Your daily Selection of IRIN Africa PlusNews reports, 11/14/2006

[Guest guest]

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

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) -

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

CONTENT:

1 - BURUNDI: Food cuts for HIV-positive people worry NGOs

2 - PAKISTAN: Lonely truck drivers face HIV/AIDS threat

3 - SOUTH AFRICA: Govt AIDS programme on course but people still dying

1 - BURUNDI: Food cuts for HIV-positive people worry NGOs

BUJUMBURA, 14 November (PLUSNEWS) - AIDS advocacy groups in Burundi are worried

that a decision by the United Nations World Food Programme (WFP) to cut special

feeding programmes next year for HIV-positive people will harm their long-term

health.

Drought, crop disease, endemic poverty and more than a decade of instability

mean Burundi suffers from serious food insecurity. WFP is expected to feed an

estimated 874,000 Burundians by the end of 2006, including particularly

vulnerable groups such as internally displaced persons, school children and

HIV-positive people.

However, the agency's new policy means that feeding programmes for people

infected and affected by HIV/AIDS will come to an end in December 2005 and will

not be renewed.

" We have previously considered people infected and affected by HIV as a separate

category of beneficiaries, " Guillaume Foliot, programme manager for WFP in

Burundi, told IRIN/PlusNews. " But we found that we were diverting an important

tranche of our monthly food distribution to HIV patients, when the fact of being

HIV positive in itself does not make one vulnerable - many people can carry on

working and can purchase food, whereas people in northern Burundi [who are

worst-affected by food insecurity] sometimes have literally nothing to eat. "

Burundi is struggling with a 500,000-tonne food deficit, but WFP is able to

provide just 70,000 tonnes in aid. " People infected and affected by HIV/AIDS

have been taking up between 10 and 15 percent of our monthly distributions, "

Foliot said.

Local AIDS organisations dependent on WFP assistance are worried that the end of

the programme could have disastrous consequences for already vulnerable people.

" We have been feeding orphans, child-headed households and our most desperate

patients with WFP food, but with the programme coming to an end, we do not know

what is going to happen to them, " said Jeanne Gapiya Niyonzima, a leading AIDS

advocate and president of the National Association to Support HIV-positive

People. Gapiya's organisation has 1,700 people on life-prolonging antiretroviral

(ARV) drugs, many of whom are currently receiving food aid from WFP.

Foliot said WFP would continue to provide food to people starting on ARVs for

the first nine months of treatment, which Gapiya - herself HIV-positive for

several years - said was insufficient.

" I have been on the drugs for years and I still need a very good diet to feel

okay, " she said. " We are negotiating with WFP to see if they can continue

feeding the patients who really are in urgent need. "

The Burundi chapter of the Society for Women Against AIDS in Africa (SWAA),

which runs a programme for prisoners, said WFP's decision would also affect the

health of the country's HIV-positive inmates.

" Conditions in prison are really difficult; the inmates do not get a balanced

diet, which is especially dangerous for HIV-positive people, " said Baselisse

Ndayisaba, coordinator of SWAA Burundi.

Foliot said WFP's decision was made after consultations with the Burundian

Ministry of Health and UNAIDS to allow the agency to focus on the " the worst of

the worst " . Apart from the programme for HIV-positive people, programmes for

elderly people in institutions, street children and hospitals have also been

cut.

" There are so many thousands of people in Burundi who desperately need food, and

those HIV-positive people who are indeed vulnerable should still qualify for

food aid under one of our other vulnerable categories, " he added.

kr/oa/he

[ENDS]

2 - PAKISTAN: Lonely truck drivers face HIV/AIDS threat

LAHORE, 14 November (PLUSNEWS) - Leaning against his brightly painted truck,

Muhammad Rafiq, 30, looks furtively at the two condoms he holds in his hand. " I

plan to use these soon, but I hope I can remember to do so when the time comes, "

he says, a little shyly.

