UNGASS-AIDS Forum arrives in Paraiba

On the way to expanding the network within the country, a new state wide UNGASS-AIDS Forum will gather on 23 July 2009, in Joao Pessoa, Paraiba. The Forum has invited fifty organizations to participate in the meeting. It is coordinated by the Paraiba AIDS Articulation with the objective of broadening knowledge on UNGASS and to stimulate monitoring and advocacy initiatives in the state level.

The Forum will be a capacity-building workshop that will introduce the issue of monitoring through using the United Nations General Assembly Special Session on AIDS as the basic instrument. Essentialy, the health care supply chain is municipal. Advocacy needs to go to the city level to cause practical and visible impacts.

Kenya to hold III UNGASS-AIDS Forum

The UNGASS-AIDS Forum Kenya will happen on 7–8 July, in Nairobi. Around forty organizations have been invited to participate on strengthening the monitoring drive on women’s sexual and reproductive health in the country.

The new UNGASS-AIDS Forum leadership has taken the project to new communication heights. The Kenya Broadcasting Corporation – KBC – will broadcast a program about the preparation for next week’s Forum. It also has participation in a weekly one hour show on Reproductive Health Programme named “Afya ya Usazi,” on KBC National Radio.

Sexual and reproductive health and rights awareness is growing in Kenya, it might just create opportunity for important and positive changes for the women there, that needs to overcome many traditional barriers to be able to have their rights met.

Uganda Forum renews commitment to monitoring SRH policies

With the presence of thirty-six people representing Uganda’s networks of people living with HIV, non-governmental organizations, and two government ministries (Gender and Development, and Health), the III UNGASS-AIDS Forum met for two days at the Nob View Hotel, in Kampala, on June 4th and 5th, to design advocacy strategies for monitoring the government’s commitment to dramatically reduce the incidence of HIV/AIDS while securing sexual and reproductive health and rights of women and girls.

III UNGASS-AIDS Forum Uganda, Ntinda, Kampala.

The opening remarks by Beatrice Were, Executive Director of UGANET—Uganda Network on Law Ethics and HIV/AIDS—were focused on the human rights of people living with HIV/AIDS. “UGANET, in existence for fifteen years, was created to fill in a vacuum at a time when the epidemic was treated as a medical issue alone”, highlighted Were. In addition, she hoped for a fruitful partnership with Gestos to set forth a movement able to produce a study and a strategy for action.

Ms. Alessandra Nilo addresses the Forum. Mr. Musiime Michael Koima sits behind her.

Gestos’ Executive Director, Alessandra Nilo, set the desired tone for the large picture. “The role of this project is not only to produce a research to send to UNAIDS, but to stimulate the AIDS and women’s movements to work together toward making their government accountable, therefore improving the AIDS response throughout the country.”

The first session of the Forum was devoted to the analysis of the report produced by UWONET—Uganda Women’s Network—, the research results of the first phase of the Monitoring Women’s Sexual and Reproductive Health project, based on the UNGASS-AIDS goals and commitment. The national coordinator of the I and II Uganda Forum, Carol Indembe, showed a bleak picture of the country situation: “Are we able to get prevention, care, social support for women? Our report brought out the reality that it is not so, particularly if you are a woman.” According to the former forum’s coordinator, the report also confirms that gender unbalance is the main driver for the epidemic in Uganda. “What is being done to overcome that when the women have to share the drugs they are entitled to with their husbands or children?” Cultural tradition makes this issue even more complex when those women say, for example, “what my husband says is what I say.”

Ms. Indembe addresses the Forum.

Another great problem, explained Indembe, is that women are still not financially independent. “Women walk in the clinic and you help them, but if they are not economically empowered they go back to their torturer husbands. The day this woman was able to buy her own clothes was the moment, she said, that she was liberated.”

