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CMAJ: Canadian Medical Association Journal. 2007 Jun 5; 176(12):1728-1730.Between the early 1980s and 2000 the prevalence rate of HIV infection in sub-Saharan Africa increased from less than 1% to 12%, as illustrated in the prevalence maps in Fig. 1. This represents an increase in the number of people living with HIV infection from less than 1 million to 22 million. During this period, neither African governments nor the international donor community sufficiently prioritized HIV/AIDS or allocated adequate resources to help prevent and control its spread. In sub-Saharan Africa, the total amount of official development assistance actually declined in the 1990s, to about $3 per HIV-infected person by 1999. By this time, the international donor community had begun to focus on the HIV/AIDS pandemic and in 2000 began to send billions of dollars to sub-Saharan Africa to tackle the crisis. These investments appear to have had a positive effect: between 2000 and December 2005, HIV prevalence rates among adults were reported to have decreased in more than two-thirds of the countries in sub-Saharan Africa, falling from a mean rate of 10% to 7.5%. (excerpt)
Notes from the Field. 2001 Sep; (10): p..International Planned Parenthood Federation, Western Hemisphere Region staff visited several Caribbean countries in August 2001 to identify the particular needs of each affiliate in expanding their HIV program and to help them integrate their programs with national and regional strategies. The International Planned Parenthood Federation/Western Hemisphere Region is currently developing a project to scale up HIV services in the Eastern Caribbean. Lara T., IPPF/WHR's Program Advisor for HIV/STIs, visited several Caribbean countries in August 2001 to identify the particular needs of each and to help IPPF/WHR affiliates fit their HIV programs into the national and regional strategies put forth by the ministries of health and the Caribbean Community coalition, CARICOM. Lara: The Caribbean has the highest HIV prevalence rate of any region outside of sub-Saharan Africa, and in the Caribbean the country with the highest prevalence rate, after Haiti, is Guyana, which is where my trip began. The prevalence rate in Guyana was last measured at 3%, but that's considered a low estimate. (excerpt)
BMJ. British Medical Journal. 2006 Aug 19; 333(7564):367.The world's richest nations are failing to ensure that people living with HIV/AIDS in the developing world have universal access to antiretroviral drugs, delegates at the 16th international AIDS conference in Toronto were told this week. In an opening address, Microsoft founder Bill Gates said that he was making AIDS the top priority of his foundation, at which resources doubled last month to $62bn (£33bn; €49bn), after a donation by US investor Warren Buffett. Bill Gates, who with his wife Melinda pledged $500m to the Global Fund to Fight AIDS, Tuberculosis, and Malaria last week, emphasised the importance of seeking more funds, creating cheaper drugs with fewer side effects, and achieving more widespread treatment for the world's most vulnerable people with HIV/AIDS. (excerpt)
AIDScience. 2003; 3(10): p..The belief that sex is the primary mode of human immunodeficiency virus (HIV) transmission in sub-Saharan Africa is an assertion so widely accepted and has remained unquestioned for so long that it has taken on the status of a received truth. The World Health Organization (WHO) and the Joint U.N. Programme on HIV/AIDS (UNAIDS) recently convened an expert consultation to review issues raised in a series of papers published in the International Journal of STD & AIDS (1-4) that questioned the validity of that assertion. After examining the papers, WHO and UNAIDS issued a press release announcing that "the vast majority of evidence [supports the view] that unsafe sexual practices continue to be responsible for the overwhelming majority of infections". As co-authors of the controversial articles, and as participants in the Geneva meeting (three of us), we state that WHO's conclusion is premature. It is neither based on those discussions, nor on a more considered review of the relevant literature. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 1993. vii, 119 p. (WHO/NUT/MCH/93.1)This World Health Organization (WHO) publication was prepared to provide current technical information and recommendations to policymakers and program planners involved in the promotion of breast feeding. This book summarizes the discussions and recommendations that grew out of the 1990 WHO/UNICEF Technical Meeting on breast feeding. The first chapter presents a technical overview of global breast-feeding prevalence and trends for each WHO region (Africa, the Americas, the Eastern Mediterranean, Europe, Southeast Asia, and the Western Pacific). Chapter 2 looks at the practices related to breast feeding in maternity care services and in postnatal services. The implementation of programmatic changes to support breast feeding as well as cost issues are also considered. The third chapter provides a technical overview of lactation management training as well as a comment on program implementation. Chapter 4 considers the role of breast-feeding support groups from a technical and implementation viewpoint. Chapter 5 is devoted to issues of information, education, and communication in support of breast feeding as well as examples of program implementation in Brazil, Iran, Guatemala, Australia, and Kenya. Specific problems in implementation are also covered. The final chapter discusses breast feeding in working situations and covers such issues as maternity and child care entitlements on the international, national, community, and individual levels as well as cost issues. Each chapter contains specific recommendations, referrals for further reading, and references (if applicable). The Innocenti Declaration on the Protection, Promotion, and Support of Breastfeeding is annexed to the volume.
