Monday, 23 December 2013

Making prevention and treatment possible

HIV and AIDS


World AIDS Day 2013: Gift's Last 10 Years (Click to view video)
World AIDS Day 2013: Gift's Last 10 Years
Since the launch of USAID's HIV and AIDS program in 1986, the Agency has been on the forefront of the global AIDS crisis.
Today, with more than 34 million people living with HIV worldwide, USAID is a key partner in the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the largest and most diverse HIV and AIDS prevention, care and treatment initiative in the world.
As a result of PEPFAR, USAID and other implementing partners have:
  • Provided lifesaving AIDS treatment to more than 5.1 million people and HIV counseling and testing to more than 46.5 million people.
  • Supported more than 11 million pregnant women with HIV testing and counseling and provided prevention of mother-to-child transmission (PMTCT) services to more than 750,000 HIV-positive women. As a result approximately 230,000 infants were born free of HIV.
  • Reached nearly 15 million people with care and support, including more than 4.5 million orphans and vulnerable children.
  • Supported approximately 2 million male circumcision procedures worldwide cumulatively.
Our Work [PDF, 183KB]: Learn more about our efforts in the fight against HIV and AIDS and chart the course of USAID's work in our interactive timeline.
It Takes A Village. Empowering Communities to Fight HIV: Read about USAID's long history in working with communities in combating HIV and AIDS.
Reflections and Impressions from AIDS 2012: Read our insights from last year's conference in D.C.
Related Sectors of Work 
Global Health
Last updated: December 02, 2013

World AIDS Day
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Treatment to those who need it most

Antiretroviral Therapy

Researcher showing young boy HIV treatment drugs
EGPAF/James Pursey

DELIVERING LIFESAVING HIV TREATMENT TO THOSE WHO NEED IT MOST

At a Glance

HIV continues to be one of the deadliest infectious diseases in the world. At the end of 2011, 34 million people were living with HIV, with approximately 69 percent of them living in sub-Saharan Africa. Worldwide, an estimated 2.5 million people became newly infected with HIV in 2011. Without treatment, HIV infection progresses to AIDS in approximately 8 years; once diagnosed with AIDS, median life expectancy is under 2 years.
Antiretroviral therapy (ART) stops the replication of the HIV virus inside a person infected with HIV, affording the body’s immune system time to recover and rebuild itself. While not curative, these medicines are dramatically powerful, with studies suggesting that HIV-positive patients in resource- limited settings can achieve near-normal life expectancies when taking ART. In addition, by lowering the amount of HIV virus in the body, antiretroviral drugs (ARVs) help reduce the chance that an HIV-positive individual transmits the infection to an HIV-negative partner.

THE USAID RESPONSE: ROBUST ANTIRETROVIRAL THERAPY PROGRAMS TO IMPROVE HEALTH, REDUCE TRANSMISSION AND BUILD STRONGER HEALTH SYSTEMS

In spite of the severity of the challenges posed by the epidemic, access to antiretroviral therapy globally has increased substantially since 2003 to over 8 million people, with over 5 million people supported directly by U.S. Government assistance under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The number of AIDS-related deaths in sub-Saharan Africa declined by nearly one-third between 2005 and 2011. The U.S. Government is the world’s largest donor to HIV and AIDS programs worldwide, having provided over $36 billion through PEPFAR through FY 2012, with much of that support managed by the U.S. Agency for International Development (USAID). As PEPFAR’s largest implementing agency, USAID supports comprehensive ART programs to improve access to quality HIV care and treatment services – including antiretroviral medicines – for individuals living with HIV.
USAID-supported ART programs focus on three key priorities:
Photo of a woman in a wheel chair with a young boy
USAID/Senegal
  1. Improving Access to ART for individuals living with HIV
  2. Improving the Quality of ART services
  3. Fostering Sustainability of lifelong HIV treatment services
To accomplish these priorities, USAID and its implementing partners have utilized a variety of innovative programmatic approaches. They include:
  • Pooling procurement and utilizing generic antiretroviral medicines to lower the price of HIV medicines in resource-limited settings 10-fold.
  • Using new technologies such as mobile phones to help support patient adherence to medication and engagement with health services.
  • Making care more accessible through mobile outreach and patient support.
  • Task sharing among groups of health care workers to ensure patients can receive the services they need.
  • Developing robust information systems for clinical settings and for the management of commodities; using these systems to improve the quality of care provided to patients.

