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HIV/AIDS

Vietnam: Spreading knowledge to prevent HIV/AIDS from spreading

Dung Anh Hoang's picture

Cũng có ở Tiếng Việt

Doing something useful for my country, Vietnam, always makes me happy. And I’ve tried to get this feeling through my work in developing the transport infrastructure network in Vietnam for over 10 years. Vietnam has come a long way, but there are still many related challenges ahead to make such development sustainable.

I still recall a conversation with a Bank’s specialist on HIV/AIDS a few years ago. We were discussing about the people who have recently availed of the Voluntary Counseling and Testing centers in the Mekong Delta region for HIV tests. She pointed out that they were mostly wives of construction workers employed in infrastructure projects. Sometime later I visited the construction sites and talked to the workers and their managers about the subject. I felt so worried, as their understanding on HIV/ AIDS was quite limited and wondered what could be done to protect this group of people from such a deadly disease?

Việt Nam: “Lan truyền” hiểu biết về HIV/AIDS - hạn chế lan truyền đại dịch

Dung Anh Hoang's picture

Available in English

Tôi luôn cảm thấy vui khi làm được điều gì đó có ích cho đất nước Việt Nam. Và trong hơn 10 năm làm việc cho Ngân hàng Thế giới, tôi đã luôn nhận được niềm vui đó qua công việc của mình, một công việc giúp cho sự phát triển của ngành giao thông vận tải Việt Nam. Tuy nhiên, bên cạnh những thành tựu mà ngành giao thông vận tải Việt Nam đã đạt được, vẫn còn những thách thức cho sự phát triển bền vững của ngành khiến tôi phải trăn trở.

Tôi còn nhớ vài năm trước khi tình cờ nói chuyện với một đồng nghiệp của tôi là chuyên gia về HIV/ AIDS. Chị nói những năm gần đây ở vùng Đồng bằng sông Cửu Long trong số những người đến xét nghiệm HIV tại các Trung tâm y tế thì đa phần lại là những người phụ nữ có chồng đang làm việc ở các dự án hạ tầng giao thông. Tôi đem chuyện này kể lại cho các công nhân và cán bộ đang làm việc trong dự án của mình ở Đồng bằng sông Cửu Long. Và tôi đã thực sự lo lắng khi nhận thấy vốn hiểu biết về HIV/ AIDS của họ rất hạn chế. Một câu hỏi cứ lớn dần trong tôi: “Chúng ta cần phải làm gì để có thể bảo vệ những con người này khỏi căn bệnh chết người?”.

How Can South Africa Promote Citizenship and Accountability? A Conversation with Some State Planners

Duncan Green's picture

How can states best promote active citizenship, in particular to improve the quality and accountability of state services such as education? This was the topic of a great two hour brainstorm with half a dozen very bright sparks from the secretariat of South Africa’s National Planning Commission yesterday. The NPC, chaired by Trevor Manuel (who gave us a great plug for the South African edition of From Poverty to Power) recently brought out the National Development Plan 2030 (right), and the secretariat is involved with trying to turn it into reality.

I kicked off with some thoughts which should be familiar to regular readers of this blog: the importance of implementation gaps, the shift in working on accountability from supply side (seminars for state officials) to demand side (promote citizen watchdogs to hold the state to account) and the challenge from the ODI-led Africa Power and Politics Programme that accountability work needs to break free of such supply/demand thinking and pursue ‘collective problem-solving in fragmented societies hampered by low levels of trust’, which seems a pretty good description of South Africa, according to the NPC. I gave the example of the Tajikistan Water Supply and Sanitation Network as an example of how this can be done through ‘convening and brokering’.

Once I shut up, it got more interesting (funny how often that happens). Some of the most interesting questions (and responses from me and others).

How does Africa fare? Findings from the Global Burden of Disease Study

Patricio V. Marquez's picture

The Global Burden of Disease Study 2010 (GBD 2010), a systematic effort to assess the global distribution and causes of major diseases, injuries, and health risk factors, was launched last week in London.

And a special issue of The Lancet has published its results (http://www.thelancet.com/themed/global-burden-of-disease).

What are some of the main findings for Africa that can be drawn from the GBD 2010?

Since 1990, the largest gains in life expectancy worldwide occurred in sub-Saharan African countries, especially in Angola, Ethiopia, Niger and Rwanda, where life expectancy increased by 12-15 years for men and women. Overall, male life expectancy increased from 48.8 in 1990 to 53.2 years in 2010 in central sub-Saharan Africa, 50.9 to 59.4 years in eastern sub-Saharan Africa, and 53.0 to 57.9 years in western sub-Saharan Africa.