BMJ. British Medical Journal. 1992 May 2; 304(6835):1135.India will receive $85m from the World Bank to supplement a $100m national AIDS control program which started this month. The money will be spent over 5 years on HIV screening, improving the safety of blood products, and putting into operation the WHO's strategies for controlling HIV infection. The assistance follows the release of results from India's nationwide surveillance program in 1991, which looked at the prevalence of HIV in over 1.2 million high risk people. About 7000 people were found to be infected with HIV and over 100 had AIDS. India has had a system of a nationwide surveillance for people infected with HIV since 1985, when a study by the Indian Council of Medical Research identified the 1st cases, found among prostitutes. Further studies showed that HIV was being spread predominantly through heterosexual activity and by intravenous drug users. In Bombay the proportion of prostitutes infected with the virus rose dramatically from less than 1% in 1986 to 1 in 5 in 1990. In some parts of the city 70% of prostitutes were found to be infected. Bombay has the highest number of recorded cases, followed by Madras and Manipur. Under Prime Minister Narasimha Rao the government set up regional AIDS management centers, which offer blood tests, educate the public about transmission of HIV, and try to alleviate the economic effects of HIV infection. Its 1989 AIDS Prevention bill, however, has been criticized for going too far. Critics complained that people were harassed to have blood tests, doctors were forced to disclose the names of patients infected with HIV, and people who were found to be positive for the antibody were put in isolation. After complaints from human rights organizations the government has withdrawn the bill for amendments. (full text)
In: AIDS and associated cancers in Africa, edited by G. Giraldo, E. Beth-Giraldo, N. Clumeck, Md-R. Gharbi, S.K. Kyalwazi, G. de The. Basel, Switzerland, Karger, 1988. 6-10.The global acquired immunodeficiency syndrome (AIDS) epidemic has, in fact, been comprised of 3 successive epidemics. The 1st of these epidemics is infection with human immunodeficiency virus (HIV), which has already affected 5-10 million people worldwide. The 2nd epidemic, following the 1st but with a delay of several years, is the epidemic of AIDS and other related conditions. By September 1987, a total of 59,563 cases of AIDS had been reported to the World Health Organization (WHO) from 123 countries. However, given the reluctance of some countries to report AIDS and underrecognition of the syndrome, WHO believes the actual number of global AIDS cases is closer to 100,000. 10-30% of HIV-infected persons appear to develop AIDS within a 5-year period, suggesting that 500,000-3 million new cases of AIDS will emerge during the next 5 years. The 3rd epidemic is the wave of economic, social, and political reaction to the 1st 2 epidemics. Since AIDS most often affects individuals in the most economically and socially productive age groups, it can be expected to have a devastating effect on social and economic development in Third World countries. In areas where 10% or more of pregnant women are infected with HIV, projected gains in infant and child health anticipated through child survival initiatives will be cancelled out. AIDS is also having a devastating effect on the health care system in Third World countries as AIDS patients consume limited supplies of drugs, require costly diagnostic tests, and occupy limited numbers of hospital beds. Fear and ignorance about AIDS has threatened free travel between countries and open international exchange and communication. WHO believes the spread of AIDS can be stopped, but only through a sustained, longterm commitment that extends beyond the boundaries of individual countries. AIDS control will require both committed national AIDS programs and strong international leadership, coordination, and cooperation.
Geneva, Switzerland, WHO, 1985. 110 p.3 World Health Organization (WHO) Scientific Groups have examined different technical aspects of the problem of sexually transmitted diseases and their reports have been published in the Technical Report Series. This book has been prepared following the meeting of a scientific working group that was held in Washington in April 1982 to discuss the formulation of appropriate strategies and programs for the control of this group of diseases. This book emphasizes the need for such programs to be integrated into general programs for the control of communicable diseases and for the gynecologcal, obstetric, pediatric, and urological services to play an active and dynamic part. A control activity for sexually transmitted diseases is any activity which minimizes the adverse health effects of this group of diseases. Control activities may reduce the incidence of the disease; the duration of the disease; the effects of each case, including both the physical complications and psychosocial consequences; or the cost of achieving certain outcomes, i.e., increase the efficiency of services. Many different control activities, for example, clinical services, screening, and contact tracing, can reduce the effects of sexually transmitted diseases. A control program is composed of various control activities. Priorities are established, various options for control are examined, and appropriate methods are adopted. Control programs for sexually transmitted diseases define the population to be covered and specify the control activities related to that group. The 1st section of this book covers initial planning steps, focusing on estimating the public health importance of sexually transmitted diseases, priority groups, and sociological aspects of control. The section devoted to intervention strategies deals with health promotion, disease detection, national treatment programs, contact tracing and patient counseling, and clinical services. The 4 chapters that make up the support components section discuss centers for prevention of sexually transmitted diseases, information systems, professional training, and laboratory services. The 2 chapters devoted to implementation examine program management and evaluation of control programs. This book may appear to suggest that the disease control process should be highly systematic, comprehensive, and compartmentalized. Yet, in practice, many activities take place simultaneously and in a manner that is far from systematic, sequential, and ordered.