FUTURE DIRECTIONS

In order to meet the substantial need for ART, USAID is actively working on projects to increase the efficiency of treatment programs while simultaneously improving program quality.
Essential HIV and AIDS medicines and supplies flow through this SCMS warehouse.
Essential HIV and AIDS medicines and supplies flow through this SCMS warehouse.
PHD
  • The USAID Supply Chain Management Systems (SCMS) project is harnessing the power of pooled forecasting and procurement beyond ARVs to include critical diagnostic laboratory supplies. In addition, the project continues to work closely with host country logistics systems to improve their capacity to forecast, procure, store and distribute key commodities. In close collaboration with other U.S. Government partners, the SCMS project operates an Emergency Commodities Fund to mitigate potential stock-outs of ARVs and rapid HIV test kits.
  • USAID is supporting implementation science and operations research through studies looking at linking patients to care and treatment, retention and integration of ART services.
  • Through mechanisms like the Health Finance and Governance Project, USAID is providing support for cost-modeling to help inform governments, country teams and implementing partners in planning for future commitments and maximizing the impact of available resources. This includes planning for changes in national guidelines in 2013 and in the adoption and spread of new technologies for improving care, such as HIV viral load testing.
For more information on HIV treatment programs, please see the Treatment Issue Brief [PDF, 197KB].
Last updated: October 17, 2013
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Maternal, newborn, child and adolescent health

Maternal, newborn, child and adolescent health

Ending preventable child deaths from pneumonia and diarrhoea by 2025

The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD)

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Authors:
WHO/UNICEF
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Publication details

Number of pages: 64 (16)
Publication date: 2013
Languages: English, French
ISBN: 978 92 4 150523 9

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Overview

Stopping the loss of millions of young lives from pneumonia and diarrhoea is a goal within our grasp. The integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) proposes a cohesive approach to ending preventable pneumonia and diarrhoea deaths. It brings together critical services and interventions to create healthy environments, promotes practices known to protect children from disease and ensures that every child has access to proven and appropriate preventive and treatment measures.
The goal is ambitious but achievable: to end preventable childhood deaths due to pneumonia and diarrhoea by 2025.

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Friday, 20 December 2013

Africa Martyrs as devotional magnets for Africa diaspora communities


African-led Animated Mass in America

Click thumbnail to view full-size
Source: African Community-led Mass in California

Pan de Vida

Pan de vida cuerpo del Senor (Cup of blessing, Blood of Christ Lord)
Poder es servir (at this table)
Porque Dios es amor (the last shall be the first).

Martyrs of Africa

Africa as a continent features in Biblical and Koranic stories. The religions that share the Patriarchs (Abraham and Isaac) have had Africa as the center stage on a long reel of conversation and dialogue. From 5000 BCE to present day, Africa has been crucial in the organization, pilgrimage and experiences of inspired holiness. Cities cited in Holy Books such as Ophir and Faiyum are in Africa. Whole chapters in the Holy Books are dedicated to scenes depicting experiences of relations between humans and the Divine. But these stories have tended to depict events that are distant. Africa seemed to have played its roles in the far past periods. But, that is not the case. The 1800s saw a frenzied hunger for a Divine being. Converts were eager to die confessing the Word.
Many converts were existing in all of Africa, Uganda Martyrs 9also known as Africa Martyrs) are some of those converts. Where are the Uganda Martyrs found?
There along the River Nile in a land with many beautiful lakes was a great kingdom. The king in this kingdom was an accomplished leader whose kingdom had experienced a long period of tranquility. The kingdom was organized along social, cultural, economical, traditional and leadership structures. The king and subjects had roles to play to ensure this kingdom was stable and the pride of Africa. Little wonder that all who visited gave this kingdom the name "Pearl Of Africa."
The subjects were driven and served their king whole-heartedly. So, when the king ordered the converts to go against the dictates of Christianity they did not obey him. A repeat of what transpired in the times of Nebuchadnezzar and Daniel ( see Daniel 1 & 2) happened in Uganda too. But, in Uganda's case the Christian converts were not spared. They were killed for disobeying a very powerful king. Their punishment was death by burning.
By 1960s witnesses had come forward claiming miracles after praying to the burnt converts in Uganda. Witnesses were from Africa and other parts of the world. Vatican officials went through all the necessary requisites of beatification and canonization. Thus, the Uganda Martyrs and therefore the 1st African Martyrs were presented to the entire world.

