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Journal of the International AIDS Society. 2010; 13:2.BACKGROUND: Back in 1987, the World Health Organization (WHO) concluded that the screening of international travellers was an ineffective way to prevent the spread of HIV. However, some countries still restrict the entrance and/or residency of foreigners with an HIV infection. HIV-related travel restrictions have serious implications for individual and public health, and violate internationally recognized human rights. In this study, we reviewed the current situation regarding HIV-related travel restrictions in the 53 countries of the WHO European Region. METHODS: We retrieved the country-specific information chiefly from the Global Database on HIV Related Travel Restrictions at hivtravel.org. We simplified and standardized the database information to enable us to create an overview and compare countries. Where data was outdated, unclear or contradictory, we contacted WHO HIV focal points in the countries or appropriate non-governmental organizations. The United States Bureau of Consular Affairs website was also used to confirm and complement these data. RESULTS: Our review revealed that there are no entry restrictions for people living with HIV in 51 countries in the WHO European Region. In 11 countries, foreigners living with HIV applying for long-term stays will not be granted a visa. These countries are: Andorra, Armenia, Cyprus (denies access for non-European Union citizens), Hungary, Kazakhstan, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. In Uzbekistan, an HIV-positive foreigner cannot even enter the country, and in Georgia, we were not able to determine whether there were any HIV-related travel restrictions due to a lack of information. CONCLUSIONS: In 32% of the countries in the European Region, either there are some kind of HIV-related travel restrictions or we were unable to determine if such restrictions are in force. Most of these countries defend restrictions as being justified by public health concerns. However, there is no evidence that denying HIV-positive foreigners access to a country is effective in protecting public health. Governments should revise legislation on HIV-related travel restrictions. In the meantime, a joint effort is needed to draw attention to the continuing discrimination and stigmatization of people living with HIV that takes place in those European Region countries where such laws and policies are still in force.
SHS Views. 2006; (14):8-12.Poverty is not an inevitability. In its effort to fight poverty, UNESCO has mobilized all programme Sectors to work towards the first of the Millennium Development Goals as defined by the United Nations: the eradication of extreme poverty. While the Organization's Member States have yet to decide how this cross-cutting programme should continue, SHS Views takes stock of the programme's first five years. (excerpt)
London, England, ECPAT UK, 2006. 55 p.The sexual abuse of children perpetrated by foreign nationals in tourism destinations, was first formally investigated in South East Asia in the late 1980s. One of the first organizations to expose 'child sex tourism' was the Bangkok based Ecumenical Coalition On Third World Tourism (ECTWT) which had been monitoring the impacts of tourism in Asia since 1982. ECTWT researchers investigated the growth in tourism related child prostitution in several Asian countries including Thailand, the Philippines, Sri Lanka and Taiwan. While largely anecdotal, this early research found that child prostitution was reaching alarming levels and that while the highest level of demand for children in prostitution was from local men, it was increasingly also coming from foreign tourists. The research findings were the impetus for a number of Asian-based non-governmental organisations to launch the international Campaign to End Child Prostitution in Asian Tourism (ECPAT) in 1990. The ECPAT international movement has grown to encompass national representatives in over 70 countries. ECPAT UK was one of the first European ECPAT partners and was established in 1994 as The Coalition Against Child Prostitution and Tourism to campaign for new laws to prosecute British nationals travelling abroad to abuse children. (excerpt)
Children on the edge. Protecting children from sexual exploitation and trafficking in East Asia and the Pacific.
