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Report of an International Consultation on AIDS and Human Rights. Geneva, 26-28 July 1989. Organized by the Centre for Human Rights with the technical and financial support of the World Health Organization Global Programme on AIDS.
New York, New York, United Nations, 1991. iii, 57 p.In July 1989, ethicists, lawyers, religious leaders, and health professionals participated in an international consultation on AIDS and human rights in Geneva, Switzerland. The report addressed the public health and human rights rationale for protecting the human rights and dignity of HIV infected people, including those with AIDS. Discrimination and stigmatization only serve to force HIV infected people away from health, educational, and social services and to hinder efforts to prevent and control the spread of HIV. In addition to nondiscrimination, another fundamental human right is the right to life and AIDS threatens life. Governments and the international community are therefore obligated to do all that is necessary to protect human lives. Yet some have enacted restrictions on privacy (compulsory screening and testing), freedom of movement (preventing HIV infected persons from migrating or traveling), and liberty (prison). The participants agreed that everyone has the right to access to up-to-date information and education concerning HIV and AIDS. They did not come to consensus, however, on the need for an international mechanism by which human right abuses towards those with HIV/AIDS can be prevented and redressed. International and health law, human rights, ethics, and policy all must go into any international efforts to preserve human rights of HIV infected persons and to prevent and control the spread of AIDS. The participants requested that this report be distributed to human rights treaty organizations so they can deliberate what action is needed to protect the human rights of those at risk or infected with HIV. They also recommended that governments guarantee that measures relating to HIV/AIDS and concerning HIV infected persons conform to international human rights standards.
Breastfeeding, breast milk and human immunodeficiency virus (HIV). Statement from the Consultation held in Geneva, 23-25 June, 1987.
WHO REPORT. 1988; 1-2.Recommendations from a consultation on breastfeeding, breast milk and HIV infection held by the Global Programme on AIDS and the Division of Family Health of the WHO in June 1987 are summarized. 20 participants from 15 countries, experts in epidemiology, immunology, virology, pediatrics and nutrition attended. There is a 25-30% chance that HIV will be transmitted from mother to infant during the perinatal period. Whether HIV can be transmitted via breast milk is unknown and risk is thought to be small. While there is 1 report of HIV cultured from breast milk, and a few cases of mothers infected after delivery by blood transfusions who transmitted HIV to their infants by breastfeeding, there are many reports of infected mothers breastfeeding without infecting their infants. Breast milk is still the best food for infants for immunologic, nutritional, psychological and child-spacing benefits. It is recommended that breastfeeding continue to be promoted in both developing and developed countries, regardless of HIV status. The use of pooled human milk is the second best mode of infant feeding. Pasteurization at 56 degrees C. for 30 minutes will inactivate HIV. Wet nurses should be chosen with care.
Tuberculosis control and research strategies for the 1990s: memorandum from a WHO meeting] Estrategias de control e investigacion de la tuberculosis en el decenio de 1990: memorandum de una reunion de la OMS.
BOLETIN DE LA OFICINA SANITARIA PANAMERICANA. 1993 May; 114(5):429-36.Mycobacterium tuberculosis, the pathogenic agent causing tuberculosis, is carried by one third of the world's population. Some 8 million new clinical cases of tuberculosis are diagnosed annually. Pulmonary tuberculosis is the most infectious clinical manifestation, tubercular meningitis is the principal form causing infant death, and tuberculosis may affect various other organs. Untreated tuberculosis has a fatality rate of over 50%. Chemotherapy greatly reduces the rate, but some 2.9 million persons die of tuberculosis each year because of the inadequacy of many national treatment programs. Tuberculosis is the most important cause of death from a single infectious agent in the world. An estimated one fourth of avoidable deaths to adults aged 15-59 in the developing world are attributed to tuberculosis. Tuberculosis is especially prevalent in Africa south of the Sahara and in Southern Asia. Two new obstacles threaten to aggravate the problem: the HIV epidemic and drug resistance. HIV infection is the most serious risk factor yet identified because it converts latent tuberculosis infection into active disease. In Africa almost half of all persons seropositive for HIV are also infected with tuberculosis. Ineffective treatment programs favor the formation of pharmacoresistent strains, and drug resistance has become a major problem in various parts of the world. Effective measures exist to control tuberculosis. Although it does little to protect adults against infectious forms of tuberculosis, the BCG vaccine prevents the most lethal forms. Coverage of infants the BCG is over 80% in the developing world as a whole, but under 60% in sub-Saharan Africa. Chemotherapy can cure almost all cases and convert cases with positive sputum into noninfectious cases, reducing transmission. Normal treatment must be administered over at least 12 months, straining the resources of health services in developing areas. The introduction of a shorter therapy has revolutionized treatment in some national programs, which have achieved cure rates of 80% in new patients. Evaluation of some national programs has demonstrated that well managed short duration chemotherapy is cost effective even under difficult conditions. Progress in controlling tuberculosis has been slower than expected in developing countries because of excessive optimism about the prospects for quick declines as occurred in the industrialized countries, and because of lack of resources. A well organized and vigorous international effort under World Health Organization leadership is required to bring the tuberculosis problem to the world's attention, mobilize assistance on a wide scale, and provide information and direct support to national programs. Research will be needed to adapt proven control techniques to local cultures, develop new drugs, shorten treatment regimens, and encourage greater patient compliance.