The coordinator of UNYPA—Uganda Network of Youth Positive Attitude—Paddy Masembe, followed the program by sharing his experiences as the only civil society representative at the UNGASS-AIDS High Level Meeting in New York, June 2008. As part of the country delegation he witnessed the reality behind his country’s representation. “Three government delegates participated as member of the National Delegation but they were usually not present in the sessions, they only appeared in the end of the day.” Mr Mesambe, a 26 year old AIDS activist, reported that members of civil society were left out of the HLM because of political reasons. “I made to the meeting by using resources mobilized by Gestos, but I later discovered that there were resources in Uganda to fund my participation and I was denied that.”

Action Plan

The result of those two days of discussion was a strategic advocacy plan to be implemented in the next two months. By shear division of expert labour, the Forum’s participant will execute a set of activities to bring about awareness on sexual and reproductive health and rights in the country, including lobby, communication, and networking. Furthermore, there will be a research on the state of women’s SRH in Uganda, focusing on three areas: violence against women, sexual education and sexual and reproductive actions.

The UNGASS-AIDS Forum coalition will formally introduce itself to high ranks of government and the parliament. It will call attention to its monitoring tasks and will report on the government accountability toward the Declaration of Commitment to HIV/AIDS it signed in 2001. In a country with many economic and social difficulties as Uganda, “citizens or receivers of public services should be empowered to demand accountability” summarized Beatrice Were. But she also admitted that they are not able do it as a single organization. “It is very critical that there is collective responsibility and sharing of information, all the time.”

Hope is in the air

The coalition united around a set of goals that include negotiating with the private sector and the government in an open, sincere, professional (’strictly health business’) way. The objective is to build bridges and establish a sustainable dialogue toward improving SRH in a path to achieving universal access to all who need it in Uganda, a most beautiful country, bountifully blessed by nature in all levels, that has been for too long scarred by political evil-doers. Times have politically and economically changed – despite the current global crisis. The prospect for establishing rational civil relations is as positive as ever was. This is an opportunity the UNGASS-AIDS Forum Uganda is about to take on.

Participants of the III UNGASS-AIDS Forum Uganda

UNGASS-AIDS Forum Indonesia steps into High Gear

One of the quickest outcomes of the III UNGASS-AIDS Forum Indonesia, held in Jakarta on 28–30 May 2009, was the decision to establish a dialogue with the National AIDS Commission. The Forum was coordinated by JOTHI – Network of People Living with HIV. Fifteen civil society representatives discussed and agreed to:

(1) Significantly contribute to building up the country report in partnership with National AIDS Commission;

(2) Collect qualitative data and produce CS report on women’s sexual and reproductive health, advocating for its integration within the national report for UNGASS-AIDS 2010;

(3) Advocate National AIDS Commission for the Indonesian UNGASS Forum to lead the process of NCPI part B.

Rico Gustav addresses the UNGASS-AIDS Forum Indonesia.

A request for a meeting has been submitted to National AIDS Commission, and the secretary of the commission herself has welcome the Indonesian UNGASS Forum. The meeting was held on 14 June 2009. The agenda of the meeting included:

(1) Introduction of the UNGASS Forum and its expanded members;

(2) Inform the NAC on the major points that the 3rd UNGASS-AIDS Forum has agreed on;

(3) Discuss strategies of which the Indonesian UNGASS Forum and National AIDS Commission can collaborate and coordinate in equal partnership, in the sense of monitoring country response to fulfill the Declaration of Commitment;

(4) Discuss challenges faced by UNGASS Forum and request National AIDS Commission’s assistance.

Results of the meeting with NAC

The NAC representatives, Mrs. Nafsiah and their person in charge on UNGASS Reporting, Mr. Kemal, supported the Indonesian Forum to make the UNGASS-AIDS concepts more down to earth so people in the grassroots level can understand and get familiarized with them. They also agreed to fund UNGASS-AIDS Forum Indonesia to lead the NCPI part B process. And possibly fund an UNGASS-AIDS Regional Forum at the ICAAP.