World AIDS Day 2012: Looking to the Future, Learning From the Past

Jim Yong Kim's picture

Read this post in Español, Français, عربي

Although I have committed much of my career to the global fight against HIV and AIDS, this year's World AIDS Day is a special one for me in two ways. First, there's the remarkable news from UNAIDS that more than 8 million people globally are now on treatment, and 25 countries have achieved more than a 50 percent decline in HIV prevalence. With this progress, I am more optimistic than ever about our ability to end AIDS.

As the US government’s new blueprint for an AIDS-free generation demonstrates, today we have the science, the knowledge, the experience, and the tools to fight the epidemic. I was particularly happy to see that the blueprint included multi-year, sustainability strategies and that it stressed the need to support country leadership. With that leadership, and with a long-term plan owned by countries, these efforts can succeed.

As HIV/AIDS cases increase in the Philippines, so does activism

Chris Lagman's picture

Photo from Aktionsbündnis gegen Aids through a Creative Commons license

It was Christmas dinner two years ago, in 2010, among my gay friends. I just came back from an expat assignment in the US, and was greatly enjoying the uniquely Filipino way of celebrating the cheery season. Towards the end of that dinner, one of my close friends came up to me saying he wanted to speak with me in private.

The two of us went outside the restaurant, and in a dark corner of the parking lot he told me he wanted me to be among the first to know. Early that month, he had himself tested for HIV, and found out he was positive. I was so shocked that no words came out of my mouth, I remember just giving him the tightest hug I could, my mind blank, my heart racing, not knowing what to say or do next. He was my first close friend who came out to me as HIV-positive.

Malaysia: Fishermen, drug use and HIV coming full circle

Sutayut Osornprasop's picture

In Malaysia, over half of all HIV infections are transmitted through sharing contaminated needles and syringes. To combat the spread of the epidemic, the government in 2006 spearheaded 'harm reduction' interventions (pdf) which included a program where people who inject drugs are provided unused needles and syringes in exchange for used injecting equipment. Those who are addicted to opioids such as heroin, the most commonly used illicit substance in Malaysia, can also enroll in rehabilitation for synthetic opioid replacement therapy. Synthetic opioids, taken orally, help stabilize the opioid cravings of patients, thus enabling them to work. The move to introduce harm reduction in Malaysia revealed something that caught people by surprise—many of the fishermen from port city on the east coast of peninsular Malaysia use drugs.

AIDS 2012: Science and the future of AIDS

Patricio V. Marquez's picture

Amid political statements and declarations of commitment, several sessions at the ongoing International AIDS Conference 2012 have shined a bright light on the future of the pandemic and the global response.

In one session, Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the U.S. National Institutes of Health, gave a keynote address, “Ending the HIV/AIDS Pandemic: From Scientific Advances to Public Health Implementation.”

According to Dr. Fauci, who has been at the forefront of the fight against HIV/AIDS since the discovery of the virus in the early 1980s, the scientific developments in the last three decades that have helped understand, treat and prevent HIV infection bode well for the promise of a world free of AIDS. He noted that the robust arsenal of nearly 30 antiretroviral drugs and scientifically proven interventions now available to treat and prevent HIV infection and improve people’s health and longevity, offer an unprecedented opportunity in the years ahead. However, he was clear in cautioning that this will not be accomplished without sustained global commitment and effort. This means that the international community cannot retreat in the face of the current economic slowdown, but rather build upon those advances, adjusting, adapting and strengthening the response on the basis of accumulated experience and lessons learned from across the world.

If we heed Dr. Fauci’s advice, it should be clear to all of us that while we need international funding from current and new donors to sustain the global effort, developing country governments also can and should step in and prioritize funding and investments to contribute to the fight against HIV/AIDS and for other health priorities. While some people argue that the unprecedented funding for AIDS in the last decades has created imbalances in the global health agenda, we should also remember that in previous decades the underfunding and underdevelopment of health systems in most of the world, and the resulting lack of or limited access to basic health services for the majority of the population, was a common phenomenon that came before the AIDS response.

HIV/AIDS: Reflecting on the Caribbean’s call to action and other turning points

Patricio V. Marquez's picture

Now that the XIX International AIDS Conference is in full swing this week in Washington, DC, it’s worth reflecting not only on past achievements but on future challenges.

