Your daily Selection of IRIN Africa PlusNews reports, 6/17/2005

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CONTENT:

1 - COTE D IVOIRE: US gives $42 million to help fight against AIDS

2 - NIGER: Hazardous sex and no AIDS treatment in frontier trucking town

3 - TANZANIA: Free ARVs for 100,000 by 2006, prime minister says

1 - COTE D IVOIRE: US gives $42 million to help fight against AIDS

ABIDJAN, 16 June (PLUSNEWS) - The United States said on Thursday it would give

US $42 million to Cote d'Ivoire this year to help fight HIV/AIDS in the

war-divided nation.

The money, from the President's Emergency Fund For AIDS Relief (PEPFAR), will be

spent on a wide range of initiatives from opening new clinics for sex workers to

rolling out a school curriculum that includes talking about the disease.

The ultimate aim is to prevent 265,000 new infections by 2010, treat 77,000

Ivorians already living with HIV by 2008 and help care for 385,000 children left

orphaned or vulnerable by AIDS, also by 2008.

" It's not just about working on small, individual projects. The resources are

great enough to allow us to scale up, " Nolan, the US technical

coordinator of PEPFAR in Cote d'Ivoire, told IRIN.

" We are interested not just in having a really good project in one city but in

how it can be replicated across the country. We are looking at building up

sustainable networks, " she said.

PEPFAR aims to pump US $15 billion into combating AIDS worldwide over a

five-year period.

The programme allocated US $24.3 million to Cote d'Ivoire in 2004. Nolan said

that following this year's much larger grant there could be more money in the

pipeline.

" It's results orientated, so if we get the results we will get more resources in

the future, " she said.

Cote d'Ivoire, which has one of the highest HIV prevalence rates in West Africa,

is one of 15 countries singled out for special focus under the PEPFAR scheme.

The latest figures from UNAIDS put the prevalence rate in the world's top cocoa

grower at seven percent, although some aid workers believe it is much higher,

especially in the rebel-held north and the volatile west, where medical services

have virtually collapsed.

The country has been divided into a government-run south and a rebel-held north

since a civil war broke out three years ago and this throws up some unique

problems.

Thousands of health care workers and teachers in the north fled south when the

conflict erupted in September 2002 and have yet to return to their posts.

" The complicating factor to working in the north is partly access and partly

because we do not have the health and education sectors substantially deployed, "

Nolan explained.

Wherever they go, AIDS campaigners must also cope with a strong military

presence. This not only takes the form of government soldiers and rebel

fighters. Cote d'Ivoire is also full of self-styled militiamen who are often a

law unto themselves.

" In Cote d'Ivoire there are a lot of men in uniforms and men with guns that are

mobile, separated from their partners and with a higher income than those around

them. There's a lot of transactional sex, whether it's for money or soap, and

that's a big factor for transmission, " Nolan said.

Some of the new funding will be used to open two confidential clinics for sex

workers, adding to three already established with US assistance in the de facto

capital Abidjan and the western port city of San Pedro.

Nolan said 8,000 people a year visit the three clinics. The two extra sites

should become operational before the end of this year at locations as yet to be

determined.

Another key aspect of the fight against AIDS that will benefit from US funding

is prevention through education.

" The rate of pregnancies in schools and sexually transmitted infections has

increased dramatically since the crisis, " Nolan explained. " We're working with

the Ministry of Education to develop a Life Skills curriculum to look at healthy

living. "

[ENDS]

2 - NIGER: Hazardous sex and no AIDS treatment in frontier trucking town

BIRNIN-KONNI, 16 June (PLUSNEWS) - Truckers from all over West Africa converge

daily on this bustling frontier town, where several hundred of prostitutes wait

to greet to them in roadside bars and crowded brothels, where gaudy neon lights

flash a welcome.

AIDS is rampant in this epicentre of the sex trade in Niger, where heavy trucks

jostle for road space with camels, donkeys and motor-cycle taxis.

But the town's medical facilities are limited and efforts to control the disease

here are still in their infancy.