Rafiq, from the town of Kohat in Pakistan's North West Frontier Province (NWFP),

is an exception. A long-distance truck driver who regularly transports goods

from the southern port city of Karachi to Lahore and up to Peshawar along

thousands of kilometres of highway, he says he " quite often " uses a condom, and

generally only has sex with women.

There are thousands of truck drivers like him, many of them young men from

northern parts of the country. Displaced from their home, families and social

environments, they are one of the groups most vulnerable to HIV/AIDS, mainly

because of the dangerous behaviour they engage in, including multiple sex

partners and drug use.

The huge truck terminal at Mauripur in Karachi, one of the busiest in South

Asia, sees 20,000 trucks pass through it each day. The terminals in Lahore,

including the ones located at Badami Bagh in the congested heart of the city

where Rafiq parks his truck, are less busy, but still accommodate thousands of

the giant, rumbling vehicles, gaudily decorated with lights, coloured paper and

mobiles that spin in the slipstream, arriving from destinations outside the city

each day.

According to limited research carried out on the subject, very few among the

thousands of long-distance truck drivers in the country are as cautious as

Rafiq, who says he picked up information on HIV/AIDS from television, and is

anxious to protect his wife from the " incurable illness. "

Others among the small gang of truck drivers who Rafiq hangs out with while in

Lahore generally confess they do not use any protection. " It is all in Allah's

[God's] hands anyway. Besides, a condom is not always available, " says Dilshad,

from the Attock area of northern Punjab.

He adds that he knows a former truck driver who now has AIDS, but refuses to

provide details as this man has sworn him to secrecy. " He was diagnosed by a

doctor in Karachi, but he has not told anyone, not even his wife, because of the

stigma, " explains Dilshad.

" We are aware that long-distance truck drivers are among the groups most at risk

from HIV/AIDS, " said Raza Hussnain, coordinator of the Islamabad-based Amal

Human Development Network, an NGO which since 1994 has been working on raising

awareness about HIV/AIDS.

Talking to IRIN, Hussnain explained that the organisation worked with

" marginalised communities, and aimed to raise awareness and change the lives of

affected people. "

The task is not an easy one. There seems, in the minds of many of the truck

drivers, to be a strong association of condoms with contraception, but not with

protection against sexually transmitted diseases (STDs) including HIV/AIDS.

These gaps in knowledge are largely due to limited official awareness-raising

efforts. Categorised by the World Health Organization (WHO) and UNAIDS as a low

prevalence, but high-risk country with regards to HIV infection, Pakistan has

recently witnessed a rapid rise in rates on infection, mainly among injecting

drug users.

According to UNAIDS, about 85,000 people in Pakistan, or 0.1 percent of the

adult population, are infected with HIV/AIDS. Heterosexual transmission (52.55

percent) and contaminated blood or blood products (11.73 percent) are the most

commonly reported modes of transmission for HIV/AIDS in Pakistan.

This is one of the reasons why the country's long-distance truck drivers are

seen as a group particularly at risk. Away from home for prolonged periods of

time that sometimes stretch into months, most truck drivers are believed to

engage in regular sex with both female and male sex workers, including 'hijras'

or transvestites.

The limited studies carried out indicate HIV infection stands at around 1 or 2

percent among female sex workers and long-distance truck drivers.

Among injecting drug users, the rate is much higher. According to a 2004 UNAIDS

study, 10 percent of injecting drug users in the town of Larkana, in Sindh

province, tested positive for HIV/AIDS.

Ministry of Health findings have found that over 20 percent of female sex

workers in Karachi and Lahore had sold sex to injecting drug users and condom

use was very low during those encounters.

High intravenous drug use among truck drivers means that the unsafe sexual

practices they routinely engage in make them extremely vulnerable to infection.

