Vector Issue 12 - 2011

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2 www.ghn.amsa.org.au 26 6 MDG Up to 2 million people die from AIDS related illnesses every year, many of whom are in southern Africa (38%). Increased access to antiretroviral drugs in poorer countries means this is decreasing; however over 5,000 people still die each day from AIDS. Running a close second in global mortality is tuberculosis, responsible for 1.8 million deaths in 2008, about 500,000 of whom were HIVpositive. 90 per cent of malaria deaths also occur in Africa, where it accounts for a fifth of childhood mortality (equivalent to the death of one child in the world every 45 seconds) 1-3 . [ ] vector FEB 2011 combat HIV/AIDS, malaria and other diseases Challenges to achieving the targets 1 Education and knowledge of HIV is unacceptably low Knowledge about HIV and its modes of transmission is the first step to preventing its spread. However, less than a third of young men and one fifth of young women in developing countries have received education about the illness. Condom use also remains low globally, especially among developing countries. With many young people in Africa unaware of the risks and modes of transmission for HIV, the UN’s goal on comprehensive HIV knowledge of 95 per cent of people in developing countries is still far from being achieved 1,2,4 . [] Antiretroviral treatment has expanded but HIV prevalence rates continue to rise When antiretroviral therapy was launched in 2003, only 400,000 people were able to access it. By the end of 2009, more than five million people were receiving treatment. However, for every two people starting HIV treatment each year, five new people are infected. Access to antiretroviral therapy needs to be expanded for pregnant women, as most of the 2 million children younger than 15 living with HIV were infected by vertical transmission (in the womb, at birth or via breastfeeding). In 2008 alone, over 60,000 HIV infections among at-risk babies were prevented because their HIV-positive mothers received treatment. However, less than 50 per cent of HIV-positive expectant mothers currently receive treatment 1,2,5,6 . [] 3 HIV/AIDS is becoming a chronic disease in many countries The survival rate of HIV/AIDS is growing in many countries due to the increasing availability of antiretroviral drugs in the developing world. As a result, HIV/AIDS is being transformed into a chronic disease, with a model of care that also needs to transform to focus on multidisciplinary models, continuity of care, long-term adherence support, and social support 1,4,7 . [] 4 HIV/AIDS may not just affect poorer populations Contrary to evidence for other infectious diseases, HIV may be more prevalent amongst higher-income demographic populations than previously thought. In a large study looking at eight African countries, wealthier men and women had a higher prevalence of HIV than poorer ones and were at least as likely as poorer adults to be infected. If this is in fact a common pattern, a broader approach needs to be taken in the prevention of HIV/AIDS in developing countries 8 . [] What is being done worldwide? The UN is coordinating global efforts to achieve these targets in reducing communicable and largely preventable deaths. Several UN programs aim to prevent these diseases and enhance access of treatments according to the following strategies: •Increase technical support for HIV/AIDS • The Joint United Nations Programme on HIV/ AIDS (UNAIDS) coordinates the resources of ten organisations assisting developing countries with technical support in the implementation of their national AIDS plans [1 .] •Prevent mother-to-child transmission of HIV/AIDS • The UN Children’s Fund (UNICEF), the World Health Organisation (WHO), the UN Population Fund (UNFPA) and UNAIDS have assisted countries to develop and implement programmes aimed at preventing vertical transmission of HIV, including training, funding and technical expertise [1,2 .]
