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New challenges in the face of a resurgent HIV.

20160721- RWX0694-X3Prince Harry and Elton John shared the platform to much applause at the bi-annual International AIDS conference in Durban bringing a passionate appeal for young people to be included in the AIDS response.  “What I believe” said the Prince “Is that it is time for a new generation of leaders to step forward; AIDS has drifted from the headlines (and) we risk a drift of funding and of action to beat the virus. We now face a new risk – the risk of complacency.”  

Musician, Elton mirrored the remarks of the young prince comparing himself to a mature Stilton cheese, who now needs to stand aside for younger people; or as he put it in his own humorous style; he has become “Stilton John” 

Capping the week of a conference that brings together over 18,000 health professionals advocates and activists for the bi-annual International AIDS Conference in South Africa’s city of Durban, the remarks resonated with many of the themes of the week. 

Michael Sidibe of UNAIDS spoke in an early session of his fear for the future; “complacency is the new conspiracy, our progress is extremely fragile. If we don’t act now we risk resurgence. AIDS 2016 must mark the commitment to finish what we started and Fast-Track the end of AIDS.” He had every reason to sound a warning with the budget to achieve UNAIDS goal of 90-90-90 (90% reduction of new infections, 90% on ART treatment, 90% will know their HIV status) facing an unprecedented drop at the very point it is required to rise. It needs to reach UNAIDS estimate of a $7.2 billion of additional funding by 2020.

The “Fast Track” to end AIDS by 2030 was a continual theme, and has consequences for Faith Based groups who work in the most infected area of Sub-Saharan Africa and carry much of the burden for AIDS care.  The Archbishop of Cape Town, Thabo Makgoba spoke of the  “God who wants us to embrace justice -and our goal to make places of worship safe and accessible for those with HIV and AIDS”. When quizzed on how worn out and tired clergy and churches are to achieve this and the difficulty of them achieving even more, he acknowledged this was true, but pointed to a “spiritual role where they would find their resources.” However, in September 2015, PEPFAR (Presidents Emergency fund for AIDS relief) and UNAIDS launched a two-year initiative, with a $2 million commitment for the first year to “strengthen the capacity of faith-based leaders and organizations to advocate for and deliver a sustainable HIV response”.

The pursuit of a vaccine or cure is always on the agenda at AIDS conferences but the elusive cure always seems to be 10 years away, in part because of the HIV virus’ extraordinary capacity to mutate and evade antibodies that might block it. New vigour has been urged in the search for a new drug with an optimistic claim that the long and challenging road has begun to take some promising turns, with new large-scale human trials. 

The research is not without ethical problems; Jennifer Power of La Trobe University Australia has been conducting research on AIDS trials. She pointed out that the word “cure” in itself was difficult and could mean eradication of the disease or just remission, as she spoke about the need for researchers to clarify and minimise risk in altruistic volunteers who might be asked to reduce or stop their ART. 

There were warnings about groups who are missed out.  One such group, surprisingly, are infants and children half of whom die within 2 years of contracting the disease. Assistant Secretary General of the UN Dr Loures said “all the UN’s targets are aimed at 2020 but for children we have had to reduce the target by 2 years. Children cannot wait, HIV is coming back and it’s more selective. It increasingly follows areas of conflict, with rape used as a weapon of war. 

indian cyclistsThere was a forewarning about a “teen boom” as the world faces a resurgence in HIV infections. Many of these teens caught the infection from their mothers while they were in the womb, and are now coming of age. Unless action is taken now, the surge in adolescents carrying the infection means the epidemic could spiral out of control again.

Amongst all the myriads of NGO’s and community groups represented at the conference, “Hope Riders” was one of the most unusual. A group of Indians from Hyderabad who’s own family were stricken by HIV determined to raise awareness by using their bicycles. 

Following a dream indicating he would recover, one HIV positive member of the family converted from Hinduism to Christianity. He now heads up the Hope Riders who take cycle rides to AIDS events spreading the message of HIV care to communities as they ride. This year six of them cycled 600 kms in 3 days from Johannesburg to Durban. 

The next Aids conference is in Amsterdam in 2018 and Hope Riders plan to cycle from Morocco to the Netherlands, inviting others to join them. Perhaps Prince Harry, as part of the new generation called to lead in the epidemic, could lead the way.

 



World fails children as UN steps up pressure to end AIDS


RS115813 south-africa-2016-jeffrey-iac-1823-scrThe World Council of Churches Interfaith conference prior to the International AIDS Conference in Durban began with almost 200 faith based delegates and HIV practitioners from across the world. They were warned that Children are being left behind in the HIV response, and that that Faith Based Organisations, (FBO’s), need to adjust their approach to a changing epidemic if they are to reach the ambitious targets set by UNAIDS of eradicating HIV and AIDS by 2030.

