Latin America and Caribbean
Begins Preparation for AIDS 2008
A videoconference linking 11 countries of the
Region was held in November,
with the aim of ensuring the visibility of Latin America and the
Caribbean at the next International AIDS Conference (AIDS 2008).
The panelists were Pedro Cahn, President of the
International AIDS Society, Jorge Saavedra, Director of Mexico’s
National HIV Program, and Juan Jacobo Hernández, Co-President of the
Community Program. Speaking from a location in Mexico City, they
motivated the audience to prepare early for the event, present quality
abstracts, and develop publications and materials.
PAHO Director, Mirta Roses, who participated
through a recorded message, urged the audience to use occasion to boost
the regional response.
“Mexico 2008 is a good opportunity for increasing the global visibility
of Latin America and the Caribbean, presenting the many lessons learned
in the Region and its renewed commitments as well,” she said.
The panelists described the new developments that
had been announced at the meeting of Conference’s Coordinating Committee
held two days earlier, including the donation of US$4 million by the
Mexican government and confirmation that President Felipe Calderón will
participate in the opening ceremony.
The panelists also highlighted the fact that this
will be the first conference with plenary sessions dedicated to men who
have sex with men and sex workers, two important topics for the response
to the epidemic in the region. They also mentioned the need of
registering early for the conference, since the total number of
participants cannot exceed 25,000. Abstracts and applications for
financial assistance submitted earlier have greater chances of approval,
they said.
Pedro Cahn explained that the theme of the
conference -- Universal Action Now! -- stresses the need for a continued
state of emergency in the response to HIV and for action by all the
parties involved at the global, national, regional, and local levels.
Jorge Saavedra informed that visa applications will be facilitated for
participants who sign up to attend the conference, whether or not they
are speakers.
The videoconference
was a PAHO/World Bank initiative and had the support of the Regional
Director and the Theme Groups of the United Nations system in the
Region.
The participating countries were Brazil, Colombia, the Dominican
Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua,
Peru, and Uruguay. A DVD with the content of the videoconference will be
available in late December in PAHO Country Offices. In order to ensure
the presence of the English-speaking Caribbean, the panelists recorded a
session in English with a special focus on the needs of that subregion.
That session will also be included in the DVD.
AIDS 2008 Now Accepting
Abstracts
Registration to
participate and submit abstracts for the International AIDS Conference
(AIDS 2008) has been open since 1 November.
More than half of
the sessions at the conference will be based on abstracts.
The deadline for submitting abstracts is 19 February, but the organizers
expressly recommend that they be submitted earlier.
The conference is structured around three program committees
(Scientific, Community, and Leadership) and four working groups, which
are responsible for major program activities such as the Global Village,
youth and cultural programs, and skill-building workshops.
The vision of the AIDS 2008 scientific program is to provide new,
research-based evidence, and to synthesize already available evidence in
order to inform and guide the global response to these challenges.
This vision
will guide the work of each of the five scientific tracks: Biology and
Pathogenesis of HIV, Clinical Research, Treatment and Care,
Epidemiology, Prevention and Prevention Research, Social, Behavioral and
Economic Science and Policy & Political Science.
The Community
Program offers an opportunity to reach and involve diverse communities
affected by HIV and provide spaces for wide-spread representation and
dialogue.
The conference must be a catalyst for those communities most affected by
HIV to regain an urgency and momentum to their activism in order to
reclaim ownership of the agenda through the creation of strategic
alliances and articulation of each others’ needs.
The Conference’s
Leadership Program provides a platform for leaders from all walks of
life to engage in dialogue and debate to identify solutions to the
challenges we face in addressing the HIV epidemic.
More information:
http://www.aids2008.org
New PAHO HIV Office for the
Caribbean
To improve the PAHO response to HIV and STIs in the Caribbean, and as
part of the Organization’s policy to decentralize resources to the
subregional and country levels, the PAHO HIV Coordinating Office for the
Caribbean (PHCO) has been created, with headquarters in Port-of-Spain,
Trinidad.
The PHCO will be a
decentralized office of the PAHO Headquarters and will be responsible
for the development and coordination of technical support and for the
monitoring of PAHO Caribbean HIV/STI Plan for the Health Sector, 2007 to
2012.
The PHCO will also serve as a primary contact point with partners
working on the HIV response in the Caribbean, including PANCAP, UNAIDS,
and CRN+, and will work in coordination with PAHO’s Caribbean Program
Coordination Office (CPC), based in Barbados. The PHCO became
operational in late 2007 and is headed by Gottfried Hirnschall, former
Chief of SPSTI/CAREC. The new office will maintain direct relations with
all Caribbean countries.