Bangkok, Thailand, UNICEF, East Asia and the Pacific Regional Office, . 36 p.From the go-go bars and massage parlours of Bangkok’s infamous Patpong district to the shadowy brothels of Phnom Penh’s red light district of Tuol Kork to the darkened alleys of the Philippines’ capital, children and those barely adult offer their bodies to meet the insatiable appetite of the sex industry. While other children are sleeping, playing, going to school and enjoying the innocence of childhood, child sex workers in East Asia and the Pacific are struggling to cope with the grown-up consequences of their exploitation – AIDS, malnutrition, psychological trauma and sexually transmitted disease. And all the while, their abuse is denied for shame or fear of retribution, covered up and disguised, so even now the world has no true way of knowing how widespread is their exploitation. The United Nations Children’s Fund (UNICEF) believes that one million children – mainly girls but also a significant number of boys – enter the multi-billion dollar commercial sex trade globally every year. In East Asia, the sex trade is such a huge money spinner that the International Labour Organisation (ILO) estimates the sex industry and related services to be worth up to 14 per cent of Thailand’s gross domestic product. (excerpt)
Perspectives in Health. 2004; 9(2):30-32.Think about a vacation in the Caribbean and what comes to your mind? Clean air, superb scenery, relaxation, reinvigoration, and renewal? Unfortunately, this is not the reality for many residents of the poorer Caribbean islands. In several Caribbean countries, from 15 percent to 30 percent of the population live below the poverty line. The region’s infant mortality rates vary from 10–12 per 1,000 live births in Barbados and St. Lucia to 24 in Jamaica and 52 in Guyana. Meanwhile, HIV/AIDS has taken a particularly heavy toll on the Caribbean, with prevalence rates that are second only to those of sub-Saharan Africa. In the wake of the United Nations Millennium Summit, prime ministers of the Caribbean Community (CARICOM) met in Nassau in 2001 to review the region’s health priorities and declared their conviction that “The health of the Nation is the wealth of the Nation.” Inspired by this—and by the spirit of the Millennium Development Goals—Caribbean governments have developed new strategic plans for health. How realistic are their goals in the current economic and political climate? How likely are these strategies to succeed in improving quality of life for the Caribbean poor? (excerpt)
NEW YORK TIMES. 1992 Jun 4; A1, B10.The international AIDS Center at the Harvard School of Public Health led a coalition of AIDS research from around the world in an analysis of more than 100 AIDS programs and discovered that the HIV/AIDS pandemic is more serious than WHO claims. Its findings are in the book called AIDS in the World 1992. AIDS programs do not implement efforts that are known to prevent the spread of HIV. For example, clinicians in developing countries continue to transfuse unscreened blood to many patients, even though HIV serodiagnostic test have existed since 1985. Further, programs do not evaluate what works in other programs. As long as people debate whether or not to distribute condoms, exchange needles, or offer sex education and whether people with AIDS deserve care, the fight against HIV/AIDS is hindered. The report recommends that leader come up with a new strategy to address the AIDS pandemic. WHO claims to have done just that at its May 1992 meeting. An obstacle for WHO is political pressure from member nations. On the other hand, the private Swiss foundation, Association Francois-Xavier Bagnoud, finances the Harvard-based AIDS program, allowing members more freedom to speak out. The head of the Harvard program believes the major impact of AIDS has not yet arrived. Contributing to the continual spread of HIV is the considerable difference of funding for AIDS prevention and control activities between developed and developing countries (e.g., $2.70 per person in the US and $1.18 in Europe vs. $.07 in sub-Saharan Africa and $.03 in Latin America). Even though developed countries provide about $780 million for AIDS prevention and care in developing countries, they do not enter in bilateral agreements with developing countries. 57 countries limit travel and immigration of people with HIV/AIDS. Further, efforts to drop these laws have stopped. Densely populated nations impose travel constraints to prevent an explosive spread of HIV.
WORLDAIDS. 1993 Mar; (26):9.Sri Lanka became known as a gay paradise with the advent of tourism in the late 1970s. UNICEF estimates that up to 15,000 boys in Sri Lanka may engage in homosexual prostitution. Nearly 400,000 tourists visited Sri Lanka in 1992, 50,000 of them British. The probable increase of high risk sexual contacts between tourists and Sri Lankan youths worries the government's health department. By early 1993, there were only 22 cases of AIDS and 65 people who tested HIV positive. But the government's chief venereologist says there are around 200,000 cases of sexually transmitted diseases each year, and it is estimated that as many as 2500 Sri Lankans are HIV positive. In a population of 17 million, this figure is small, but it represents an increase of 300% in just over a year. The parallels with nearby Thailand, where HIV spread explosively, are ominous. Unfortunately, cultural taboos make sex education difficult. A UNICEF doctor described the first television commercials about AIDS as ridiculous. Ignorance about AIDS is almost total. Most boy prostitutes have heard of AIDS but few use condoms and none realize that the disease kills. Organizations like Save the Children Fund recognize the magnitude of the problem but admit that reaching the beach boys, who are financially independent, is difficult. In an attempt to attack the problem, 2 social organizations compiled a list of beach boys in Hikkaduwa, the most popular tourist resort, and invited them for counselling and voluntary AIDS testing, but no one showed up.