Furthermore, the Indonesian Forum constituency is developing the research framework based on the instruments and methodology Gestos that is being lead in the country by JOTHI. Besides investigating, the UNGASS-AIDS coalition is mostly responding to growing issues that are currently happening, and coordinating actions among members.

Aditya Wardhana of JOTHI at the III UNGASS-AIDS Forum, in Jakarta.

Just recently, there was information that one of the local government was going to issue a regulation that establishes that couples that are about to marry must be HIV free. This is a very urgent issue to advocate on. One more time, technocrats manage to violate human rights.

Meanwhile, Indonesia organized civil society also face a serious ARV shortage and the spread of disrespectful practices such as expired distribution of medicines. Aditya Wardhana, JOTHI coordinator for policy development and advocacy, said that giving patients just a few days’ supply of ARV was risky because the drug was handed out in unlabeled plastic bags that did not have expiration dates on them. “This is human lives we’re talking about,” he said. Just another way of showing in fact what numbers and statistics do not.

What’s UP? Thailand News.

On 28–30 May 2009, the Thailand government held the XII National AIDS Seminar – Half of by 2011. Where are we? It was organized with the participation of Thai NGO Coalition on AIDS – TNCA, – that is composed of 17 networks and the Thai Network of People living with HIV/AIDS – TNP+. They created an official CS committee for organizing the National Seminar that had around twenty NGOs attending the meetings. Both TNCA and TNP+ used their communication channels to spread information among their members – around 850 groups of NGO and people living with HIV. Civil society also organized specific symposiums, skill-building workshops, community spaces and campaign activities during the seminar. It was informed by the media that around twenty-five hundred people attended the meeting, half of them organized civil society and PLHA groups and the other half government personnel.

Sign by the Youth Network of People Living with HIV

The importance of strengthening communication channels with CS is a key part of the government’s response in Thailand. Although the country is recognized because succeeded in addressing AIDS in many ways , this success does not guarantee that the HIV epidemic will come to a halt. In particular, the roots of the problem still exist and have often been overlooked by many policies in place.

Although, the communication channels between CS and government are not always reflected in the level of support accessed by civil society, particularly when related to funds allocation. The XII National Seminar was estimated by the media to cost 12 million Bahts. However it did face a lack of funds for CS participation that drove sex-worker groups to creates strategies on how to raise funds in order to participate in Seminar. Initially they decided to work harder (as sex workers) to support their own participation, but soon they realized that they would not be able to cover all their colleagues’ costs for traveling and lodging. They calculated how many clients they should attend, the number of days working, and how many of them would be necessary to engage to cover all people who wanted to attend the seminar. It would come short anyway. The mobilization was large and the idea led to an urgent meeting between NGOs and government to see how the matter could be solved. The result was that CS got support to include more one hundred people in the official budget. This is a very good example of how civil society mobilization works in Thailand.

UNGASS-AIDS: Monitoring Tool

Sexual and reproductive health in discussion at the XII National AIDS Seminar in Bankok, Thailand.

The National Seminar was also an important moment where the government expressed how helpful the UNGASS-AIDS Declaration of Commitment is to encourage both government and civil society to pay more attention to putting in place better M&E strategies for AIDS and health policies. Thailand is about to receive a new round of resources from the Global Fund – it will receive 100 million dollars for strengthening overall health system, and monitoring migrant, IDU, sex workers and MSM populations. The need to address these specific populations is evident. They estimate in three million the migrant population in the country, mainly coming from Laos, Cambodia and Myanmar. When they get infected with HIV or tuberculosis it is hard to access medicines, and without funds to pay for it, the situation has become a nightmare for them. The national health system is not prepared to absorb it and it is evident that there is no clear policy in place for addressing migrant women.

But even recognizing the need of the most affected populations, the problems in fact are much more complex and addressing all of them will require a more integrated, interdisciplinary, approach. Nowadays, for instance, one of the major challenge for the HIV/AIDS situation in Thailand is the increasing rate of HIV among youth – young sex workers, IDU, migrants, MSM, etc.