A study of 114 local prostitutes conducted in 2003 showed that 60 percent of

them were HIV-positive. But local doctors told IRIN there was no point in

telling the sex workers of Birnin-Konni they had AIDS since there was little

they could do to treat them.

" We don't encourage them to find out whether or not they are HIV positive, our

approach is only based on a quarterly health check which allows us to detect

syphilis and urinary infections, said Yahaya Issoufou, the head doctor at

Birnin-Konni's government hospital.

" It is no good telling you that you have tested HIV-positive, because we can't

help you if you have, " Issoufou continued. " It is like telling you that you are

in the terminal phase already. We would simply hasten the decline. "

As a result, many sex workers in this cross-roads town on the Nigerian border

have stopped going to the local hospital for treatment and the number of people

asking for AIDS tests there has plummeted.

At " Le Campement " one of a dozen busy brothels in Birnin-Konni, Imostate, a

24-year-old prostitute on the run from the imposition of Islamic Shari'ah law in

her home state in northern Nigeria, explained why.

They don't tell us what is wrong with us "

" When we go to the hospital, they don't tell us what is wrong with us, they just

give us a list of medicines to buy, " she told IRIN, as she sat in the shade of a

tree, waiting for the night shift to begin.

" Why don't they tell us what our illness really is? " piped up her friend Soyaba,

a pretty 22-year-old girl from Niger with beauty scars on her temples and

forehead. " Even if it is AIDS, we want to know! "

At night, punters pack into the brothel's large courtyard striking deals with

the girls before disappearing with their chosen partner into one of the

surrounding rooms, illuminated by garish green, yellow and pink neon lights.

But during the daytime, the sex workers of " Le Campement " lounge around and

relax.

Sitting with her friends in the shade of the tree, Fatima, a plump 24-year-old

woman from Niger, said she had stopped going to the hospital altogether.

" We noticed that they always gave us the same stuff.cotrimedazole, methonidazole

and jantamycine, " Fatima said, reeling off a list of treatments for venereal

disease.

" But now, whenever we get skin infections or abcesses in the vagina, we don't

bother going to the doctor, " she added. " We just buy Nifluril or other medicines

that we find in the stalls of street vendors. "

The sandy streets of Birnin-Konni are full of petty traders selling packets of

assorted medicines smuggled in from Nigeria alongside packets of cigarettes and

cheap Chinese torches.

Landlocked Niger, which is one of the poorest countries in the world, launched a

campaign last year to distribute life-prolonging anti-retroviral (ARV) drugs to

people living with AIDS.

Until recently, these were only distributed free-of-charge to 300 people living

in the capital Niamey, 417 km to the west of Birnin-Konni.

But this cross-roads town, which sees trucks heading north across the Sahara

desert to Algeria and Libya and south to the Atlantic ports of Lagos and

Abidjan, recently came within closer reach of effective AIDS treatment.

Not much enthusiasm for AIDS testing.

Doctor Abdoulaye Bagnou, the government top advisor on AIDS and sexually

transmitted diseases, said the people of Birnin-Konni could now pick up ARV

drugs from a recently established AIDS treatment centre at Galmi, a small town

50 km to the east.

The facility was opened in the town's Christian missionary hospital earlier this

year as part of a drive to decentralise AIDS treatment in Niger and Bagnou said

35 people there were already receiving ARV treatment.

Issoufou at the government hospital in Birnin-Konni, said he had been referring

patients to it for the past month.

A national study carried out in 2002 shows an overall HIV prevalence rate of

0.87 percent in Niger - equivalent to 80,000 people in this mainly desert

country of 12 million.

But the same survey showed a much higher infection rate of 25 percent among

prostitutes. And health workers estimate there are at least 500 of them in

Birnin-Konni.

The United Nations Children's Fund (UNICEF) set up a voluntary AIDS testing

centre in the town two years ago as part of an initiative to reduce

mother-to-child transmission of the disease.

Doctor Thalcienne Ddihokubway, a UNICEF official connected with this programme,

said it had enabled some people living with AIDS in Birnin-Konni to receive

treatment for opportunist infections connected with the decline of their immune

system, even though they could not get ARV drugs.

