A little human rights analysis, a little funding news, a little traditional medicine . . . We’re reading a little of everything on global HIV frontlines

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NewWWRAccess to HIV prevention in Rwandan prisons: Rwanda’s post-genocide government recognized the importance of meeting the needs of the nation’s poorest and most vulnerable populations and built the right to health into its 2003 Constitution. This is all looking like good news, especially as the article goes on to describe how prisoners with HIV in Rwanda have access to testing, treatment, and other necessary care with equivalent services behind prison walls as are available outside. But here’s where it stops: based on the rule that prisoners not have sex, no condoms are available to inmates of any of the nation’s 16 prisons, in spite of programs in which some prisoners work off prison grounds, in spite of evidence that prisoners do in fact have sex with wives, girl-friends, sex workers as well as with each other,  and that evidence includes children fathered by prisoners during their incarceration. In a country where general HIV prevalence is 3 percent, and among sex workers is estimated to be 51 percent, that doesn’t add up to extending the right to health to some of the most vulnerable populations in Rwanda — not only prisoners, but their offspring. This article spells out more painstakingly than usual the hypocrisy of HIV responses that don’t extend to providing condoms in prisons to prevent otherwise certain harm.

HIV Grants to Zambia Will Focus Primarily on Procuring ARVs and Other Health Products: This Global Fund Observer article also starts with news of progress — the latest Global Fund grant will strengthen supply chain management and grant management capacities, addressing issues that have led to recent and past medicine and test shortages, as the Ministry of Health regains control of funds after several years following misallocation issues in 2009. The goals of the funding also are to increase antiretroviral treatment access in line with the new WHO guidelines, work to eliminate mother to child HIV transmission, and add to the ranks of circumcized men. The country is achieving universal antiretroviral treatment coverage among adults, the Fund’s Grant Approvals Committee has noted, according to the article . . . But wait — while universal coverage is not expected to mean that literally everyone who needs treatment gets it (it usually means 80 percent of those needing treatment are getting it, which raises the question, why not just call it “80 percent coverage”?) in this case it would be hard to guess even that. That’s because entire populations in situations of high risk, including people engaged in sex work, and men who have sex with men, are going virtually uncounted, as the article notes. But, according to the National AIDS Committee, this will be changing with data to be collected by its new “Key Populations Working Group.”

Zambia Postpones Same-Sex Conduct Trial: But, again, uh-oh! Isn’t it going to be hard to collect data on men who face prison time for having same sex relationships? Two men charged with “same-sex conduct” remain in jail now, in Zambia, awaiting a trial that has been postponed and that could lead to a minimum 15 years behind bars. AIDS treatment activist Paul Kasonkomona also still faces charges for urging the government to observe the human rights of sexual minorities. On the other hand, the GFO article notes, pastors and politicians have spoken out against decriminalizing homosexuality, saying it would “harm” Zambian society. Among those pastors, incidentally, is the Chairman of Zambia’s National AIDS Council, Pentecostal Bishop Joshua Banda.

Zambia: Do Mailacin, Loso Cure AIDS? The answer would seem to be no, but that takes a long time to get to in this article that describes the experiences of a “very happy” HIV patient, a teacher by profession, who recounts how her viral load dropped, her opportunistic infections disappeared, and her strength returned after she started a course of herbal treatment. Halfway through, the article assures readers that the woman still is taking her antiretroviral medicine, and towards the end reiterates that “All the owners of herbal medicines that I have written about in this column DO NOT discourage anyone from taking ARVs.” But it also quotes a patient claiming to have become “HIV negative” after starting the herbal treatment. All of which is to say the importance of strong and clear communication, training and policies linking traditional health practitioners to HIV interventions remains critical, if patients are to get the best information possible from those, who statistics show, 80 percent or more will turn to first. And it also highlights the points made in the following article.

Traditional/Alternative Medicines and the Right to Health: Key Elements for a Convention on Global Health: Worldwide and through history, herbal and other now nonconventional medicines have been a first resort — for those suffering from illnesses that include malaria, obesity, diarrhea, fatigue, and HIV. Sometimes that’s because they are most accessible, sometimes, lacking side effects, they are the most acceptable. Sometimes, they do the job they are supposed to do. This article recommends an integrative approach that recognizes the potential values, harms and challenges surrounding nonconventional medicines, and work with all of those in the interests of global health.

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