Government data showed that 1.127.168 cases of AIDS and symptomatic HIV infection were reported to the division of epidemiology. In total, 613.510 people died because of AIDS and, in 2008, eleven thousand new cases were registered. Only 19% of the general population has been tested. This percentage increases for sex workers (52.60%) and for MSM (34.90%,) however there is no data available for IDU. The government informed that 52.90% of the people who needs it are receiving ARV treatment, and PMTCT has been available 93.96% of the time.

It was also showed that AIDS is rapidly spreading among women. The 2008 UNGASS report showed that the ratio of HIV infection among women and men has significantly increased from 1:7 in the early days of the epidemic to 1:2.5 in 2005. From 2002, the morbidity of female youth (15–19 year-olds) has been higher than male youth at the same age (2:1). The youth groups at 15-24 years tend to have a high level of unsafe sex. According to the national behavioral surveillance survey (BSS) conducted by the Ministry of Public Health (MOPH), the percentage of youth that have ever had sex is increasing, and with low condom usage. This unsafe sex correlates with the increased incidence of HIV infection and unwanted pregnancy among youth.

UNGASS-AIDS Forum in the National AIDS Seminar

Discussions about the UNGASS-AIDS Declaration of Commitment were made in many sessions. Civil Society expressed that, according to the CS report for UNGASS 2008, the vast majority of HIV positive women face more difficulty in life, many carrying more burden after their husband dies. Moreover, stigmatization from their own communities prevents them from participating in everyday activities that are part of normal life. In addition, the inadequate information hinders accessibility to treatment, ARV, or appropriate counseling and other support activities in relation to the HIV/AIDS epidemic mitigation.

Thai UNGASS-AIDS Forum group in the XII National AIDS Seminar

One of the sessions in the National Seminar presented the study performed in 2008 by the UNGASS-AIDS Forum that collected data for monitoring the implementation of the national sexual and reproductive health policy in response to HIV/AIDS in Thailand. The area covered the implementation process of PMTCT strategies in nine provinces of five parts across the country.  It was done from November 2007 to January 2008 with a total samples of 195 key informants, among them 108 HIV infected pregnant women.

The study, coordinated by the RaksThai Foundation analyzes information according to the process of PMTCT implementation in state hospitals, both at the community and provincial levels, in the nine provinces. [Access it on the link Reports]

And the good news is that government decided to implement a national research on PMTCT based on the research findings that highlights what the gaps still are on this program. An example of civil society proactively contributing to better implementation of public health services.

Synthesis of the UNGASS-AIDS Forum in Thailand:

• Held the 1st Forum in September 2007 with the participation of seventeen NGOs, networks, and Dr. Petchsri Sirinirun, Director of Epidemiology of the Ministry of Public Health.

• Concluded the research and, in January 2008, held the 2nd Forum to validate the collected data together with a national consultation with the Thai government. Over three hundred representatives of NGOs, networks, Government and UNAIDS took part in the event.

• The SRH and AIDS report produced by civil society focused on PMTCT was included as an annex in the National Report sent to UNAIDS in 2008, and Ms. Sunee Talawat, representative of the UNGASS-AIDS Forum Thailand was included in the national delegation for the HLM in the UN.

South Africa Civil Society looks deeper into Sexual and Reproductive Health

The arrival of wintertime in South Africa has not been able to cool down the III UNGASS-AIDS Forum discussions, held on June 8–9, in Cape Town. Twenty organizations – from HIV/AIDS, women, health and LGBT movements – participated in the event coordinated by MOSAIC, the meeting’s host, and Health Trust System, in partnership with Gestos, Brazil.

South Africa, with a population of 48 million, has a challenging HIV prevalence rate of 18.8%. Women have an infection rate of 55% of all cases. The AIDS epidemic has deeply marked South Africa in the past twenty years.