Africa Martyrs are modern day saints

The Africa Martyrs are saints in the same league as all the other saints in the world. They have interceded on behalf of many who have seek succor. Like all other saints they did something great in their life that was Godly. They devoted their lives to God and were recognized for that..

Praying to Saints

It is a Christian practice to ask our departed brothers and sisters in Christ—the saints—for their intercession. The practice dates to the earliest days of Christianity and is shared by Catholics, Eastern Orthodox, the other Eastern Christians, and even some Anglicans. It is shared by more than three quarters of the Christians on earth.

June 3rd

June 3rd is the day of Africa Martyrs. Uganda has the main Shrine with one of the oldest Basilicas in Africa. The pilgrimage is made to a venue called Namugongo (proper spelling is Namuggongo). The Roman Catholic Church and Anglican Church share this same site. People travel from the USA, South America, Australia, Japan, China, Canada, Europe and from within Africa.

Diaspora Devotions to Africa Martyrs

USA, Europe, Canada, Australia, Japan, Philippines, Caribbean and South America has seen a rise in popularity of Africa Martyrs. The Africa diaspora community has increased the devotions and taken more leading roles in making the liturgical accompaniments and experience that increasingly adds to the American Christian ethos.
California is a state known to lead in many things. The Ecumenical, cultural diversity and coming together of many people to observe the day of the Africa Martyrs has made an indelible mark in contemporary American lifestyles.

America and Africa meet in Spiritual Traditions

America and Africa redefine each other. There is a long tradition in which America has drawn Africa to it. But, when it came to modern day Christian liturgy, Africa is contributing to the new and diversified message. It is helping to make the fire of longing for a Divine, burn brighter. It is no longer like the fire that burnt the martyrs for their belief. It is a different fire. It is a fire that does not scorch the skin nor cause bodily disfigurement. It is a fire that cleans, brings laughter, promotes cohesion, empowers many diverse cultures to come together, contributes to the strands that make America a very diverse and allows peaceful co-existence. It is a fire that allows for freedom of worship. This is seen nowhere better than in the diverse Californian valleys, gorges, high hills, plains and mountains. This Divine fire that burnt in Africa is now burning in America.

Martyr Saints

Has Africa influenced Christianity and Islam?

  •  Yes
  •  No
  •  I do not think so
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Note

1. African led liturgies in USA are an opportunity to contribute to outcomes of the dreams and aspirations of the Declaration of Independence.
2. African led liturgies in USA and other parts of Americas and Canada are an opportunity to bring together different people in observing a day or time of devotion.
3. African led liturgies in USA and other parts of Americas and Canada are a contribution to the cornucopia of activities and cultures in the world.
4. African led liturgies in USA and other parts of Americas and Canada are a show case for music, dance, drama and dressing for GOD.
5. African led liturgies in USA and other parts of Americas and Canada is an opportunity to bring what is good, beneficial, enduring and durable from Africa.
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Sunday, 15 December 2013

Thanks!

I came around the time the skies let go of their tear drops,
Why they cry I do not know,
It is about laughter, or mischief,
may be it is a trend.

November in New England is a time of many things;
the trees just give us a farewell display of beauty;
the golden sun's rays streak through tree lines;
the moon beam settles serenely on tree tops.

Then the people are forever being...people;
some share, others are selfish, others just do not know;
so is humanity,
Who am I to judge,I mind my business first.

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Monday, 9 December 2013

HIV/Aids Must Not Win!

HIV/Aids Must Not Win

Diversities, complexities and vulnerabilities

Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: The Global Fund
Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: Global Fund
Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: Global Fund
Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: HIV/Aids and Health in in-mate settings
Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: Global Fund Figures
Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: Global Fund

Stemming the long drawn war against HIV/Aids: social diversities and vulnerabilities; introducing the 'tailgate prevention' principle.