Delegates heard the shocking news that the most vulnerable group for HIV care are being missed out. Children who don’t have a voice, usually are the last to be dealt with yet they are the quickest to die. The targets for childcare have been  missed, their medication is not suitable and earlier infant diagnosis is needed with half of those infected dying within 24 months.

Assistant Secretary General of the UN Dr Loures said “the nearest UN targets for HIV and AIDS are aimed at 2020 but for children we have had to reduce the target by 2 years. Children cannot wait, HIV is coming back and its more selective. It increasingly follows areas of conflict, with rape used as a weapon of war.” 

There was a warning from Dr Soni Vice President of Mylor  the world’s largest generic manufacturer of Anti Retro Viral drugs that children need particular medicines and that we urgently need research to develop  new drugs, even if they are not financially viable for the company. Dr Somi said “ I heard that in China adult ARV’s are crushed and given to  children, which is entirely unsuitable. We are working on a new micro-pellet drug which can be sprinkled over food.”

Yet, faith based organisations were applauded for their HIV testing of children by Dr Deborah Birx, AIDS Ambassador for the US Government when she pointed out that FBO’s were responsible for testing over 4 Million children last year. She said “ When much is done even more is expected. We are now at a different place and the risks are more complex. Girls are at risk because 1/3 to 1/2 are not in school in many countries and their first sex is forced or coerced. We need to work within communities of faith to teach that children should be able to grow up without being raped.”

In its final session at the faith based pre-conference, faith communities were called to recommit themselves to the work to end HIV and AIDS by 2030and to keep up the pressure in the face of ‘AIDS fatigue’. A  “fast track” approach is required if AIDS is to be finally defeated.

In a stirring speech Executive Director of  INERELA,*  Rev Mabilela said “ We must continue in the fast lane. We cannot return to the slow lane or go slow in the fast lane” It was a sentiment reinforced by UNAID’S Senior Advisor, Sally Smith who called on the help of FBO’s. She said, “We have the science to end HIV in 5 years, but we don’t have the funding. We need FBO’s and their willingness to go the extra mile. You are called to finish the task that you started.”

Ms Smith encouraged FBO’s to re-evaluate their targets and adapt to the changing face of HIV around the world. “You need to look at what you are doing. The Epidemic has shifted; Have you?  We need new targets - doubling the numbers on treatment; accelerating the reach of testing and ending new infections in children.” 

In a masterly theological evaluation Rev Edwin Sanders from Metropolitan Interdenominational Church, Tennessee used the symbol of a skyscraper to describe the scene. He said “The global symbols of power are the tall building we build, evidence of our advancement. But these same structures cast a shadow on the powerless and it’s the people in the pall of the shadow we are called to help.”  

In her early 20’s, Zambian Ms Melodie Jongwe brought the session back down to earth. Contracting HIV as a teenager she had no knowledge of the disease and her son was also born HIV positive. She said “My baby was delivered and I developed blisters. I knew nothing and went back to the clinic and was diagnosed. I call on all faith leaders to step up their commitment to end AIDS as a matter of justice.”

* INERELA International network of religious leaders living with HIV 


Is
 it 'pie in the sky' to ask FBO's to fast track AIDS care?

19th July 
By Rev Alan Bain


Nothing quite underlines the gap between grass root activists and those at a ‘higher level’ than some press briefings at the IAC.  Lined up for the fray were the experts from UNAIDS and PEPFAR and even the Archbishop of Cape Town. Their brief?
-The wonderfully inclusive – “Challenges and opportunities for collaboration in the Faith-based response to HIV”

Lots of good noises were made and all the right ones. “We need the faith response more than ever” from Sally Smith of UNAIDS, and she meant it. More from “PEPFAR’s Sandra Thurman who spoke of the ‘negatives’ often heard of Faith Groups and the need to change them to ‘positives’. But there was no mention from Sandra of a plan and strategy in place to achieve this or how to measure any discernable result, although there has been a recent joint PEPFAR/UNAIDS  "$2million, two year initiative launched to to "strengthen the capacity of Faith Based leaders and organisations."

The Archbishop of Cape Town, Thabo Makgoba spoke of the  “God who wants us to embrace justice -and our goal is to make places of worship safe and accessible”. When quizzed on how worn out and tired clergy are to achieve this he spoke of them being in a “spiritual role where they would find their resources.” It’s what you would expect an Archbishop to say and he also meant it, going on to explain how Confirmation courses teach about sexuality; how they train the clergy; and his own longing to increase the uptake of ARV’s among the poorest.