" Most of us smoke 'charas' [marijuana] or other substances. It is essential if

we are to survive the long, relentless hours of monotony on the roads. But now

more and more of the truck drivers have also started injecting drugs, " says

Rafiq. He believes the use of injected drugs is most common among " the younger

drivers, some just out of their teens. "

While the drivers often seem to be at least vaguely aware of AIDS, they have

little real idea of how they can protect themselves from the virus. Many argue

that their way of life - the sex with both women and men and the drugs - are a

part of a culture of migrant workers in the country that has " been just the same

for decades. "

" We need some recreation, something to do to relax - otherwise how would we be

able to continue with the work we do? Women, sometimes 'hijras' or drugs offer

us this relaxation, " says Asif Jan, a 25-year-old trucker from Lahore.

Many also confess that rather than doctors, they turn to traditional healers, or

'hakeems', when they are ill or suspect they have contracted an STD. Several

hakeems based at tiny clinics on the Grand Trunk Road that winds its way up to

Peshawar are well known to the truck-drivers, who depend on their powders and

potions.

The lack of interaction with orthodox medical practitioners, coupled with a

somewhat confused understanding of the HIV/AIDS issue, means the truck drivers,

regularly seen gathered at roadside cafes near the truck terminal in Lahore, are

at high risk of infection.

Observes say an awareness programme targeting the group and its specific culture

is desperately needed to help reduce their vulnerability and save them and their

families from the dangers they face from HIV/AIDS.

kh/sc/jl

[ENDS]

3 - SOUTH AFRICA: Govt AIDS programme on course but people still dying

JOHANNESBURG, 14 November (PLUSNEWS) - South Africa's Ministry of Health has

confirmed that close to 6,000 HIV-positive people had died while receiving

antiretroviral (ARV) drugs since the government rollout began in 2004.

Health department spokesman Sibani Mngadi said the deaths were a concern, but

constituted just below 3 percent of the number of HIV-positive people accessing

treatment at government ARV sites during the same period.

" The number of people being treated with antiretroviral therapy through our

[government's] 'Comprehensive Plan on HIV and AIDS' has increased [by] 60,000 in

the past year to 235,378 by the end of September 2006, " he told IRIN/PlusNews.

He said there might be a number of factors resulting in the death of patients on

ARVs, but " they would all be just speculation " without the proper monitoring

systems in place.

Doctor Henry Sunpath, of McCord Hospital in the eastern port city of Durban,

disagreed with Mngadi and pointed out that the factors encouraging the deaths

were all too real.

" These could be anything from fear of stigma and discrimination from both family

and community to confusing information about the benefits of ARVs, as publicly

expressed by the Health Minister Manto Tshabalala-Msimang herself, " said

Sunpath.

Tshabalala-Msimang has consistently drawn international criticism for supporting

the views of well-known AIDS dissidents, and her controversial promotion of

remedies including garlic, beetroot and the African potato as effective means of

treating HIV/AIDS.

Sunpath's sentiments are shared by Dr Francois Venter, an HIV specialist at the

University of Witwatersrand in Johannesburg, who charged that " it is conflicting

views such as these which ... [motivate] scores of people who still turn down or

prematurely quit ARV therapy because they are too afraid of the exaggerated side

effects. "

Some side effects of ARV medication could be fatal, he said, but these were

easily avoided with the proper monitoring and care of patients, as were the rare

cases of lactic acidosis (a condition caused by the buildup of lactic acid in

the body) in patients using Stavudine (also known as Zerit or d4T), which is

included in South Africa's free programme.

Venter also pointed out that some could be caused by patients reporting to

treatment sites when they were already in the advanced stage of infection.

" This is why the government, together with civil society organisations, needs to

share a common goal in the effective rollout of ARVs to the huge numbers in

need, with no fatalities in the process, " Venter added.

The government is to reveal its revised 'Strategic Plan' in December, which will

guide the country's response to AIDS and ensure continuity of the current

strategies, as well as introduce additional interventions.

hh/he/oa

[ENDS]

This is non-reply e-mail. Please do not hesitate to contact us at

Mail@....