The four USA National HIV/Aids primary goals are : to reduce new HIV infections; to improve health outcomes for people living with HIV; to reduce HIV-related health disparities and inequities; and to achieve a more coordinated national response to the epidemic.

I am so excited about the PEPFAR Commitment to eradicate HIV in the world

I am particularly happy with the tone and very apparent commitment in the White House memo: "Shared Responsibility to Strengthen Results for an AIDS-Free Generation.”Since taking office, President Obama and his Administration have taken enormous steps to address the HIV epidemic, both domestically and globally. Indeed I liked this statement most. To me it shows President Obama cares, “We can’t change the past or undo its wrenching pain. But what we can do – and what we have to do – is to chart a different future, guided by our love for those we couldn’t save. That allows us to do everything we can, everything in our power to save those that we can. And that’s my commitment to you as President.”

Tailgate Prevention

I am presenting what I term the 'tailgate prevention.' I have borrowed this from the traffic language after watching what transpires day to day on USA roads. Before defining the 'tailgate prevention' principle, as far as HIV/Aids is concerned, one needs to factor in the following six questions: Can we afford to handle HIV/Aids aggressively enough? When we pursue a given strategy how many are we allowing access? How many are we shutting out? What is in place today? What have been the achievements against HIV/Aids? Where do we need to improve? These are questions one needs to have at the back of the mind. This way one will have the readiness to see the complexities, vulnerabilities and influence of diversities in demanding and providing HIV-related services.

Scenario 1: Imagine an organization with a specific mission and objective: to address HIV/Aids needs of young persons as they transition from childhood to adolescence.

The needs could range from: defining who a transitioning adolescent is; understanding bodily growth and development; needs around testing and treatment; health education; prevention prophylactic access; access to regular medication; refills; nutrition; relationships; schooling; access to home/housing; stigma and dignity around living with HIV and transmission. There are many needs that adolescents present. These are mostly around emotional adjustment. Adolescents are readers and consumers of what their peers or media put out. There is need to have platforms that re-assure them when they are bombarded with too much information. Such information may be on work, education, conflict with law, sex and obsession. They need to have mentoring peers who may help them navigate through the information maze.

Second Scenario

Scenario 2: Imagine an organization with a specific mission and objective: to address HIV/Aids needs of young black men in USA.

The needs could range from: defining who a black person is not; the needs around normativity; access to interventions in place; access to referral services; access to regular medication; refills; nutrition; relationships and couple counseling; schooling; support associations; sexuality and gender counseling; orientation and identity counseling; same sex roles' counseling; life planning and consequential counseling needs; home/housing; work and employment; conflict with law; stigma and dignity. Young black persons fall in many categories. Some are living with HIV, some not. Many have partners age or cultural related issues. Some have sexuality-genital unresolved issues and some do not. Some are gay and others are not. Black men may have white or Latino or African or Chinese partners. There is need to have all these factors known especially if couple counseling is to be effective. Choices, especially peer pressure related ones such as alcohol and drug use should be anticipated. According to an online paper the Independent “Almost one in five hospital admissions for people in their 40s is related to alcohol and drug abuse, a new report has revealed.” Young black men can be mobilized to take up responsible roles not only as consumers but also contributors in the HIV service assembly-line.

According to the Bill & Melinda Gates Foundation blog the Impatient Optimist, “Worldwide, an estimated 3.6 [3.2–3.9] million people aged 50 years and older are living with HIV. This “aging” of the HIV epidemic is mainly due to three factors: the success of anti-retroviral therapy in prolonging the lives of people living with HIV; decreasing HIV incidence among younger adults shifting the disease burden to older ages; and the often-unmeasured, and thus often overlooked, fact that people aged 50 years and older exhibit many of the risk behaviours also found among younger people. Well. Whether focusing on the unborn babies or the elderly, can the spread of HIV can be brought to a halt? Can we still get to zero?” They raise the issue of diversity across longevity.

Third Scenario

Scenario 3: Imagine these as the trending prevention services as far as HIV/Aids is concerned in USA:

National HIV/Aids Strategy;


To reinvigorate leadership and accountability in the domestic response to HIV, in 2010 President Obama released the first comprehensive National HIV/Aids Strategy, which has four primary goals: to reduce new HIV infections; to improve health outcomes for people living with HIV; to reduce HIV-related health disparities and inequities; and to achieve a more coordinated national response to the epidemic.