 There were back-handed compliments; Ms Thurman of PEPFAR spoke of how churches have grown in the face of HIV; “it’s made them look at their biases and traditions. HIV has been a real gift to strengthen the churches.” And Sally Smith spoke of the need for religious leaders “to confront the rise of conservatism and exclusion in society and to scale up their delivery of HIV care at a faster rate.”

What is crystal clear from the briefing is that there is a widening gulf between those at the top and religious leaders on the ground; who are under-resourced, balance busy lives and families; look after places of worship, congregations, parishes and on top of all this organise their important HIV work.

UNAIDS and PEPFAR are asking for a fast track response from faith groups on HIV work; a scaling up, but have offered just $2 million of further resources. Taking into account the many hundreds of thousands of FBO's working on AIDS throughout the world this is meagre indeed.  In fact, it’s implied and has been said, that faith leaders should step up and fill the gaps of UNAID's and PEPFARS  own funding crisis. It’s doubtful on today’s showing that with such a slim strategy in place, that this will ever be achieved.

Children are being let down over HIV care

Children are being let down over HIV care
Dr. Luiz Loures, UNAIDS. © Paul Jeffrey/WCC


17 July 2016
By Rev. Alan Bain

We are failing our children with HIV care was the stark message of a joint session of the interfaith and Catholic pre-conferences being held in Durban, South Africa in advance of AIDS 2016. Targets for childcare have been missed, medication is not suitable and we still need earlier infant diagnosis with half of infants infected dying within 24 months.

Dr Luiz Loures, deputy executive director of UNAIDS and assistant secretary general of the United Nations said: “All the UN’s targets are aimed at 2020 but for children we have had to reduce the target by two years. Children cannot wait, HIV is coming back and it’s more selective. It increasingly follows areas of conflict, with rape used as a weapon of war.”

There was a warning from Dr Anil Soni, vice president of Mylan - the world’s largest generic manufacturer of antiretrovirals (ARVs) - that children need particular medicines and that we urgently need research to develop new drugs, even if they are not financially viable for the company. Soni said: “I heard that in China adult ARVs are crushed and given to children, which is not suitable. We are working on a new micro-pellet drug which can be sprinkled over food.”

Faith-based organizations (FBOs) were applauded for their HIV testing of children by Dr Deborah Birx, AIDS Ambassador for the USA government, who noted that FBOs were responsible for testing more than 4 million children last year. She said: “When much is done, even more is expected. We are now at a different place and the risks are more complex. Girls are at risk because one-third to one-half are not in school in many countries and their first sex is forced or coerced. We need to work within communities of faith to teach that children  should be able to grow up without being raped.”

The message to FBOs from Loures is that they were crucial in changing the face of HIV in the past and their expertise is required even more now. “We need the experience and the community-based approach of FBOs. Medicines and the clinical approach is not enough,” he said. “It’s about the way we care for people.”

Finish the race faith communities urged!
image preview

17th July
By Rev Alan Bain

In its final session at the Faith based pre-conference faith communities were called to recommit themselves to the work to end HIV and AIDS and to keep up the pressure in the face of ‘AIDS fatigue’ if they are to reach ambitious UNAIDS targets to end AIDS by 2016

In a stirring speech Executive Director of  INERELA,  Rev Mabilela said “ We must continue in the fast lane. We cannot return to the slow lane or go slow in the fast lane” It was a sentiment reinforced by UNAID’S Senior Advisor, Sally Smith who called on the help of Faith Based Organisations (FBO’s); She said, “We have the science to end HIV in 5 years, but we don’t have the funding. We need FBO’s and their willingness to go the extra mile. You are called to finish the task that you started.”

Ms Smith encouraged FBO’s to re-evaluate their targets and adapt to the changing face of HIV around the world. “You need to look at what you are doing. The Epidemic has shifted; Have you?  We need new targets - doubling the numbers on treatment; accelerating the reach of testing and ending new infections in children.”

In a masterly theological evaluation Rev Edwin Sanders from Metropolitan Interdenominational Church, Tenesse used the symbol of skyscrapers to describe the scene. He said “The global symbols of power are the tall building we build, evidence of our advancement. But these same structures cast a shadow on the powerless and it’s the people in the pall of the shadow we are called to help.” 

In her early 20’s, Zambian Ms Melodie Jongwe brought the session back down to earth. Contracting HIV she had no knowledge of the disease and her son was also born HIV positive. She said “My baby was delivered and I developed blisters. I knew nothing and went back to the clinic and was diagnosed. I call on all Faith leaders to step up their commitment to end AIDS as a matter of justice.”