By specifically focusing in the sexual and reproductive health of women in the country, the Executive Coordinator of MOSAIC, Marieta de Vos, opened the UNGASS-AIDS Forum bringing up the importance of having civil society monitoring the goals accorded to by the government at the UNGASS-AIDS 2001. She also pointed out the goals of producing a research report, and an advocacy plan, in order to achieve better monitoring in the country. “We will put together a clear advocacy plan to keep the government accountable for sexual and reproductive health, what civil society can do, how we can work together with them, and how we can get issues in the map,” she said.

Marion Stevens, the coordinator of Health Trust Systems, highlighted that many advances in the AIDS field have been achieved since 2007, when the I UNGASS-AIDS Forum was held and few organizations acknowledged the declaration signed in 2001. She also highlighted that strategies have been discussed to strengthen the policies of SRH and HIV/AIDS locally. “We ought to: strengthen collaboration between SRH and HIV/AIDS advocacy organizations in the country; get SRH and rights into the agendas of AIDS policy discussions; develop advocacy actions toward the next high level meeting on UNGASS-AIDS in 2010; follow the ICPD+15 – International Commission on Population and Development – implementation; actively participate in the XVIII international AIDS Conference Vienna, in 2010; and build further international momentum for the inclusion of SRH and rights as a priority area”, said Stevens.

The presence of UNAIDS, represented by Henry Damisoni, M&E Officer, reinforced the importance of the UNGASS-AIDS Forum initiative. He defended the participation of civil society in the elaboration of country report, which will be presented in 2010, and also in the delegation that will go to the next UNGASS-AIDS High Level Meeting, in New York, as a way to strengthen the policies in the country. “We must have a single country response; and this response should not be divided by civil society and government. The goal is that UNGASS should serve the interests of the country as a whole, not only a process of exporting data to the UN. Initially UNGASS-AIDS was created to encourage governments to commit, but over time, the process has evolved from the government focus to a wider focus, showing how the country as a whole was responding to AIDS,” said Mr. Damisoni.

In the second part of the event, the country 2008 reports prepared by the government and by civil society were reviewed by the participants in order to put everyone on the same level of understanding and to analyze the strong and weak points the new monitoring effort should focus on. This was an important discussion for the second day of work that focused primarily on the analysis of the research tool that will be utilized to prepare the 2010 CS Report. The organizations divided the roles of the research, according to the subject of each theme. The aim is to prepare a high quality document to send to UNAIDS as a shadow report or as an annex of the country report, in the case the South African government accepts to include it.

Group work at the III UNGASS-AIDS Forum South Africa

Finally, after so much political and technical baggage, the groups defined some issues for the Advocacy Plan: cervical cancer, sterilization and medical abortion, were the main issues brought up. Part of the strategies includes data collection and “advocacy alerts” to be sent to government personnel, partners and media. A discreet set of communication tools will be used to try and reach as many people as possible, such as cell phone messaging, electronic discussion lists and press releases.

The IV UNGASS-AIDS Forum will be held in South Africa before the submission of civil society’s report to Gestos, in December. At this moment they will analyze what has been achieved thus far and strengthen their actions towards the UNGASS HLM in 2010.

Civil Society Monitors UNGASS-AIDS

Since 2001, Gestos – HIV+ Communication & Gender – follows the resolution of the United Nations General Assembly Special Session on AIDS – UNGASS-AIDS.

In 2003, during the National Meeting of AIDS’ NGOs (ENONG) in São Paulo, Gestos was ellected to be part of the UNAIDS Working Group of Brazil in the seat of Civil Society with a proposal of mobilization and monitoring of the UNGASS-AIDS Declaration of Commitment, signed by one hundred and eighty nine countries. The result of this work was the first Fórum UNGASS-AIDS, held in the same year, with the partnership with the NGO Forum of São Paulo. Since then, Brazilian civil society has been an international reference for monitoring UNGASS-AIDS (please see tables below), taking the issue to state and municipal levels in different parts of the country.

