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EPIDEMICS
Haitians with AIDS hit by broken promises of aid

AIDS: Fewer than 10 percent of drug users get help
Vienna (AFP) July 20, 2010 - Fewer than 10 percent of injecting drug users (IDUs) get practical help to prevent them from spreading HIV to others, according to research presented at the world AIDS conference on Tuesday. Of the roughly 16 million IDUs around the world, some three million have the human immunodeficiency virus (HIV), although the tally could be as high as 6.6 million, it said. By being marginalised and criminalised, this group can become a major vector for spreading HIV through shared use of syringes or through prostitution to feed a drug habit, it said.

Only five percent of all IDUs have access to a programme where they can swap used syringes for sterile ones, according to a study led by Louisa Degenhardt of the National Drug and Alcohol Research Centre at the University of New South Wales, Australia. Only eight percent have safer, legal substitutes such as methadone to opiate drugs like heroin. And only four percent of IDUs with HIV receive antiretroviral drugs, which can repress blood levels of the virus to such low levels that the risk of contaminating others can be slashed by more than 90 percent. These are the most effective techniques to help drug users to return to good health, wean themselves off their addiction and reduce their risk to others, according to the papers, which were also published by the British journal The Lancet.

Combined, these practices can help reduce HIV prevalence among drug users by more than half, investigators have found. The studies were presented at the 18th International AIDS Conference in Vienna, which has swung a spotlight on the state of the pandemic of HIV/AIDS in the countries of the former Soviet bloc. In these states, HIV spread is being driven especially by the overlap between drug use and sex work. From 2001 to 2008, the number of people in Eastern Europe and Central Asia rose by two-thirds, reaching 1.5 million, according to the UN agency UNAIDS.

More than two-thirds of them live in Russia, which combined with Ukraine accounts for more than 90 percent of the region's infections. More than 33 million people have HIV, two-thirds of whom live in sub-Saharan Africa, where the pandemic is driven especially by sexual intercourse. Last year UNAIDS said 19 percent of resources needed for preventing HIV should be earmarked for IDUs, but as little as one percent was allocated this way.
by Staff Writers
Vienna (AFP) July 20, 2010
As Haiti struggles to rebuild itself after a devastating earthquake, people with AIDS are still waiting for aid promised to them before the catastrophe, activists here said Tuesday.

There are some 120,000 people with the human immunodeficiency virus or HIV in Haiti, which was hit by a huge earthquake on January 12, killing 250,000 people and leaving 1.5 million homeless.

An international pledge of 500 million dollars (385 million euros) in reconstruction aid has been slow in materialising, with the World Bank saying last week that the fund was only 20 percent full.

But people with HIV and AIDS are suffering even more as their previously promised aid also continues to trickle in only very slowly or not at all, according to organisations attending the World AIDS Conference this week in Vienna.

"It's very difficult for grassroots organisations to operate since the quake. We simply don't have the means to do so," said Liony Acclus, head of PHAP+, a Haitian coalition of organisations for people with AIDS.

Around 90 percent of all funding for AIDS in Haiti comes from abroad, Acclus said.

"Since the quake, the programmes set up by international organisations to help people with AIDS to earn a living are no longer operating," complained Edner Boucicaut, head of Housing Works, a non-governmental organisation.

It was still common practice that prospective employees had to prove they were HIV negative to get work, Boucicaut said.

"We have to stop helping Haiti on paper and start taking action," said Liony Acclus.

However, there are more optimistic voices.

"We've lost 70 percent of our office space. But that isn't stopping us working," said Jean-William Pape, director of the Haitian NGO Gheskio.

"The situation is not going to deteriorate, because health organisations are well organised."

"What we hear about Haiti is always very negative, but before the earthquake, good things were happening there, in the health sector particularly," said Jonathan Quick, director of Management for Social Health (MSH).

The prevalence rate of HIV in Haiti has declined from 6.2 percent in 1993 to 2.2 percent in the middle of this decade, Quick noted.

Free care for people with AIDS, HIV tests and preliminary treatments are still available, Edner Boucicaut of Housing Works conceded.

"But we still don't have second-line antiretrovirals (drugs used when a patient develops a resistance to the first treatment), and even before the quake, 43,000 people were not receiving treatment," he said.

The organisations all share the view that the entire population be integrated into the process of reconstruction.

In a joint statement, NGOs Gheskio, MSH, the Global Health Council and Partners in Health, called on the international community to direct its support to a "'whole of society' integrated approach to strengthening health systems as the best way to sustain HIV/AIDS prevention, care and treatment over the long term".

Edner Boucicaut complained of a lack of coordination in the programmes of the NGOs and the government.

"Integrate us into your programmes," he said.

There is a general scepticism towards the public authorities in Haiti, with organisations saying people expect more of the UN's special envoy Bill Clinton than their own president Rene Preval.



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