The Secretariat has drafted this strategy to deal with alcohol abuse through an inclusive and broad collaborative process with member states. In doing so, it took into consideration the outcomes of consultations with other stakeholders on ways in which they can contribute to reducing the harmful use of alcohol. The draft strategy is based on existing best practices and available evidence of effectiveness and cost-effectiveness of strategies and interventions to reduce the harmful use of alcohol. This document first outlines the history of the consultative process to determine what approaches to take for combating alcohol abuse before it describes the strategy, which consists of a number of areas: increasing global action and international cooperation; ensuring intersectoral action; according appropriate attention; balancing different interests; focusing on equity; considering context in recommending actions; and strengthening information systems.
Values, Policies and Rights
This document presents ten reasons why exposing or transmitting HIV to someone else should not be criminalised. It argues that criminalising HIV transmission is justified only when individuals purposely or maliciously transmit HIV with the intent to harm others. In these rare cases, existing criminal laws can and should be used, rather than passing HIV-specific laws. Furthermore, applying criminal law to HIV exposure or transmission does not reduce the spread of HIV, undermines HIV prevention efforts and promotes fear and stigma. Instead of providing justice to women, applying criminal law to HIV exposure or transmission endangers and further oppresses them. It points out that laws criminalising HIV exposure and transmission are drafted and applied too broadly, and often punish behavior that is not blameworthy. They are often applied unfairly, selectively and ineffectively, and ignore the real challenges of HIV prevention. Rather than introducing laws criminalising HIV exposure and transmission, legislators must reform laws that stand in the way of HIV prevention and treatment, and instead take a human-rights position in response to the problem.
The United Nations Development Programme (UNDP) has unveiled its new agenda for action to combat the spread of HIV among women and girls, which underscores the need to understand and respond to the particular effects of the HIV epidemic on women and girls and translate political commitments into scaled-up action. It calls on the United Nations to support governments, civil society and development partners in reinforcing country actions to put women and girls at the centre of the AIDS response, ensuring that their rights are protected. The UNDP will support leadership development for HIV positive women and girls in 30 countries, support positive women’s networks being fully involved and reporting on the Millennium Development Goals, encourage countries to put HIV reporting into their reporting under the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), and initiate 'know your rights' campaigns focusing on the rights of women and girls in a number of countries.
These clinical guidelines are designed to address the current goals of the South African government's programme for managing HIV and AIDS, including: integrating services for HIV, tuberculosis (TB), maternal and child health, sexual and reproductive health, and wellness; earlier HIV diagnosis; preventing HIV disease progression; averting AIDS-related deaths; retaining patients on lifelong therapy; reducing infection; and mitigating the impact of HIV and AIDS. They contain relevant information on the government's national eligibility criteria for starting anti-retroviral therapy (ART) regimens, national ART regimens, national monitoring for adults and adolescents with HIV, national ART and anti-retroviral regimens for HIV positive pregnant women and their infants, and recommended ART regimens for treatment-naive adults and adolescents. They also indicate what to expect in the first four months of ART and when it is necessary to switch ART. Concomitant TB and its relationship with HIV is also addressed. Most of the document is dedicated to the relevant criteria and correct procedures for patient management.
These guidelines contain essential information on prevention of mother-to-child transmission, as well as counselling, support and testing, and preventing paediatric HIV infection. Clinical features of HIV-positive children are provided. Care guidelines are given on HIV-positive children on anti-retroviral therapy (ART). Nutritional support is also covered, providing indicators for assessing the nutritional status of children and requirements for nutritional support, including nutrition interventions in situations where children have not been adequately nourished. Treatment guidelines for concomitant tuberculosis are also given, along with responses to adverse advents, like side-effects from ART, and guidelines for treatment of a range of typical secondary infections, like respiratory infections, thrush and gastro-enteritis.