PAHO Adapts Guidelines for Antiretroviral
Treatment for LAC
PAHO has completed the adaptation to the Latin American and Caribbean
context of the 2006 WHO guidelines for antiretroviral treatment for HIV
in adults and adolescents, in order to support the standardization of
medical care and antiretroviral treatment in the Region of the Americas.
The review and
adaptation took into consideration that the countries of the Region of
the Americas, especially those in Latin America and the Caribbean, have
a wide range of capacities of health services and systems This helped to
ensure relevance and applicability and facilitate the adaptation and the
use and implementation of the guideline by the countries of the region.
The guidelines will support the development of national directives, as
well as the process of harmonization of guidelines at the subregional
level.
The PAHO Guidelines: Guidelines for Antiretroviral
Treatment for HIV Infection in adults and adolescents in Latin America
and the Caribbean: on the road to universal access, 2007 version,
Spanish only
http://www.paho.org/spanish/ad/fch/ai/Guia_Adultos_Final_editada.pdf
The original WHO Guidelines: Antiretroviral therapy
for HIV infection in adults and adolescents. Recommendations for a
public health approach. 2006 revision (http://www.who.int/hiv/pub/guidelines/artadultguidelines.pdf)
Latin American Develops Strategy
to Address Drug Resistance
In collaboration
with the Ministry of Health of Brazil and the Public Health Agency of
Canada, PAHO/WHO organized a workshop on evaluating and preventing the
emergence of HIV drug resistance (HIVDR) in Latin America. Fifty
participants from 16 PAHO member states and the PAHO suregional Adviser
for the Andean Area Dr Bertha Gomez attended this 3 day workshop which
was held from November 26 to November 28, 2007 in Rio de Janeiro,
Brazil.
Dr Bilali Camara
from the FCH/HIV Unit has coordinated this workshop and other
facilitators included Dr Silvia Bertagnolio from WHO-HIVDR Team, Dr
Chris Archibald and Dr James Brooks from the Public Health Agency of
Canada, Dr Amilcar Tanuri, from the Ministry of Health, Brazil, and
Michael Jordan from Tufts University, Boston.
The workshop helped
to develop a Latin American strategy that enables countries to evaluate
and prevent HIVDR in accordance with PAHO/WHO international
protocols using the population based approach to measure the emergence
of HIVDR strains.
By the end of the
workshop, each country had prepared a draft “2008–2012 Plan of Action”
for the evaluation and prevention of HIVDR, agreed to establish a
National Expert Committee to finalize and implement this Plan of Action.
The draft plans were based on the epidemiological situation in each
country using the PAHO/WHO public health approach which contains three
key strategies: Early Warning Indicators, Monitoring HIV Drug Resistance
among people newly put under ART and using antiretroviral treatment
sites based approach, and the threshold survey among newly HIV infected
persons.
More than 2,000 Attend V CONCASIDA
Managua, Nicaragua
was the site of the V Meeting of People Living with HIV and the V
Central American Congress on STI/HIV/AIDS. More than 2,000 people from
several Latin American countries participated in the event, held
November 4-9. During a week of discussions and presentations, the
panels emphasized the need to center efforts around meeting targets for
universal access.
Peter Piot, Executive Director of UNAIDS, pointed out that even though
nearly 65% of people in Central America receive antiretroviral
treatment, that still leaves out 35% who do not receive treatment. He
emphasized that this latter group represents “the true indicator of
universal access.” Piot added that prevention is a critical
intervention. According to him, treatment can not be neglected, but
prevention should be given high priority in HIV response strategies,
something that is not happening at present.
CONCASIDA also
included a series of activities and satellite meetings promoted by PAHO.
Among them were a satellite roundtable on gender-based violence and HIV,
in which participated the First Lady of Honduras, Xiomara Castro de
Zelaya, and another on pediatric AIDS, in which PAHO participated at the
invitation of UNICEF. Another highlight was the presentation of
instruments developed by PAHO to evaluate national HIV responses, as
well as a panel on second-generation surveillance, in which
representatives from UNICEF, the World Bank, and UNAIDS participated.
CONCASIDA was also the site of meetings of women leaders, ministries of
education, and a meeting of Central American health ministers and
authorities, at which a study on progress towards the agreements of the
4th CONCASIDA (El Salvador, 2005) was presented. The study, which
analyzed 10 of the 11 recommendations of the Declaration of San
Salvador, found varying degrees of progress in the countries.