Principal donors: IRIN is generously supported by Australia, Canada, Denmark,

ECHO, Japan, Netherlands, Norway, Sweden, Switzerland, the United Kingdom and

the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

Tel: +27 11 895-1900

Fax: +27 11 784-6759

Email: Mail@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments

[Guest guest]

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

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) -

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

CONTENT:

1 - BURUNDI: Food cuts for HIV-positive people worry NGOs

2 - PAKISTAN: Lonely truck drivers face HIV/AIDS threat

3 - SOUTH AFRICA: Govt AIDS programme on course but people still dying

1 - BURUNDI: Food cuts for HIV-positive people worry NGOs

BUJUMBURA, 14 November (PLUSNEWS) - AIDS advocacy groups in Burundi are worried

that a decision by the United Nations World Food Programme (WFP) to cut special

feeding programmes next year for HIV-positive people will harm their long-term

health.

Drought, crop disease, endemic poverty and more than a decade of instability

mean Burundi suffers from serious food insecurity. WFP is expected to feed an

estimated 874,000 Burundians by the end of 2006, including particularly

vulnerable groups such as internally displaced persons, school children and

HIV-positive people.

However, the agency's new policy means that feeding programmes for people

infected and affected by HIV/AIDS will come to an end in December 2005 and will

not be renewed.

" We have previously considered people infected and affected by HIV as a separate

category of beneficiaries, " Guillaume Foliot, programme manager for WFP in

Burundi, told IRIN/PlusNews. " But we found that we were diverting an important

tranche of our monthly food distribution to HIV patients, when the fact of being

HIV positive in itself does not make one vulnerable - many people can carry on

working and can purchase food, whereas people in northern Burundi [who are

worst-affected by food insecurity] sometimes have literally nothing to eat. "

Burundi is struggling with a 500,000-tonne food deficit, but WFP is able to

provide just 70,000 tonnes in aid. " People infected and affected by HIV/AIDS

have been taking up between 10 and 15 percent of our monthly distributions, "

Foliot said.

Local AIDS organisations dependent on WFP assistance are worried that the end of

the programme could have disastrous consequences for already vulnerable people.

" We have been feeding orphans, child-headed households and our most desperate

patients with WFP food, but with the programme coming to an end, we do not know

what is going to happen to them, " said Jeanne Gapiya Niyonzima, a leading AIDS

advocate and president of the National Association to Support HIV-positive

People. Gapiya's organisation has 1,700 people on life-prolonging antiretroviral

(ARV) drugs, many of whom are currently receiving food aid from WFP.

Foliot said WFP would continue to provide food to people starting on ARVs for

the first nine months of treatment, which Gapiya - herself HIV-positive for

several years - said was insufficient.

" I have been on the drugs for years and I still need a very good diet to feel

okay, " she said. " We are negotiating with WFP to see if they can continue

feeding the patients who really are in urgent need. "

The Burundi chapter of the Society for Women Against AIDS in Africa (SWAA),

which runs a programme for prisoners, said WFP's decision would also affect the

health of the country's HIV-positive inmates.

" Conditions in prison are really difficult; the inmates do not get a balanced

diet, which is especially dangerous for HIV-positive people, " said Baselisse

Ndayisaba, coordinator of SWAA Burundi.

Foliot said WFP's decision was made after consultations with the Burundian

Ministry of Health and UNAIDS to allow the agency to focus on the " the worst of

the worst " . Apart from the programme for HIV-positive people, programmes for

elderly people in institutions, street children and hospitals have also been

cut.

" There are so many thousands of people in Burundi who desperately need food, and

those HIV-positive people who are indeed vulnerable should still qualify for

food aid under one of our other vulnerable categories, " he added.

kr/oa/he

[ENDS]

2 - PAKISTAN: Lonely truck drivers face HIV/AIDS threat

LAHORE, 14 November (PLUSNEWS) - Leaning against his brightly painted truck,

Muhammad Rafiq, 30, looks furtively at the two condoms he holds in his hand. " I

plan to use these soon, but I hope I can remember to do so when the time comes, "

he says, a little shyly.