The UNGASS-AIDS Forum Brazil is coordinated by GAPA and Gestos.

There are scheduled for 2009 the state forums of Paraiba and Rio Grande do Sul.

Understanding the National UNGASS-AIDS Forums

Forum	Where and when	Demands	Achievements
I Forum UNGASS-AIDS Brazil	Recife/PE. September, 2003	• Present and discuss the Goals of the Commitment Declaration for HIV and AIDS signed in 2001, at the United Nations General Assembly Special Session.	• Production of a Political Letter of Civil Society – The Letter of Recife; • Participation of civil society representatives at the UNGASS meeting in NY, 2003.
II Forum UNGASS-AIDS Brazil	Recife/PE. March, 2005	• Broaden the knowledge on UNGASS-Aids among the AIDS Movement; • Raise civil society participation at the UNGASS process; • Setting up of a WG UNGASS-Brazil.	• Production of a Case Study with the theme: Access to Treatment in Brazil – A Civil Society Perspective, with the following axis: Technological capacity, the performance of Civil Society, Access to treatment by women, Sex Workers, MSM, People deprived of liberty, IDUs and Transvestites and Transsexuals
III Forum UNGASS-AIDS Brazil	Curitiba/PR September, 2005	• Raise Brazilian civil society participation at the UNGASS-AIDS monitoring process; • Discuss civil society’s contribution in the making of the Brazilian Government report and the preliminary presentation, of the Case Study “Access to Treatment”.  • Articulate civil society’s agenda for the official revision of UNGASS in 2006	• Publication of the Case Study, of which content was incorporated to the official Brazilian government report; • Civil society participation  at the UNGASS-AIDS – NY 2006
IV Forum UNGASS-AIDS Brazil	Recife/PE June, 2007	• Plan Brazilian civil society actions for monitoring UNGASS/AIDS in 2007 and 2008;	• Building of an advocacy agenda with the investigation theme: the Inclusion of Women’s Sexual and Reproductive Health Actions in the National AIDS Policy • Composition by different research groups by theme and regions • Report incorporated by the Brazilian Government in its Official Report to the United Nations Assembly held in June, 2008 • Civil society representatives in the Brazilian delegation
V Forum UNGASS-AIDS Brazil	São Paulo/SP. May 2008	• Evaluate the monitoring actions of UNGASS-AIDS developed by civil society in 2007 • Promote political incidence of the AIDS Movement, derived from the report produced on Sexual and Reproductive Health policies	• Building of an agenda to follow up the State Plans of Fighting the Feminization of HIV and AIDS • Production of the São Paulo Letter with remarks on the Brazilian Country Report, which was sent to the National STD and AIDS Program

 

