Publications

The Samoa Family Health and Safety Study (SFHSS) is a component of the larger Pacific Multi-site Study of the Effects of Violence Against Women on Family Health and Safety, which is a joint research initiative of the Secretariat of the Pacific Community (SPC) and the United Nations Population Fund (UNFPA). The Multi-site study follows the methodology of the World Health Organization (WHO) Multicountry Study of Women's Health and Domestic Violence, and uses questionnaires based on those developed by WHO.

On the first World TB Day of the new millennium, ministerial representatives of the 20 countries carrying 80 percent of the global tuberculosis (TB) burden adopted the Amsterdam Declaration to Stop TB. By adopting the Declaration, these governments pledged to take bold new steps in addressing the TB epidemic in their countries and affirmed their commitment to “implement, monitor and evaluate” their national TB programs according to the TB con- trol strategy recommended by the World Health Organization (WHO).

Approximately 123,000 Cambodians aged 15-49 are estimated to be living with HIV. An additional 12,000 (approximately 10% of the total) are children under the age of 15.2 The provision of antiretroviral treatment (ART) to people living with HIV/AIDS (PLHA) is a relatively new phenomenon in Cambodia. The National Strategic Response to HIV was, until 2004, primarily focused on HIV prevention thought VCCT and health education. But the advent of high level funding from the Global Fund for AIDS, TB and Malaria (GFATM) has drawn attention to the need to expand and support ART services. The Cambodian National Strategic Response to HIV/AIDS has a clearly articulated Continuum of Care (CoC) to provide HIV treatment to PLHA. The CoC has a particularly strong community component within it, but children with HIV are not currently encompassed within this structure. The Clinton Foundation HIV/AIDS Initiative is committed to supporting the government of Cambodia to expand pediatric HIV/AIDS care in Cambodia as outlined in the Memorandum of Understanding between CHAI and the Ministry of Health. This concept paper is a first step to try and achieve that goal.

With a view to facilitating the scaling up of access to antiretroviral therapy, and in line with a public health approach, this publication outlines recent revisions WHO has made to case definitions for surveillance of HIV and the clinical and the immunological classification for HIV-related disease. HIV case definitions are defined and harmonized with the clinical staging and immunological classifications to facilitate improved HIV-related surveillance, to better track the incidence, prevalence and treatment burden of HIV infection and to plan appropriate public health responses. The revised clinical staging and immunological classification of HIV are designed to assist in clinically managing HIV, especially where there is limited laboratory capacity. The final revisions outlined here are derived from a series of regional consultations with Member States in all WHO regions held throughout 2004 and 2005, comments from public consultation and the deliberations of a global consensus meeting held in April 2006.

China's AIDS epidemic began in the early 1980s as a localized epidemic among needle-sharing intravenous drug users along the border with Myanmar in China’s Yunnan Province. HIV infections are now found in all of China’s 31 provinces, municipalities, and autonomous regions, with new infections growing at an estimated rate of 30% annually since 1999 and 44% in 2003 (Wu, Rou, and Cui 2004). The epidemic has been unfolding for at least a decade and accelerating for the last few years (Kaufman and Jing 2002), and a narrowing window of opportunity exists to avert a much larger epidemic.

The challenges posed by HIV have progressed inexorably during the past decade, especially for young people in developing countries. At the same time, many lessons have been learnt about developing and implementing programmes for young people’s health and development, including programmes to prevent the spread of HIV. In 2004, the UNAIDS Inter-Agency Task Team on Young People decided that it was time to review the progress that had been made and to look again at the evidence for the effectiveness of interventions, focusing explicitly on interventions to prevent the spread of HIV among young people in developing countries. This report is an attempt to rise to the challenge by providing systematic reviews of the evidence for policies and programmes to decrease HIV prevalence among young people, as a contribution towards achieving universal access to prevention, treatment and care (7) and attaining the Millennium Development Goal on AIDS (8).

Stigma-AIDS is a time-limited, global forum on HIV- and AIDS- related stigma and discrimination. The forum is managed by Health and Development Networks (HDN), working together with the International Federation of the Red Cross and Red Crescent Societies (IFRC), the Global Network of People Living with HIV/AIDS (GNP+) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) on the IFRC global campaign against HIV/AIDS-related stigma and discrimination: ‘The Truth About AIDS. Pass it on...’, launched in 2002. The objective of the forum is to provide a place where knowledge, experience and practical solutions about stigma and HIV can be discussed and shared among people from all regions.

An estimated 1,700 children under the age of 15 are infected by HIV around the globe everyday. Many of these are young children, infected at birth by mothers who are unaware of their HIV status. A host of social and economic factors are exacerbating the vulnerability of young women and if they are already living with HIV, they often suffer more sever stigma and discrimination than males. The Pacific Islands are not being spared. Though data are limited, 1,028 HIV cases have been reported in the Pacific Island countries (excluding Papua New Guinea). Although the total number is still low compared to other countries in the region, the trend in new infections is a major cause for alarm.

Poverty has decreased dramatically throughout most of the Asia and Pacific region. From 1990 to 2000 the number of people living in poverty across the region fell by 165 million (ADB, 2004a). However, economic growth in India and the People’s Republic of China has driven much of the reduction in headline poverty figures. Other parts of the region, most notably the Pacific, have not witnessed a similar spectacular fall in poverty. Isolation, erosion of human capital, youth unemployment, inequitable growth, and political instability are challenges that Pacific states need to overcome if they are to reduce poverty and achieve development goals shared internationally. The overall objectives of this study are to quantify the poverty impacts of an escalating HIV/AIDS crisis in the Pacific, and to raise awareness and increase understanding among key decision makers.

This initiative is based on informing and informed understanding about causes and issues of HIV and AIDS from the perspective of governance and power relationship, unequal and unjust power equations. HIV and AIDS is also a political issue, warranting a political response from governments and the corporate sector. The role of civil society and non-government organisations is crucial in making change happen on ground. ActionAid is committed to galvanise synergy and facilitate co-ordinated action. The issue of HIV and AIDS has socio-political, gender and cultural implications. There is a need to initiate organised action and concentrate public effort to fight the stigma and discrimination against people living with HIV. Changing this situation requires both societal action and public advocacy.