SNAPSHOT 33 million people are currently living with HIV worldwide. Two thirds of these are in Africa (mostly women) and this number continues to grow, despite a decrease in new infections (as those infected with HIV are now surviving longer). There are also 11 million people currently suffering from tuberculosis, and a staggering 240 million cases of reported malaria in 2008 1,2 . nets condoms & drugs minh nguyen flinders university Widespread HIV/AIDS prevention and care programs • The UN Development Programme (UNDP) has engaged over three million people in prevention activities over the last five years. In Burkina Faso, an African country in West Africa, this programme provided regular support to nearly 36,000 people living with HIV, including home visits, meals and assistance to set up small-scale enterprises 1,2,5-7 . [ Increasing access of mosquito nets to prevent malaria • Global production of mosquito nets has increased 500% since 2004 to 150 million nets in 2009. Nearly 200 million nets were delivered to African countries between 2007 and 2009. However, nearly 350 million are needed to achieve universal coverage and this effort needs to be intensified 1,2,9 .] • The first scoping study, on HIV prevention initiatives targeting men who have sex with men in Asia and the Pacific (with a focus on Vietnam Cambodia Burma Philippines and PNG), was completed in 2009. A second study on greater involvement of people living with HIV was completed in November 2009 and the final study on HIV legal and policy frameworks was completed in March 2010. Initial responses to the recommendations include 3 million dollars of funding over three years (2009-12) to support programs for men who have sex with men in Indonesia, PNG and Burma, and 1.5 million dollars over three years (2009-12) to PNG and the Solomon Islands for legal and policy development activities. Further work on incorporating recommendations from these studies into longer-term HIV programming is underway 10 .] Australia’s role in achieving MDG 6 The Australian Government has a focussed strategy aimed at helping partner countries address MDG6. The main focus for Australia’s support to the global HIV/AIDS effort is based in the Asia Pacific region. In Africa, Australian support is channelled through the Global Fund and UNAIDS. Currently, AusAID, Australia’s aid program, has focussed its global research efforts into three areas: • HIV prevention for men who have sex with Men; • greater involvement of people living with HIV; • and legal and policy enabling environments for effective HIV responses. 1.United Nations. 2010. The millennium development goals report 2010. New York: United Nations. 2.UN Development Programme (UNDP). 2010. What Will It Take to Achieve the Millennium Development Goals? An International Assessment 2010. New York: United Nations. 3.WHO. 2009. Global Tuberculosis Control: A Short Update to the 2009 Report. Available from http://whqlibdoc.who. int/publications/2009/9789241598866_eng.pdf (accessed 13 November 2010). 4.Center for Global Development. 2004. Millions Saved: Proven Successes in Global Health. CGD Brief. October 2004, 3:3. 5.MARCO. 2009. Five-Year Evaluation of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, Synthesis of Study Areas 1, 2 and 3, Marco International Incorporation. 6.Nunn, A. S., da Fonseca, E. M., Bastos, F. I. and S. Gruskin. 2009. AIDS Treatment in Brazil: Impacts and Challenges. Health Affairs, vol. 28, no. 4, pp. 1103-1113. 7.Janssens, B., et al. 2007. Offering integrated care for HIV/AIDS, diabetes, and hypertension within chronic disease clinics in Cambodia. Bull WHO, Vol. 85, pp. 880-885. 8.Mishra, V. et al. 2007. A study of the association of HIV infection with wealth in sub-Saharan Africa. DHS Working Papers. 9.WHO. 2007. WHO Releases New Guidance on Insecticide-treated Mosquito Nets: Recent Data from Kenya “Ends the Debate” About How to Deliver the Nets. Available from http://www.who.int/mediacentre/news/releases/2007/pr43/ en/index.html (accessed 20 November 2010) 10.AUSAID [homepage]. 2010. HIV/AIDS: Australia's response. Available from http://www.ausaid.gov.au/keyaid/ hivaids/default.cfm (accessed 22 November 2010) www.ghn.amsa.org.au vector FEB 2011 27
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Page 3 and 4: contents 4 EDITORIAL 5 8 Reflection
Page 5 and 6: arthur cheung university of queensl
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Page 19 and 20: It would be simplistic to assume th
Page 21 and 22: Progress to date: MDG5 is the worst
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Page 29 and 30: PLAY A PART AND MAKE A DIFFERENCE U
Page 31 and 32: key goals 1. Raise the commitment o
Page 33 and 34: several hundred million additional
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Page 37 and 38: alexandra f r a i n & l u k e hamil

Vector Issue 12 - 2011

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