Understanding the Regional, State and City UNGASS-AIDS Forums

Forum	Where and when	Demands	Achievements
I Forum UNGASS-AIDS Maranhão State	São Luís/MA. 2004.	• Contribute to community answers  facing the monitoring of UNGASS/AIDS Goals and strengthening the National AIDS Movement in the State	• Perception of a dramatic AIDS panorama in the State, with total chaos in Health and Educational Policies • Need to involve more social actors in the process of fighting the epidemics and articulate a partnership with the University in order to broaden researches on the subject and build indicators to advance in the local monitoring
I Forum UNGASS-AIDS Pernambuco State	Recife/PE. December, 2005	• Broaden local knowledge on UNGASS-AIDS and discuss how the Declaration’s commitments may influence public policies on HIV/AIDS control at State end City level.	• Building of a work agenda with action directed at the setting up of the II Forum UNGASS/AIDS Pernambuco; • Need to mobilize a greater number of policy makers in STD/HIV and AIDS • Discussion and deepening about the relation between local and international policies • Setting up of a reference WG to systematize and analyze the proposals related to STD/HIV and AIDS made at the conferences of Health, Women, Human Rights, and children and Adolescents
II Forum UNGASS-AIDS Maranhão State	São Luís/MA. 2005	• Strengthen community answers against STD/HIV and AIDS	• Building of monitoring indicators through most vulnerable groups • Advance towards strengthening and politization of AIDS activism in Maranhão; • Production of a more political diagnosis of the social political economic conjuncture in Maranhão that points out the epidemics impact in the State.
I Forum UNGASS-AIDS North and Northeast Regions	Recife/PE. February, 2006	• Raise knowledge of AIDS NGOs and PLWAs Leaderships in the regions on UNGASS-AIDS, TRIPS, international policies and their impact on national policies on AIDS epidemics control and prevention.	• Production of an Action Plan for 2006 and setting of the participants priorities related to the axis of UNGASS-AIDS.
II Forum UNGASS/AIDS Pernambuco State	Recife/PE. December, 2006	• Give continuity to the monitoring agenda of the Declaration of Commitment and broaden knowledge on UNGASS/AIDS in the State, under the perspective of following up the epidemics interiorization	• Aprovação de várias propostas para ação de execução em 2007 pelo GT de Referência do UNGASS-AIDS PE
III Forum UNGASS/AIDS Maranhão State	São Luís/MA. 2006.	• Strengthen civil society participation in Maranhão on the process of monitoring the Declaration of Commitments of UNGASS-AIDS • Analysis of a political scenario in Maranhão (HDI – Epidemics – Public Policies/Epidemics) • Discuss Civil Society participation in this process; •  Set up a group with several social segments to give continuity to Monitoring in MA	• Setting up of a permanent WG with representations from the capital and interior and a more organized Work Plan
I Forum UNGASS-AIDS São Paulo State	São Paulo/SP. May, 2008.	• Report under construction	• Building of na Action and Monitoring Plan. (Report under construction)
I Forum UNGASS-AIDS North Region	Belém/PA. September, 2008	• Evaluate UNGASS monitoring actions developed in the region for the past two years • Plan UNGASS monitoring actions for the next two years;	• Building of a Monitoring Plan to monitor HIV/AIDS Public Policies in the region
I Forum UNGASS-AIDS Campinas/SP City	Campinas/SP. November, 2008	• Present the Declaration of Commitments to civil society and policy makers of the city	Report under construction
I Forum UNGASS/AIDS Acre State	Rio Branco/AC. March, 2009	• Discuss the importance of Implementing the AIDS Feminization Fighting Plan in Acre and the monitoring performed by Brazilian Civil Society	Report under construction

Sources: UNGASS-AIDS Forums Reports (Nationals, Regional, State and City); Case Study: ARV Treatment in Brazil: the Civil Society Perspective, and National Program on STD and AIDS.

 

HIV and Maternity in Pernambuco

The housewifre P.J.S, thirty-five years old, born in Recife, northeastern state of Pernambuco, could not imagine that the happiness attached to having a baby could become a judicial nightmare.

When fnding out she was pregnant of her second child, in 2003, she took all medical pre-natal care. She did all blood tests, including the HIV reagent. The doctor at Maternity Barros Lima, northern area of the city, assured her she had nothing to worry about.

The child had a normal birth delivery. Two months later, to a complete surprise, the tests came back with the news that both her and the baby were HIV positive.

Ms Kariana Guerios, attorney of Gestos, who is following the case, says this is one of four similar cases in the Juridical Counseling department of the institution. She points to the fact that prevention of mother to child transmission is still failing in the health system and that this is somewhat frequent. “For the lack of appropriate assistance, my client was told to breast feed, what is completely inappropriate for HIV positive mothers for raising the risk of the baby getting infected. But fortunately such cases are becoming more rare,” explains Ms Guerios.

