Your daily Selection of IRIN Africa PlusNews reports, 8/6/2004

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U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - GHANA: Global Fund urges wider use of impregnated mosquito nets

2 - SOUTH AFRICA: Campaign to create awareness on sexual offences law

3 - TOGO: Battling third highest HIV-rate in West Africa

1 - GHANA: Global Fund urges wider use of impregnated mosquito nets

ACCRA, 5 August (PLUSNEWS) - Ghana lags behind most of Africa when it

comes to using insecticide-treated malaria nets and the government needs

to go on an offensive to promote them, the head of the Global Fund To

Fight AIDS, Tuberculosis and Malaria said on Thursday.

Just three percent of the Ghanaian population string up the treated nets

over their beds, whereas the average in most African countries is between

25 and 40 percent.

And there is an even bigger mountain to climb if the West African nation

is to meet the Roll Back Malaria campaign target of 60 percent coverage by

2005.

" There is still the need for progress in the use of insecticide-treated

nets to reach the level that is obtained in other African countries, "

Feachem, executive director of the Global Fund, told a press

conference in the capital Accra at the end of a three-day visit to Ghana.

Malaria accounts for over 40 percent of cases at Ghanaian outpatient

departments, hitting pregnant women and children under the five the

hardest, according to government statistics.

More than three million Ghanaians catch the life-threatening parasitic

disease transmitted by mosquitoes every year and 16,000 children are

killed by it.

Most malaria-carrying mosquitoes bite at night and a net treated with

insecticide and hung over a bed is one of the best ways to avoid catching

the disease, the World Health Organisation (WHO) says. But people can be

sceptical of the nets and often they are too expensive for the families

most at risk of malaria, who are among the poorest in the world.

In Ghana, the Health Ministry is currently offering a 60 percent discount

on insecticide treated nets for all pregnant or nursing mothers, but some

recipients say much more should be done to control the spread of malaria.

" It is good they are helping us to contain this disease, " said Esther

Adjei, a new mother at the Military Hospital in Accra. " But I believe this

must go hand in hand with education on how to keep our surroundings clean.

Without that, all the money spent, will go down the drain since mosquitoes

grow in unhealthy environments. "

Since 2002, the Global Fund has pledged a total of US$ 68.1 million to

help Ghana fight three of the world's most deadly diseases. Malaria

accounts for more than two thirds of these funds -- $48.2 million.

The Global Fund has committed a further $14.2 million to fighting AIDS in

Ghana, where 3.6 percent of the population is HIV positive. That rises to

8.5 percent in some parts of the country.

About 50,000 people living with AIDS in Ghana need anti-retroviral (ARV)

treatment to help improve their quality of life and prolong their

survival, but at present only about 1,000 use the drugs.

Ghana has said it will use the Global Fund AIDS grant to build 16

voluntary testing and counselling centres, provide mother to child

transmission prevention services to 600 mothers per year, and begin

antiretroviral therapy for a further 2,000 people living with HIV/AIDS.

The $5.7 million allocated to fighting tuberculosis will allow Ghana to

treat an additional 20,000 patients over the next two years using DOTS,

the internationally approved treatment strategy.

A quarter of these patients will be treated in private health clinics in

order to strengthen the capacity of the private sector to work with the

public sector to fight TB.

[ENDS]

2 - SOUTH AFRICA: Campaign to create awareness on sexual offences law

JOHANNESBURG, 6 August (PLUSNEWS) - South African NGOs involved in gender

violence issues are to launch a week-long campaign in Johannesburg on

Monday to create public awareness around the Sexual Offences Bill,

currently before parliament.

" Since the parliament is in session this month, the awareness campaign is

also an attempt to lobby for the bill's enactment, " Vetten of the

Johannesburg-based Centre for the Study of Violence and Reconciliation

told PlusNews.

South Africa has one of the highest incidences of sexual abuse in the

world. According to police statistics, 52,107 rapes and attempted rapes

were reported in 2002, while a 1999 health department study found that

seven percent of women aged between 15 and 49 had been raped or coerced

into having sex against their will.