But Doctor Issoufou said local people who feared they might have AIDS, appeared

to be losing faith in his hospital's ability to help them.

He noted that about 20 women per day came to the hospital's HIV testing centre

when it first opened in 2003, but the number of people turning up there had

since dwindled to between five and 10 per day.

" If the number of women agreeing to be tested is going down, it is simply

because we can't provide them with the necessary treatment, " he said. " Any woman

who tests HIV positive is left to her own devices. "

Although treatment for AIDS remains woefully inadequate at Birnin-Konni, some

progress has been made on the prevention side in conjuction with Niger's

national union of truck drivers.

Use a condom or forget it

The European Union has financed an AIDS awareness and condom distribution

campaign, " Aids on the move " , implemented by the US non-governmental

organisation CARE, that has succeeded in making both truck drivers and sex

workers more aware of the need for protected sex.

The truck drivers have been briefed to pass the message on to thousands of

seasonal migrant workers who flock into Birnin-Konni's lorry park looking for

transport south towards Cote d'Ivoire.

And the sex workers have become so condom-conscious that they sometimes gang up

to expose and harass a punter who refuses to wear a sheath.

At " Le Campement, " ma, a 35-year-old sex worker, proudly flourished a

packet of 72 condoms.

She said she had bought it from a nearby kiosk run by the Niger Association of

Truck Drivers for the subsidised price of 1,250 CFA francs (US $2.50).

" Say a client comes into the room, and he pays 1,000 CFA ($2) for the ride, "

ma said.

" I give him the condom and will even put it on him if I need to. If he refuses,

he only gets half his money back. And if he won't agree to that, I keep the lot.

If he wants to make a fuss about things, we argue. But in the end he is the one

losing out. "

Rakia, a young colleague who looked half her age, agreed.

" Sometimes we get together and beat up a customer who refuses to wear a sheath, "

she said as a group of other girls listening in on the conversation nodded in

agreement.

" Since I received awareness training, it is a sheath or nothing, " Rakia said.

" That also has the advantage of protecting us against other sexually transmitted

diseases. "

It sounds good in the clear light of day.

But later that night ma, with several drinks inside her, could be seen

chatting up a client at a nearby bar.

She held a cigarette in one hand and a bottle of Conjoncture - a local brand of

beer - in the other. Soon the couple headed off, arm in arm towards the brothel,

with tipsy ma unsteady on her feet.

" It is difficult to believe right now that she is going to remember to use a

condom before they get down to business, " remarked Ibrahim Adama, an outreach

worker of the local CARE programme, as he looked on.

[ENDS]

3 - TANZANIA: Free ARVs for 100,000 by 2006, prime minister says

DAR ES SALAAM, 17 June (PLUSNEWS) - At least 100,000 people living with HIV/AIDS

in Tanzania will receive antiretroviral drugs (ARVs) free of charge by the end

of 2006, Prime Minister Frederick Sumaye announced on Thursday.

" The target is to ensure at least 400,000 people are on free ARV treatment

within the next five years, " he said in a speech before parliament in Tanzania's

administrative capital, Dodoma.

He added the government planned to expand ARV treatment, currently covering only

4,200 people out of at least two million HIV-positive people. The government

recently bought ARVs for 17,000 patients across the country, he said, and that

the drugs had already been distributed to 64 hospitals.

" There are plans to distribute ARVs to all government and private hospitals to

enable more patients to benefit from the programme, " he said.

A household-level survey conducted in Tanzania recently by the National Bureau

of Statistics in collaboration with the Tanzania Commission for AIDS indicated

that 7 percent of Tanzanians aged between 15 and 49 years were HIV-positive.

The survey also indicated that the rate of HIV prevalence was higher among women

than men, with the prevalence among women averaging 7.7 percent while that of

men averaged at 6.3 percent.

Moreover, the survey showed that HIV was more prevalent in urban areas, with

10.9 percent of the population infected with AIDS compared with 5.3 percent of

the infected in rural areas.

[ENDS]

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