Ongoing implementation of the Strategy means:

· Focusing on science-driven HIV prevention efforts by supporting and expanding targeted use of evidence-based HIV prevention approaches;
· Making smarter investments by intensifying HIV prevention in the communities where HIV is most heavily concentrated;
· Increasing access to HIV screening and medical care, including through implementation of the Affordable Care Act;
· Supporting a shared response to the domestic epidemic through the support of HIV prevention efforts across all levels of society, including Federal, state, and local governments, centers of learning, faith-based communities, and the private sector.

Children and Young People Matter

Eradicate HIV/Aids From the world.
Eradicate HIV/Aids From the world.
Source: Global Fund

The diversities and vulnerabilities

The diversities may be (this is not an exhausted list): race/gender-based; demographic-based; practice-based; knowledge-based; environment-based; somatic-based.

The vulnerabilities may be (this is not an exhaustive list): domestic violence; human to human violence; community driven stigma (school, workplace, religious setting; home/shelter/house access); bio-medical vulnerabilities (mental, physical and health); socio-political vulnerabilities; assimilation needs; skills-set and trainability.

Partnering and Networks are the next line of defense

Organizations tend to narrow down their mandates and put them in boxes. The reason could be because of specificity, an anticipation for smart results or mostly due to budget constraints. The disadvantage with this is that there is risk of missing out on the holistic picture. To address HIV/Aids there is need to look deeper into the issues and how they cascade into the national strategy. These issues feed the fires of vulnerabilities and become the apparent spikes or re-infection drivers as far as HIV/Aids is concerned. By virtue of its quick changing nature, HIV/Aids is sending us a message. Since it is appearing in a coat of many colors, humans should use the 'tailgate prevention' approach too. We need to think deeper and use a potpourri of interventions. There is value for the money invested if this approach is adopted.

Methodology of Tailgate prevention

'Tailgate prevention' is an analysis tool that seeks out diversity-based vulnerabilities. It is when there is a bold move to be mindful of diversities, identify and tag the vulnerabilities as far as HIV/Aids is concerned. Proceed to address them by showing roles of all stakeholders and stop-gaping them. Vulnerabilities follow each other in quick succession and open the way for further infection in case of HIV/Aids. These vulnerabilities frequently raised as far as the fight against HIV is concerned are: unintentional ostracism due to labels; neglect; Intimate partner violence, use of /access to interventions in place against sexually transmitted diseases (STDs), HPV transmission, Hep B transmission, low health seeking practices, lack of cancer examination, low usage of prophylactic prevention tools, Syphilis transmission, gonorrhea transmission, genital warts transmission, lack of testing, lack of treatment and other contexts of vulnerability.

Imagine HPV, gonorrhea or syphilis. These are sexually transmitted diseases. They are also known as gate openers because they lay bear the skin membrane by causing wounds. It is through these wounds that HIV gains entry into the blood stream. In order to manage this, there are layers of interventions that need to be in place. These are: mobilization for testing and treatment; mutual monogamy; immunization; use of protective prevention means in place, involvement in researchand trials with the goal to eradicate HIV. There is need to enroll as many people in investigational immunotherapeutic treatment drives. According to CDC, “Sexually transmitted diseases (STDs) remain a major public health challenge in the United States. CDC estimates that there are approximately 19 million new STD infections each year — almost half of them among young people 15 to 24 years of age. Yet, most infections have no symptoms and often go undiagnosed and untreated, which may lead to severe health consequences, especially for women. The only way to know for sure is to be tested. Talk to a health care provider about which STD tests are right for you.”

The Good Side of Tailgate Prevention

In using the 'tailgate prevention; approach, one makes the mission and objectives of their organization the pinnacle and proceeds to unpack attendant diversities and vulnerabilities (problematizing). This way HIV/Aids will cease to be a moving target.
Tailgate prevention calls for:
-acknowledging existing interventions;
-analyzing different missions and objectives;
-tagging aspects of diversity;
-tagging consequential vulnerabilities;
-making plans to address the vulnerabilities;
-map all stakeholders;
-create partnerships for referral and experience sharing;
-documenting all experiences.
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