The participation of PAHO staff at CONCASIDA focused on the topics of
human rights and HIV, second-generation surveillance, gender violence
and HIV, prevention of HIV infections in adolescents, HIV communication,
and health service care models.
CONCASIDA Examines
Sustainable, Quality Services for HIV
During a roundtable discussion on health service care models held at the
V CONCASIDA, Amalia del Riego of PAHO noted that, despite significant
efforts in the Region to guarantee access to antiretroviral therapy and
the prevention of mother-child transmission of HIV, major challenges
remain for health services to ensure access to quality services and the
financial sustainability of universal care and coverage.
The PAHO expert explained that for health services to meet emerging
needs, greater decentralization and integration is necessary, as well as
and more strategic, efficient use of funds. She emphasized the
opportunity represented by the renewed approach to primary health care,
which facilitates greater participation by people with HIV and the
community in supporting the health services supply, including gender,
ethnicity, and intercultural approaches to service delivery.
Del Riego noted that it is urgent that countries integrate HIV into
health surveillance and information systems, integrate interventions for
HIV prevention, care, and treatment into existing services (for example,
services for tuberculosis, STI, maternal and child health, domestic
violence, etc.), expand critical programs such as sexual and
reproductive health and human resources development, and explore new
financing mechanisms. Achieving and sustaining these goals warrants the
strengthening of health systems as a whole, including insurance and
financing policies and mechanisms.
Second-Generation Surveillance: a Closer Look at the Epidemic in
CONCASIDA
Second-generation surveillance is increasingly becoming an effective
tool for measuring the impact of the epidemic by monitoring the risk
patterns of vulnerable populations or groups. This was one of the
conclusions of the roundtable on second-generation surveillance held at
CONCASIDA, with the participation of experts from PAHO and the Centers
for Disease Control and Prevention/Global AIDS Program (CDC/GAP).
Monica Alonso of PAHO explained that the exclusive use of
first-generation surveillance has limitations in terms of reporting
changes in the epidemic, since this surveillance focuses mainly on the
general population and not on vulnerable groups. She also added that
second-generation surveillance makes it possible to use the data
obtained for better planning of the efforts to prevent and control the
epidemic, because it provides more detailed information.
Edgard Monterroso of the CDC of Guatemala called attention to the
constant migration of workers in the Region, which facilitates
interaction between the Central American countries and the Caribbean
islands, where infection rates are higher. In this regard,
second-generation surveillance is a key factor in monitoring trends in
the epidemic.
Roberto Flores of the CDC/GAP of El Salvador emphasized that
second-generation surveillance poses new challenges, especially in terms
of strengthening the laboratory network for HIV diagnosis and screening,
which is necessary for the production of HIV incidence studies, the
evaluation of current diagnostic
algorithms
to find cost-effective models, and the strengthening of laboratory
diagnosis for opportunistic diseases. He also mentioned the need to
develop mathematical models to complement knowledge about the HIV
epidemic; for example, software and spreadsheets that make it possible
to evaluate the incidence and prevalence of HIV cases.
PAHO Strengthens Dialogue with Civil Society in CONCASIDA
A meeting was held
with representatives from several nongovernmental organizations from the
Central American countries within the framework of CONCASIDA in order to
strengthen the dialogue with the civil society organizations involved in
the HIV response in Central America, forge ties between PAHO and civil
society, and listen to recommendations and suggestions from civil
society for consideration during the biennial planning process.
At the meeting, participants learned about the PAHO new planning cycle,
including both the new Biennial Plan (2008-2009) and the Regional HIV
Plan, which represents a long-term commitment by the Organization and
coincides with the Millennium Development Goals.
Civil society representatives stated that they look forward to ongoing
support from PAHO for the processes that will permit the achievement of
comprehensive universal access. Recommendations to PAHO included
requests for technical support to the countries in areas such as
patents, compulsory licenses, drug surveillance, and the NAFTA process,
as well as coordination of the dialogue between civil society and
government in each country.
The civil society participants included the Nimehuatzin Foundation and
ASONVIHSIDA of Nicaragua, ICW Latina and Agua Buena of Costa Rica, the
Central American Network of HIV+ People (REDCA+), Gente Buena, Oasis and
Agua Buena of Guatemala, Grupo Génesis, and the Association of New Men
and Women of Panama, and Equity House of Belize. Also present was UNAIDS’
Regional Director, César Nuñez.
Pos-CONCASIDA, Nicaragua Repeals
Article that Penalized Same-Sex Relations
Fifteen years after
approving it, and a few days alter the closing of the V CONCASIDA, the
Nicaraguan National Assembly repealed Article 204, which penalized
sexual relations between people of the same sex.