The bill has been delayed for almost five years, said Lawyers for Human

Rights gender project coordinator Tizeta Wodajo. " Initially the bill came

into being to protect children from rape - it later went on to cover

adults. "

The NGOs will also attempt to engage the public in a debate around issues

contained in the bill, one of which is the definition of rape.

" Currently the definition covers the unlawful sexual penetration of the

vagina by a penis - it does not cover digital rape, where the vagina has

been penetrated by an object such as a gun barrel, or even anal rape, "

Wodajo said. The definition also does not cover rape committed by a member

of the same sex as the victim.

The other problem with the definition is that the wording " without her

consent " in the proposed legislation " places the victim on trial " because

she is required to provide physical evidence to prove that the sexual act

was committed without her approval. " The woman could have been threatened

at gun-point, or the perpetrator could have threatened to kill her

family, " said Wodajo.

The NGOs have been lobbying for the replacement of " without her consent "

with " coercive circumstances, " Vetten said.

Attempts are also being made to include sexual acts committed by people

aware of being HIV positive without disclosing their status to their

partners as violations.

" We are supporting the NGOs' attempts to create public awareness around

the bill, " said a spokesman for the ministry of justice, Kaizer Kganyago.

" Ultimately it is the parliament which will decide on the bill and we

cannot put pressure [on it]. "

[ENDS]

3 - TOGO: Battling third highest HIV-rate in West Africa

LOME, 6 August (PLUSNEWS) - Togo lies smack bang in the middle of West

Africa's main trade and transport corridor and health experts say the tide

of people passing through this narrow strip of territory have helped to

land it with the third-highest HIV prevalence rate in the region.

According to government statistics, six percent of Togo's five million

people are HIV positive, putting the country just behind Cote d'Ivoire

with 10 percent and Liberia with an estimated eight percent.

But one bright spot is condom use. Packets of six can be found by the

bedside in many a hotel room and according to Togo's national AIDS

programme, there are now some 11 million condoms being sold a year

compared to just seven million in 2002.

However that still works out at less than four per person per year for

Togo's adult population. And since this former French colony is one of the

world's poorest countries, with the economy generating just US $291 per

inhabitant each year, not everyone can afford to protect themselves

against HIV infection and pregnancy every time they have sex.

This problem will soon be aggravated because Togo's current source of

cheap condoms is set to dry up next year. USAID recently announced that

its condom donations to the country would stop at the end of 2005.

Now the race is on to ensure a steady and affordable alternative supply of

condoms to keep the safe sex momentum going.

At its last board meeting at the end of June, the Global Fund To Fights

AIDS, Tuberculosis and Malaria approved a $33 million funding request from

Population Services International (PSI) to help plug the condom gap.

PSI will use some of the new funds to buy a stockpile of condoms. It will

gradually increase the retail price so that when USAID condom donations

cut out in 2006, people in Togo will be psychologically used to paying an

amount that covers the basic cost of producing, packaging and shipping the

contraceptives.

" We either have to gradually increase the prices or provide nothing, "

explained Manya s, PSI's woman on the ground in the capital Lome.

PSI condoms, sold by street hawkers whose wares include everything from

tomato paste to soap, still dramatically undercut those on sale in private

pharmacies.

Today you can buy a PSI condom for 25 CFA (5 US cents), whereas

unsubsidised equivalent products retail for 290 CFA (53 US cents) - more

than 10 times the price.

s hopes that local consumers will take the gradual increase in the

price of PSI condoms in their stride.

" My driver said to me the other day 'Well I remember the day I paid 50 CFA

for a beer. Today it cost me 500 CFA but I'm still drinking', " she said.

But Leon Adom, the head of Togo's national AIDS programme, is worried.

" Already there are people who can't afford to buy condoms. It could

disrupt the whole programme and ruin what we've achieved, "

he told PlusNews.

Sanctions clipping wings

In this small West African nation, poverty and meagre inflows of

international aid are taking their toll.

The European Union has withheld aid since 1993 in protest at what it calls

poor governance by President Gnassingbe Eyadema, who has been in power for

37 years and is Africa's longest serving head of state.