Development. 1993; (1):66-7.In the recent past, conferences served as a means to exchange, discuss, and clarify ideas. They sometimes were called to develop a common policy after reconciling dissimilar positions. Yet, many recent international conferences, especially UN-sponsored conferences have been held for show and ceremony. They serve to promote agencies and individuals and as substitutes for action. Nongovernmental organizations also advocate international meetings to further their cause. These conferences entail great financial and social costs, as was the case for the UN Conference on the Environment (Earth Summit) in Rio de Janeiro, Brazil, in June 1992. 30,000 persons, including 114 heads of state and world leaders, attended the Earth Summit. Their travel costs alone equaled at least 30 million dollars. The entire conference probably cost a few hundred million dollars. Besides, many rounds of national, regional, and international consultations occurred worldwide to prepare for the conference, keeping many public officials and environmental advocates busy for about 1 year in drafting treaties and resolutions. Attendance at these rounds required considerable travel costs. Despite these costs and extravaganza, the treaties did not reduce emissions of greenhouses gases or help poor countries to preserve forests and species. Even the Secretary General of the Conference felt that the Conference did not change any of the underlying conditions causing the global environmental crisis. Developing countries viewed the Conference as an opportunity to request more aid and to bail out from the debt crisis. Developed countries see the environment as new grounds to steer and control developing countries. Environmental advocates in developed countries and UN agencies hope to introduce global regulations. Developing countries fear the growing internationalism (new colonialism). Yet these fear are dismissed at international conferences. In conclusion, these conferences preempt social learning and inhibit public accountability of officials and leaders, especially in developing countries.
[Unpublished] 1992. , 15 p. (WHO/GPA/RES/SFI/92.1)A summary of current state and future trends to HIV infections and AIDS cases in world regions prepared from the most recent information on file at the WHO Global Programme on AIDS as of January 1992. HIV infection and AIDS began in the 1980s or earlier in homosexual or bisexual men and intravenous drug users in urban Americas, Australia, and Western Europe, and in heterosexuals in East and Central Africa. There is another virus called HIV-2 with a lower virulence, but similar mode of transmission and clinical syndrome prevalent in West Africa. By 1992 450,000 AIDS cases were reported to WHO, but about 1.5 million AIDS cases are thought to have occurred, including 500,000 in children. About 9-11 million HIV infections, including 1 million in children, are estimated to exist. In Australia, North America, and Western Europe, spread of HIV to homosexuals has decreased, but growth in the intravenous drug-using population and heterosexuals may still occur. In Latin America prevalence is high in homosexual or bisexual men, injecting drug users, and prostitutes, and is increasing dramatically in women. In Africa heterosexual transmission is still the rule; infections from blood products account for about 10% of cases. In East and Central Africa 2/3 of the HIV cases are in 9 countries, where urban HIV prevalence reaches 25-33% in adults. In Africa there is also a growing problem of 750,000 pediatric AIDS so far, and possible 10 million orphans in the 1990s. Spread of HIV in high risk populations in South East Asia is rapid, notably in Bangkok, Thailand, in Yangon, Myanmar, and in Bombay and in northeastern India. The potential for spread in this region is a great concern. Areas of East Asia contiguous with South East Asia are also at risk. In Eastern Europe there are clusters of outbreaks related to improper use of blood products. WHO predicts that 4 million people have HIV and TB. WHO projects that global HIV infection will amount to 15-20 million by 2000. A major research topic and concern is estimation of when and at what level HIV prevalence will peak in world regions.
New York, New York, Oxford University Press, 1990. xvii, 423 p.This text on international health covers historical and contemporary health issues ranging from water distribution systems of the ancient Aztecs to the worldwide endemic of AIDS. The author has also included areas not in the 1979 version: the 1978 Alma Ata conference on primary health care, infant and maternal mortality, health planning, and the role of science and technology. The 1st chapter discusses how each population movement, political change, war, and technological development has changed the world's or a region's state of health. Next the book highlights health statistics and how they can be applied to determine the health status of a population. A text on international health would be incomplete without a chapter on understanding sickness within each culture, including a society's attitude towards the sick and individual behavior which causes disease, e.g. smoking and lung cancer. 1 chapter features risk factors of a disease that are found in the environment in which individuals live. For example, in areas where iodine is not present in the soil, such as the Himalayas, the population exhibits a high degree of goiter and cretinism. Others present the relationship between socioeconomic development and health, e.g., countries at the low socioeconomic development spectrum have low life expectancies compared to those at the high socioeconomic end. An important chapter compares national health care systems and identifies common factors among them. An entire chapter is dedicated to organizations that provide health services internationally, e.g., private voluntary organizations. 1 chapter covers 3 diseases exclusively which are smallpox, malaria, and AIDS. The appendix presents various ethical codes.