLS' vision is to achieve an HIV-free society, as well as full societal inclusion for persons with disabilities (PWDs). We advocate for the rights of PWDs, particularly regarding their access to health, and we provide HIV prevention programs. Generally, UPHLS supports disabled persons' organizations (DPOs) through capacity-building efforts, monitoring and evaluation of HIV-related activities, and providing health promotion activities for PWDs.

 

Before establishing this kind of organization, you must understand the area in which you will operate. When UPHLS was founded in 2006, HIV represented a very big problem in Rwanda. We sought to address the issue by collaborating with DPOs and the Ministry of Health to determine how persons with disabilities could be included in the HIV response. The idea was that UPHLS would advocate for PWDs and respond to the challenges they faced in accessing HIV services, including communication barriers and poor socioeconomic situations.

 

 

HIV Policy and Advocacy Monitor: What factors have motivated you and led to your involvement in policy and advocacy with UPHLS?

 

First, I have a physical disability. For me, working with UPHLS was a good opportunity to advocate for my rights to healthcare and become more involved in policy and advocacy work for PWDs.

 

Second, when you examine the historical treatment of persons with disabilities in Rwanda, we have come a long way. Before independence in 1961, our culture allowed for children with disabilities to be thrown out or hidden. It wasn't until after the genocide in 1994 that advocacy for the rights of PWDs gained traction. Today, every Rwandan knows that PWDs have a right to live with dignity and respect; international conventions, such as the UN Convention on the Rights of Persons with Disabilities, further affirm this.

 

Third, my legal background and master's degree in public health provide me with a unique perspective in PWD advocacy--specifically, the intersection of the law and public health issues.

 

 

HIV Policy and Advocacy Monitor: Why is advocacy important in the response to HIV?

 

Now that donors and the Ministry of Health are working more with civil society and community-based organizations, UPHLS has the opportunity to present its messages to a broader range of stakeholders and technical working groups to ensure that PWDs are included in the HIV response. Our key achievements include the adaptation of HIV tools (including information on family planning, gender-based violence, prevention of mother-to-child transmission, and opportunistic infections) to address communication barriers often faced by PWDs. These tools have been disseminated to our beneficiaries countrywide. We have also worked with six neighboring countries (Uganda, Kenya, Tanzania, South Sudan, Ethiopia, and Rwanda) and have called for advocacy activities at the Eastern African Disabilities Organization to mainstream PWDs within society and the health system.

 

 

HIV Policy and Advocacy Monitor: What are the main policy priorities in Rwanda for you and your organization?

 

The first priority would be to ensure that health polices acknowledge the challenges faced by persons with disabilities when accessing services. We have a law mandating medical insurance, but provisions to help PWDs access insurance and receive necessary medical care would make it more disability-friendly.

 

For me, the second priority is related to education policies--especially for children with disabilities. If these children are able to go to school and develop technical skills, carefully designed educational policies can make a positive impact on their professional development and economic security.

 

The third priority is to address gender-based violence and rape. Policies and social movements related to these issues can too often ignore people with mental impairment or disabilities, placing them at greater risk for acquiring HIV.

 

Finally, and perhaps most importantly for me, is the issue of job equality. Rwanda has policies that require employers to hire PWDs and women to fill select quotas. The government must work with the private sector to increase employment opportunities for PWDs--for example, by providing tax breaks as an incentive to hire employees with disabilities--thereby improving their likelihood for economic security.

 

The USAID- and PEPFAR-funded Health Policy Project's HIV Policy and Advocacy Monitor is a monthly newsletter focusing on the advancement, development, and analysis of policies, advocacy campaigns and organizations, and policy-related data to inform the response to HIV and AIDS at the global, national, and local levels. It includes news items, resources, advocacy reports, and innovative policy analyses on a wide range of topics such as treatment, key populations issues, gender, and financing for HIV policies and programs.

 

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

 

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 Plan International USA, Avenir Health (formerly 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).