AIDS Education and Prevention. 1992 Fall; Suppl:1-13.Homelessness among youth is universal, but is particularly great in developing countries. Children advocates have categorized youth with no fixed address in the US as runaways, throwaways, homeless youth, system youth, and street youth. About 50% of such youth are system youth who have lived in institutions or foster homes. Around 21% are children whose parents forced them out of the home. 60% have been sexually abused at home. Homeless youth are at higher risk of HIV than those who have a home. This risk comes primarily from unprotected, often homosexual, intercourse and iv drug use. Some subgroups of street youth in Brazil have an HIV prevalence rate of 35%. Street youth take on these risky behaviors to just survive. PAHO, WHO, and UNICEF have placed HIV prevention among teenagers as a top priority. VArious countries have hosted national and international conferences on this topic. In June 1990, the 1st International Conference on AIDS and Homeless Youth took place in San Francisco to gather international community specialists from 32 countries to respond to the AIDS crisis. Many recommendations came from this conference. 1st, all nations and international bodies must recognize and enforce the rights of children. Street youth must have access to comprehensive health care (mental health care, treatment for substance abuse, bereavement services, and HIV testing and counseling). Health workers must be prepared to provide street-based services. HIV prevention messages based in reality must reach these children. Research needs include epidemiologic data, cross-national and cross-cultural trends, ethnographic descriptions, and high risk behaviors. The next international conference is planned for September 1992 in Brazil and will include street youths as delegates.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1992; 70(1):1-6.Rural-urban migration and population growth are occurring more quickly now than ever before in history. These phenomena have resulted in overcrowded urbanization and increased densities of vectors which in turn have caused an increase in disease such as malaria and dengue and dengue hemorrhagic fever. Besides urban areas foster the breeding of mosquitoes, rats, and other pests. Further governmental services in both developed and developing countries have not been able to keep up with housing and sanitation needs. Moreover new migrants continue to move into temporary housing (slums) made of inferior materials with no services while the previous occupants improve their wages and move on to better housing. Thus little incentive exists to improve slums where sanitation is poor and disease common. In addition, many formerly rural people continue rural practices and traditions in urban areas such as patterns of water storage. Further people often try to control vectors by applying pesticides, but do so haphazardly and/or in an unsafe, uncontrolled manner. They even use empty pesticide containers for storing water or food. Besides insecticide resistance is spreading. WHO encourages governments to integrate disease control programs with primary health care, but most such integrated programs operate in developed countries. Integrated approaches include less dependence on pesticides; encouraging changes in human behavior; disseminating health messages; community participation, particularly the youth; mobilization of human and financial resources; and proper urban development, e.g., better quality housing and adequate sanitation and potable water.
INTERNATIONAL HEALTH NEWS. 1988 Feb; 9(2):7.At a panel on Acquired Immune Deficiency Syndrome (AIDS) and the 3rd world in January 1988, experts focused on the profound problems generated by the AIDS pandemic. The World Health Organization (WHO) estimates that 3-5 million people in at least 127 countries now suffer from AIDS and that this figure will reach 10-30 million by 2000. The disease represents a highly debilitating force, both socially and economically, even in nations able to afford the approximately $6000/patient cost per year of treating AIDS patients. Panelists suggested that this could prove devastating for the poorer nations. WHO's AIDS program, launched in February 1987, focuses on the development and support of national AIDS control programs. It now operates in 93 countries, and 34 more countries are scheduled to join in 1988. WHO has assisted another 58 countries with shortterm AIDS action plans. The US Agency for International Development has developed a 2-pronged strategy for curbing the pandemic with prevention-emphasis programs operating under WHO.