As recounted by Dr. Peter Piot, the former executive director of UNAIDS, in his recently published memoire, No Time to Lose, after overcoming many obstacles and naysayers, the UN system, with its many organizations and agencies, working together with governments, civil society and religious organizations, groups representing people living with AIDS, and eventually the pharmaceutical industry, came together this past decade to redefine existing HIV/AIDS prevention and treatment paradigms.

There have been landmark political events as well, such as the UN Security Council Session held in January 2000 that for the first time focused on AIDS as a global health challenge, and the UN Special Session on AIDS held in June 2001, which paved the way for establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

Not only was the power of scientific and technological developments leveraged to confront the global epidemic, but an unprecedented commitment of funds helped scale up the international response.

Responding to HIV/AIDS efficiently and effectively

Kavita Watsa's picture

The World Bank’s new President Jim Yong Kim caught the attention of many as the first head of this development institution to speak at the opening of a global conference on HIV/AIDS, where he called for applying the moral energy and practical lessons of the global AIDS movement to the global fight against poverty. Yesterday he returned to the 19^th International AIDS Conference now underway in Washington D.C.’s massive Convention Center to join Bill Gates, US Global AIDS Coordinator Eric Goosby, and former Lesotho health minister Mphu Ramatlapeng on a panel that discussed how developing countries can achieve greater effectiveness and efficiency in the fight against HIV/AIDS.

Globally, there has been a lot more money invested in this fight over the past decade than ever before. As a direct result, thousands of lives have been saved and new infections averted, including among newborns whose mothers received treatment. But in today’s challenging financing environment, an increasingly effective and efficient HIV/AIDS response is needed to help countries to sustain their gains, prevent new infections, and continue to get treatment out to people already living with the virus.

President Kim said the Bank's main strengths are its broad involvement across many sectors—spanning health, education, social safety nets, and more—and its close engagement with national policymakers in developing countries, as well as with private sector investors. This breadth of operation positions the Bank to be, as the President said, “a very good partner” in improving health delivery systems that address not only diseases like HIV/AIDS, but also other urgent health needs such as good healthcare for mothers and children.

Após duas décadas, ainda não estamos falando o suficiente sobre sexo

Keith Hansen's picture

Also available in English, Spanish, French

À medida que a atenção do mundo se volta para a Conferência Internacional sobre AIDS, realizada esta semana, em Washington D.C, vale a pena destacar o importante trabalho realizado pela América Latina e o Caribe (i) na abordagem do HIV/AIDS (i).

Nas duas últimas décadas, a região aumentou de modo significativo o nível de debate e de conscientização sobre esse tema, desenvolvendo estratégias nacionais contra o HIV/AIDS (i), integrando respostas à epidemia aos sistemas de saúde e garantindo uma conscientização quase universal sobre os fatores de risco para transmissão do HIV. Mas ainda não estamos falando o suficiente sobre sexo.

AIDS in 2012: "We can finish the job"

Julia Ross's picture

Speaking ahead of the XIX International AIDS Conference, World Bank Group President Jim Yong Kim says that ending AIDS—an idea that seemed inconceivable only a few years ago—is within our reach thanks to international efforts by activists and communities. Kim, who will address the conference's opening plenary session July 22, says the lessons learned in the fight against AIDS can be used to eradicate poverty.

The World Bank, together with USAID, PEPFAR and The Lancet, will host a debate at 6:30 pm ET on Monday, July 23, on global health funding for HIV/AIDS. Watch the debate webcast, follow the live blog, or follow on Twitter at #WB Live or #AIDS2012.

2012, une année charnière pour le sida et les avancées attendues

David Wilson's picture

Lors de la dernière conférence internationale sur le sida organisée à Washington, en 1987, les États-Unis étaient présidés par Ronald Reagan, l’Union soviétique tenait encore debout, un mur coupait Berlin en deux et la taille de l’économie chinoise était comparable à celle de l’Espagne. Personne n’aurait pu prédire les évolutions de notre planète ni celle de l’épidémie de sida.

En cette année 2012 décisive, la conférence est de retour à Washington. Le sida reste le plus grave défi de notre temps sur le front des maladies infectieuses, avec plus de 65 millions de contaminations et 30 millions de décès depuis le début de la pandémie, sans compter les quelque 3 millions de nouveaux cas et les 2 millions de victimes supplémentaires chaque année.