Rwanda's national condom awareness campaign has failed to include messages designed for people with disabilities, despite their risk of HIV being the same as the rest of the population. Many disabled people are sexually active and may take part in unprotected sex, according to Jacques Sindayigaya, coordinator of the HIV programme for the non-governmental organisation, Handicap International. A three-month government campaign, which mainly used radio and television spots as well as billboards and more than 200,000 posters to spread information on condoms, ended in February 2010. According to government sources, it was successful in raising awareness. However, this article points to the need for such campaigns to also target the specific needs and situations of those with disability.
More than 450,000 people have signed an online petition urging Uganda's parliament to drop a bill that would impose the death sentence when a positive person has sex with someone of the same sex who is disabled or under the age of 18. On 1 March, the petition was presented to the speaker of Uganda's Parliament, Hon Edward Ssekandi, by the country’s AIDS activists, including founder of the national non-governmental organisation, The AIDS Support Organization, Noerine Kaleeba, and Canon Gideon Byamugisha, the first religious leader to publicly declare that he was living with HIV. Responding to the petition, Hon Ssekandi said it could not be withdrawn at this stage, not even by the MP who tabled it; but he assured the activists that their concerns would be passed on to the legislature. The legislature would debate passing the bill, amending it or not passing it. Homosexuality is illegal in Uganda, but the new law would impose more stringent punishments for homosexual activity, while compelling people in authority with knowledge of such activity to report it or face criminal charges.
Indoor residual spraying (IRS) and insecticide-treated nets (ITNs), two principal malaria control strategies, are similar in cost and efficacy. This study aimed to describe recent policy development regarding their use in Mozambique, South Africa and Zimbabwe. Using a qualitative case study methodology, semi-structured interviews of key informants were undertaken from May 2004 to March 2005, and a document review was carried out. Most respondents in the study strongly favoured one strategy over the other – IRS versus ITNs. In all three countries, national policy makers favoured IRS, and only in Mozambique did national researchers support ITNs. Outside interests also played a significant role in influencing policy. Research evidence, local conditions, logistic feasibility, past experience, reaction to outside ideas, community acceptability, the role of government and non-governmental organisations, and harm from insecticides used in spraying influenced the choice of strategy. In conclusion, it may be time for policy makers to consider changing from their favoured IRS strategy, while those intending to promote new policies such as ITNs should examine the interests and ideas motivating key stakeholders and their own institutions, and identify where shifts in thinking or coalitions among the like-minded may be possible.
WHO international guidelines for the control of tuberculosis (TB) in relation to air travel require – after a risk assessment – tracing of passengers who sat for longer than eight hours in rows adjacent to people with pulmonary TB who are smear positive or smear negative. A further recommendation is that people with active TB should not carry out commercial air travel until the person has two consecutive negative sputum smears for drug-susceptible TB or two consecutive cultures for multidrug-resistant TB. This review examines the evidence put forward to support these recommendations and assesses whether such an approach is justifiable. A systematic review identified 39 studies of which 13 were included. The majority of studies found no evidence of transmission. Only two studies reported reliable evidence of transmission. Various factors made the screening process highly inefficient, including time and money spent on tracing and investigating passengers who tested positive and contacting different national authorities in the course of investigations. The analysis suggests that there is reason to doubt the value of actively screening air passengers for infection with TB and that the resources used might be better spent addressing other priorities for the control of the disease.
More than a decade after world leaders agreed to eliminate all forms of discrimination against women, their empowerment remains a necessary element in attaining development targets, said United Nations (UN) Secretary-General Ban Ki-moon, addressing the Commission on the Status of Women in the run-up to International Women’s Day, which is observed annually on 8 March. ‘Until women and girls are liberated from poverty and injustice, all our goals – peace, security, sustainable development – stand in jeopardy,’ Ban said. This year is the 15th anniversary of the adoption of the Beijing Declaration and Platform for Action – the outcome of the Fourth World Conference on Women in Beijing in 1995 – which remains the most comprehensive global policy framework to achieve the goals of gender equality, development and peace. In September 2009, it was announced that four UN agencies and offices – including the UN Development Fund for Women (UNIFEM) – will be amalgamated to create a new single entity within the world body to promote the rights and well-being of women worldwide and to work towards gender equality. Mr Ban urged the General Assembly to adopt a resolution ‘without delay’ to set up this new entity.