These sanctions have limited the government's ability to spend money on

social services and have hurt the fight against AIDS. According to World

Bank data, the Togolese government spends just $9 per capita per year on

healthcare. That compares to $19 in neighbouring Ghana and $12 in Benin.

" The sanctions against Togo have definitely discouraged the traditional

donors. Until the Global Fund came in, the donor situation had been

extremely difficult, " s explained.

National statistics show there are some 200,000 HIV-positive people in

Togo, which lies in the middle of the coastal highway between Lagos, the

commercial hub of Nigeria, and Abidjan, the main city in Cote d'Ivoire.

Kossi Attisso, a doctor working for United Nations Development Programme

(UNDP), says Togo's position at the centre of this busy trade corridor

has been a key factor.

" The mobility of the population plays an important part. Togo is a pretty

much a crossroads, " he explained. " Many foreign truckers make stopovers in

the country and the economic crisis at home has pushed more and more women

into prostitution which makes for a lethal cocktail. "

Civil war broke out in Cote d'Ivoire two years ago, seriously disrupting

the port of Abidjan's traditional import-export traffic with landlocked

Burkina Faso, Mali and Niger.

Much of the external trade of these countries now passes through the port

of Lome instead. The main road running north through Togo to the Burkinabe

frontier has become crowded with heavily laden trucks plying to and from

the Sahel. And health experts believe the development of this new trade

corridor could have aggravated Togo's AIDS problem.

" It's impossible to know because we haven't got before and after data, but

the conditions that tend to favour the spread have definitely

intensified, " PSI's s explained. " There are more... men far away

from their families with a bit of money in hand and women who are

increasingly desperate. More risky encounters are inevitable. "

Getting the message out

However, some progress is being made in getting the message out to

ordinary people.

" Two years ago we had just 2,000 people coming forward for voluntary

(AIDS) testing. Now's it's in the region of 5,000, " said Adom, the

coordinator of the government's national campaign against AIDS.

He said the government had opened seven news testing centres in the

interior, thanks to grants from the Global Fund, which has to date

approved $53 million worth of AIDS funding for Togo.

By 2005, the Global Fund aims to cut HIV transmission by 40 percent among

Togo's sex workers and their partners and by 25 percent among young people

aged between 10 and 25 years old.

It also wants to improve the medical and psychological counselling

services available to those living with the disease and implement measures

to make blood transfusions safer.

Another important target is increasing access to antiretroviral drugs

(ARVs), which improve the quality of life and prolong the survival of

people living with AIDS.

At present, there are an estimated 2,000 people on ARV therapy in Togo,

but the government will shortly launch a drive to make the drugs cheaper

and more widely available.

Last month, the government took delivery of $2.8 million worth of

antiretroviral drugs purchased by the Global Fund. The delivery will be

enough to treat another 1,500 people living with the disease, although

officials cautioned there may be some overlap with current ARV users.

Under the new scheme pregnant women and children under 10 with

HIV-positive mothers will be offered free treatment. Officials said other

people living with AIDS would pay around 5,000 CFA francs ($20) for a

month's treatment, compared to 16,000 CFA ($32) at present.

But for Augustin Dokla, who coordinates several associations of people

living with HIV in Togo, the main battle to be fought is not over drugs,

but against people's prejudices.

" If we keep quiet then people are happy to eat and drink with us. But as

soon as we say openly that we are HIV positive then we face the stigma

everyday, " he told PlusNews. " It's not easy living with HIV. "

Humanitarian workers note that even efforts to destigmatise the disease

can sometimes end up reinforcing inaccurate stereotypes.

Schoolchildren skits often include portray the person living with AIDS as

someone who is continually vomiting or having diarrhoea. And a local NGO

recently put out a comic book where the main character was portrayed as a

heroine because she turned out to be HIV-negative.

Some people living with HIV want laws to be drawn up to prevent

stigmatisation, but aid workers said all the drafts of such protection

laws were languishing in government offices, unable to get onto the

parliamentary floor for discussion.

" Everyone is willing to talk the rhetorical script but every effort to get

to the personal level runs into a wall of resistance, " PSI's s said.

[ENDS]

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