ZIMBABWENational government• Address macro-economic fundamentals as a point of departure in solvingmost of <strong>the</strong> social and political challenges that ultimately affect healthdelivery and subsequently treatment access.• Through ZINWA, urgently address <strong>the</strong> water situation, including ensuringavailability and quality.• Improve relations with o<strong>the</strong>r countries, multilateral agencies, andinternational donors to ensure increased funding and support.• Provide a friendlier policy environment and work with civil society ando<strong>the</strong>r partners, ra<strong>the</strong>r than isolate and treat <strong>the</strong>m with suspicion.International community• Support Zimbabwe to fight HIV from a humanitarian perspective.• Improve relations with <strong>the</strong> government of ZimbabweAll stakeholders• Conduct a massive joint campaign to deter people from buying ARVs fromunregistered selling points and encourage <strong>the</strong>m to purchase <strong>the</strong>ir drugsonly from registered pharmacies, clinics, and hospitals.• Conduct treatment literacy so that patients do not turn to unprovenremedies.• Train communities and service providers who live and work with HIVpositiveadolescents on counseling and communication skills.• Increase access to testing and care for adolescents, including dedicatedfacilities that address <strong>the</strong>ir unique challenges within HIV services.• Develop sustainable joint initiatives to train and retain healthprofessionals.13 Speech by Reserve Bank of Zimbabwe (RBZ) govenor, Dr. Gideon Gono at <strong>the</strong> Harare CentralHospital School of Nursing and Midwifery graduation ceremony, 27 October 2006.27
Making marginalized groups a priorityBy Sergey Kovalevsky, Anastasia Agafonova,Vladimir Osin, ITPC; Shona Shonning,Eurasian Harm Reduction Network (EHRN)<strong>Access</strong> to services for marginalized groupsPoverty, powerlessness, and social discrimination continue to exacerbate <strong>the</strong> healthproblems of marginalized groups in Russia. Injection drug users (IDUs), sex workers(SW), men who have sex with men (MSM), prisoners, and migrants have poor accessto health care resources and services. These individuals are particularly vulnerableto HIV infection, and face stigma and discrimination throughout society, includingin <strong>the</strong> workplace and in medical institutions. While national funds for HIV increasedsubstantially over <strong>the</strong> last years, funding for evidence-based prevention programsstill mainly relies on international funding.MSMMSM tend to remain invisible and meet significant opposition when <strong>the</strong>y becomevocal. Although highly vulnerable to HIV infection, MSM are not targeted byprevention activities of government and national projects, which may be taken asevidence that <strong>the</strong> government is not concerned with <strong>the</strong> welfare of this population.Recently, some officials have begun discussing <strong>the</strong> idea of criminal punishmentfor homosexual behavior, and some government representatives have becomeincreasingly aggressive about homosexual issues.IDUIn Russia, despite <strong>the</strong> fact that as many as 85% of PLWHA are IDUs, active drugusers still face significant barriers to accessing HIV treatment and care. Treatmentuptake among IDUs has been low and rates of cessation of treatment are high.Addiction treatment is not accessible and substitution <strong>the</strong>rapies proven to supporttreatment adherence among IDUs are still illegal. Few IDUs have access to harmreduction services. Though some good models of providing integrated care exist inRussia (in which TB, HIV, drug addiction, psychological support, and harm reductionare offered), <strong>the</strong>y are rare. Stigma, discrimination, and punitive ra<strong>the</strong>r than medicalapproaches to drug-related harm, continues to deter many drug users fromaccessing care.Sex WorkersSex workers in Russia face a multitude of vulnerability factors. Some studies suggestthat HIV prevalence among sex workers is quite high –- as much as 15% in Moscowand 48% in St. Petersburg among street-based sex workers. Sex workers are oftenat risk from both sexual and injection-related transmission. Many are migrantsand face additional difficulties accessing health care services. There are very fewprograms specifically targeting sex workers with outreach and client-orientedservices. Russia does not yet have a union or network of sex workers.28
- Page 1 and 2: Missing the Target #5:Improving AID
- Page 4 and 5: ArgentinaDr. María Lorena Di Giano
- Page 8 and 9: Executive SummaryAt the G8 meeting
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- Page 26 and 27: DOMINICAN REPUBLICIn Santo Domingo
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- Page 40 and 41: FamiliesIn Kenya, families are the
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- Page 74 and 75: Cambodiaby Mony PenOnly pharmacists
- Page 76 and 77: ChinaBy anonymous Missing the Targe
- Page 78 and 79: CHINAThe current process for regist
- Page 80 and 81: Dominican RepublicBy Eugene Schiff
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MalawiBy Lot Nyirenda and Grace Bon
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MALAWIStock-outsAccording to an ext
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MoroccoBy Othman MelloukMorocco has
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Determine the patent status of all
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MOROCCOThe shortage occurred becaus
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As of November 2007, the unit cost
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NIGERIADiagnostic testsDiagnostic t
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The government’s initial inabilit
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Increase training and capacity buil
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treatment practice. The Minster ann
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Ugandaby Richard Hasunira, Prima Ka
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UGANDAExtracts from the MoH’s rep
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ZAMBIAIn gathering this information
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However, since manufacturing prices
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105SHORT SUMMARY
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PAKISTANAccess for marginalized gro