The attorney filed a case of moral damage and negligence against the County in the Civil Court, asking for a pension for the child because the mother has no financial condition for the treatment and care. “They are poor. It is necessary to try and repair a damage the municipal competence because this child, that could have been born healthy, was infected with HIV because of a sloppy pre-natal.”

Data from the report of monitoring the goals of the United Nations General Assembly Special Session on AIDS – UNGASS-AIDS – in sexual and reproductive health, prepared by the UNGASS-AIDS Forum Brasil, in 2008, shows that, despite the government’s efforts, reducing “vertical transmission” or PMTCT has a wide regional fluctuation in both care and eduction.

Based on the Plan for Preventing Mother to Child Transmission of HIV and Sifilis of the Ministry of Health, 2007, there is a 0,41% prevalence of HIV infections in mothers. There is an estimate of 12,456 newborns are exposed to HIV yearly. The transmission rate of HIV from mother to child, when the treatment intervention with prophylaxis is not done, reaches about 25% of newborns of HIV+ mothers, but it can lower to one or two percent with the application of the necessary measures during pre-natal care, delivery and post-delivery procedures. Such interventions are: the use of anti-retroviral medicines starting at the fourteenth week of gestation; use of injected AZT during labor; perform cesarian section when advisable; give oral AZT to the newborn exposed to HIV from birth to forty-two days and do not breast feed, use mild substitute instead.

Girls United Against Violence and AIDS

There is a direct relationship between HIV/AIDS and violence affecting all social strata, be it through sexual exploitation or abuse – that many times have roots at home. “It is crucial to teach the girls how to defend themselves and to denounce the violence they are victim of,” says one of the participants of the workshop Girls United Against Violence and AIDS that reaches the counties of Recife and Cabo. The campaign, beyond the workshop, has a blog that is used by them to post their views on cases of violence reported by the media, or just to show their views on ways to comfort victims of peculiarly violent situations for being a girl.

The campaign, launched in 2007, has a pioneer approach when interfacing violence and AIDS. The actions include monitoring the system of the Children and Adolescent Rights Act – ECA –, the care structure for youth victim of violence, while reinforcing the need for preventing violence and the HIV/AIDS with youth victim of abuse and sexual exploitation through a sequence of “dialogue roundtables” on the issue at public schools.

Even though there are positive response, the Campaign identifies many challenges such as the lack of unified database system that would ease the monitoring of violent cases, that are badly monitored for the sheer lack of basic information entry. The health care professional resist to write down the cases in detail. And the worst case scenario, the lack or limited prophylaxis medication for HIV in cases of rape.

Sexual and Reproductive Health and the ICPD+15

Between 30 March and 03 April, the United Nations held in New York the 42nd Session of the Commission of Population and Development (ICPD+15.) After a week of debates, the government heads present confirmed the Cairo Action Plan and broadened the reach of the International Conference for Population and Development, held in Cairo in 1994, fifteen years ago, hence ICPD+15.

The resolution the Commission reached in 2009 advanced in the sense of proposing more inter-sectorial approach for AIDS and sexual and reproductive health policies, recognizing the rights of the youth and adolescent populations and, even without citing reproductive rights, strengthening the issue as something to be present in the policies for population and development.

Other important aspects were the specific reference to the assurance of the human rights and the confrontation of stigma and discrimination of people living with HIV/AIDS; the confirmation of the commitments made at UNGASS-AIDS and the affirmation that sexual and reproductive health must be contemplated in the strategic national policies for preventing the spread of HIV and for caring for the people living with HIV (see paragraphs 16, 17, 18, and 19.) In the three months prior to the session, Gestos was active in many discussion groups about Cairo+15 and participated in the elaboration of the Latin American civil society shadow report, organized by the National Feminist Health Network, that, among other themes, focused on sexual and reproductive health of women, violence against women, and the feminization of the HIV/AIDS epidemic. According to Ms Alessandra Nilo, Gestos’ representative in the ICPD+15 Brazilian delegation, “civil society’s presence was fundamental for advancing the commitment.”