Ces statistiques sinistres ne doivent pas masquer les incroyables progrès accomplis. Lors de la conférence de 1987, le monde était démuni face à cette pandémie mortelle alors qu’il n’existait aucun médicament pour atténuer une lente et douloureuse agonie. Aujourd’hui, la palette des outils de prévention à l’efficacité avérée ne cesse de s’étoffer ; les infections sont en recul dans plus de 33 pays ; et jamais l’humanité n’a disposé d’autant de traitements pour lutter contre un virus. Les coûts de traitement annuels ont été divisés par 100 et ils atteignent désormais 8 millions de personnes à travers le monde, soit 60 fois plus. C'est, à ce jour, l'expansion la plus importante d'un traitement qui permet de sauver des vies.

Avec l’accélération des progrès scientifiques, des percées encore plus spectaculaires sont attendues.

C’est en Afrique surtout que ces progrès incroyables sont le plus visibles. En Afrique de l’Est et en Afrique australe, l’épidémie de sida était responsable à son paroxysme de 50 à 70 % des hospitalisations et des deux tiers des décès dans la population adulte. Imaginez un instant ce que cela signifierait à l’échelle de votre quartier. Dans mon pays, le Zimbabwe, les hôpitaux étaient remplis de mourants décharnés, le personnel soignant transformé en fossoyeurs, les hôpitaux en hospices et toute la vie sociale réduite à deux activités : visites aux malades et funérailles. Les marchands de cercueils, à l’activité florissante, s’installaient le long des routes menant aux cimetières surchargés.

AIDS 2012: In a watershed year, breakthroughs await

David Wilson's picture

When the International AIDS Conference was last held in Washington, D.C. in 1987, Ronald Reagan was U.S. president, the Soviet Union stood, a wall scarred a divided Berlin and China’s economy was roughly the size of Spain’s. The wider world – and the AIDS epidemic – has changed more than anyone foresaw.

The conference returns to Washington in a watershed year. AIDS remains the greatest infectious disease challenge of our age: more than 65 million people infected and 30 million deaths since the epidemic began, and roughly 3 million new infections and 2 million deaths a year.

These are grim statistics, but they belie the incredible progress made. When we met at the 1987 AIDS conference, the world had few tools to prevent deadly infections and no drugs to commute slow, agonizing, wasting death. Today, there is an expanding armory of proven prevention tools; new HIV infections have been reduced in more than 33 countries; and there are more drugs to treat HIV than for every retrovirus in history combined. Annual treatment costs have been reduced 100-fold and AIDS treatment has been expanded 60-fold to reach 8 million people worldwide in the largest-ever expansion of lifesaving treatment.

As the pace of scientific progress accelerates, even greater breakthroughs await us.

Nowhere is this amazing progress more evident than in Africa. At its peak in Eastern and Southern Africa, AIDS was responsible for 50-70% of bed occupancy and two-thirds of all adult deaths. Let each of us simply try to imagine experiencing this in our own neighborhoods. In my country, Zimbabwe, hospitals overflowed with emaciated, dying people, nurses and doctors were undertakers, hospitals were hospices, and an entire society’s social life rotated from hospital beds to funeral gravesides. Coffin-making was the fastest growing business, lining miles of roads to overcrowded cemeteries.

Transitions in financing HIV/AIDS programs

Patrick Osewe's picture

While participating in a study of HIV spending efficiency in South Africa, I met a young HIV-positive mother who had just received the joyful news that her new-born daughter was healthy and HIV-free. Wiping away tears of relief, she described the gratitude she felt for the antenatal clinic staff, who had helped start her on antiretroviral treatment (ART) and thanks to whom she now had the hope of a bright future for her daughter. This encounter was just one among many similar incidents during the study – and, as our preliminary data show, is representative of the positive impact of the Government’s strong commitment to bringing down rates of HIV.

South Africa has mounted one of the strongest responses to HIV in the world. Its most dramatic success has been the scale-up of ART since 2003, growing from almost nothing to the country’s largest health program that treated about 1.5 million people in 2011 (out of a total HIV-infected population of 5.6 million).

The impacts of this treatment drive are already showing, with overall mortality, maternal and infant deaths all on a downward trend following their HIV-related peaks in the early-to mid-2000s. However, the cost of sustaining this success is huge: South Africa has committed to putting an estimated target of almost 10% of the entire population on a life-long course of expensive drug treatment. And, even with government negotiators bringing down ART drug prices by 65% since 2008, successful testing campaigns coupled with the worrying increase in resistance to first-line therapies look set to further raise the financial risk.

These challenges extend beyond South Africa. An analysis of the fiscal dimensions of HIV/AIDS released by the World Bank earlier this year in a number of countries concluded that without significant additional investments in prevention starting now, the cost of treatment will rapidly become unaffordable for even the most cash-rich countries on the African continent.

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