This marks an important step to guarantee observance of the human rights
in that country.
Article 204 had stated that “the crime of sodomy is committed when a
person scandalously induces, promotes, advertises, or practices
relations between people of the same sex.… That person will incur a
penalty of one to three years in prison…” Several international
agencies supported the efforts of Nicaraguan society for the repeal of
this article.
Third TAC Reviews Progress and Priorities
A review of
progress in the implementation of the Regional HIV Plan, the results of
the evaluation of the health sector response to HIV in the Dominican
Republic, and establishment of priorities for PAHO’s cooperation for the
next biennium were part of the work agenda of the third meeting of the
HIV Technical Advisory Committee (TAC), held September 16 to 18 in
Managua, Nicaragua.
The TAC meets every year, and its purpose is to advise the PAHO
Secretariat on the identification of work priorities for HIV in the
region, propose optimal strategies to ensure that these goals are met,
and promote the support and understanding of these goals by the Member
States, including governments, civil society, technical institutions,
and private sector.
The TAC consists of ten members from civil society, academia, and
international organizations. During the Third TAC Meeting, Marisela
Padrón, former Minister of Labor and Social Security of Venezuela,
officially joined the committee.
More information:
http://www.paho.org/spanish/ad/fch/ai/tac_2007.htm
PAHO and Representatives from the Religious Sector to Cooperate
PAHO and representatives of several religious
denominations held a one-day technical consultation at PAHO Headquarters
in Washington, in which the two sectors had an opportunity to exchange
information and cooperate for the purpose of strengthening the regional
response to HIV.
The participants approved the creation of a working group, which will
involve representatives of a broader number of religious groups, with
the purpose of maintaining a communication system to share experiences
and best practices, and monitoring the development of a plan of action
that addresses of human resources education, research, dissemination of
information, and increase of awareness and knowledge in both PAHO and
the religious sector.
Representatives
from the Catholic University of Chile, the Latin American and Caribbean
Council for Religious Leaders, US-Brahma Kumaris, and the Caribbean RST,
a professor of theology from Boston College, representatives from the
HIV Office of the D.C. Government, and UNAIDS also participated in this
meeting.
Suggested
Readings:
Faith-Based
Organizations: Contributions to HIV Prevention
http://www.usaid.gov/our_work/global_health/aids/TechAreas/community/fbo.pdf
Guía para Tratamiento Antirretrviral para Adultos y Adolescentes para
Latinoamérica y el Caribe [Guidelines for Antiretroviral Treatment of
Adults and Adolescents in Latin America and the Caribbean] Spanish
only
http://www.paho.org/spanish/ad/fch/ai/Guia_Adultos_Final_editada.pdf
PAHO Caribbean HIV/STI Plan for the Health Sector, 2007 to 2012
http://www.paho.org/English/AD/FCH/AI/CaribbeanPlan.pdf
Análisis de Situación del VIH de la Subregión Andina 2003-2005, Plan
Subregional Andino de VIH para el Sector Salud, 2007-2010. [Analysis of
the HIV Situation in the Andean Subregion 2003–2005: Andean Subregional
HIV Plan for the Health Sector, 2007–2010
Spanish only
http://www.paho.org/Spanish/AD/FCH/AI/Situacion_VIH_Region_Andina_2003-05_Esp.pdf
Explorando las intersecciones entre Empoderamiento, VIH, y Violencia
contra las Mujeres en Latinoamérica y el Caribe [Exploring the
Intersections between Empowerment, HIV, and Violence against Women in
Latin America and the Caribbean] Spanish only
http://www.dvcn.org/Documents/InterseccionesVIHVCM2.pdf
Estrategias Nacionales sobre VIH y violencia contra las Mujeres en
América Latina y el Caribe: Un reto impostergable [National Strategies
on HIV and Violence against Women in Latin America and the Caribbean: An
Urgent Challenge]
Spanish only
http://www.dvcn.org/Documents/PlanesNacVIHVCM4.pdf
Conversando con Niza Picasso (ICW-México) sobre el VIH y la violencia
contra las mujeres [A Conversation with Niza Picasso (ICW-Mexico) about
HIV and Violence against Women]
Spanish Only
http://www.dvcn.org/Documents/EntrevistaNizaPicassoVol1No31.pdf
Most frequently
used HIV Acronyms:
http://www.paho.org/English/AD/FCH/AI/Acronym_hivAIDS.pdf
The purpose of this
bulletin, produced by the FCH/AI Unit, is to share information
on the efforts of PAHO
professionals involved in the response to HIV/STI.
It is not an official
document of the Organization.
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