Rafiq, from the town of Kohat in Pakistan's North West Frontier Province (NWFP),

is an exception. A long-distance truck driver who regularly transports goods

from the southern port city of Karachi to Lahore and up to Peshawar along

thousands of kilometres of highway, he says he " quite often " uses a condom, and

generally only has sex with women.

There are thousands of truck drivers like him, many of them young men from

northern parts of the country. Displaced from their home, families and social

environments, they are one of the groups most vulnerable to HIV/AIDS, mainly

because of the dangerous behaviour they engage in, including multiple sex

partners and drug use.

The huge truck terminal at Mauripur in Karachi, one of the busiest in South

Asia, sees 20,000 trucks pass through it each day. The terminals in Lahore,

including the ones located at Badami Bagh in the congested heart of the city

where Rafiq parks his truck, are less busy, but still accommodate thousands of

the giant, rumbling vehicles, gaudily decorated with lights, coloured paper and

mobiles that spin in the slipstream, arriving from destinations outside the city

each day.

According to limited research carried out on the subject, very few among the

thousands of long-distance truck drivers in the country are as cautious as

Rafiq, who says he picked up information on HIV/AIDS from television, and is

anxious to protect his wife from the " incurable illness. "

Others among the small gang of truck drivers who Rafiq hangs out with while in

Lahore generally confess they do not use any protection. " It is all in Allah's

[God's] hands anyway. Besides, a condom is not always available, " says Dilshad,

from the Attock area of northern Punjab.

He adds that he knows a former truck driver who now has AIDS, but refuses to

provide details as this man has sworn him to secrecy. " He was diagnosed by a

doctor in Karachi, but he has not told anyone, not even his wife, because of the

stigma, " explains Dilshad.

" We are aware that long-distance truck drivers are among the groups most at risk

from HIV/AIDS, " said Raza Hussnain, coordinator of the Islamabad-based Amal

Human Development Network, an NGO which since 1994 has been working on raising

awareness about HIV/AIDS.

Talking to IRIN, Hussnain explained that the organisation worked with

" marginalised communities, and aimed to raise awareness and change the lives of

affected people. "

The task is not an easy one. There seems, in the minds of many of the truck

drivers, to be a strong association of condoms with contraception, but not with

protection against sexually transmitted diseases (STDs) including HIV/AIDS.

These gaps in knowledge are largely due to limited official awareness-raising

efforts. Categorised by the World Health Organization (WHO) and UNAIDS as a low

prevalence, but high-risk country with regards to HIV infection, Pakistan has

recently witnessed a rapid rise in rates on infection, mainly among injecting

drug users.

According to UNAIDS, about 85,000 people in Pakistan, or 0.1 percent of the

adult population, are infected with HIV/AIDS. Heterosexual transmission (52.55

percent) and contaminated blood or blood products (11.73 percent) are the most

commonly reported modes of transmission for HIV/AIDS in Pakistan.

This is one of the reasons why the country's long-distance truck drivers are

seen as a group particularly at risk. Away from home for prolonged periods of

time that sometimes stretch into months, most truck drivers are believed to

engage in regular sex with both female and male sex workers, including 'hijras'

or transvestites.

The limited studies carried out indicate HIV infection stands at around 1 or 2

percent among female sex workers and long-distance truck drivers.

Among injecting drug users, the rate is much higher. According to a 2004 UNAIDS

study, 10 percent of injecting drug users in the town of Larkana, in Sindh

province, tested positive for HIV/AIDS.

Ministry of Health findings have found that over 20 percent of female sex

workers in Karachi and Lahore had sold sex to injecting drug users and condom

use was very low during those encounters.

High intravenous drug use among truck drivers means that the unsafe sexual

practices they routinely engage in make them extremely vulnerable to infection.

" Most of us smoke 'charas' [marijuana] or other substances. It is essential if

we are to survive the long, relentless hours of monotony on the roads. But now

more and more of the truck drivers have also started injecting drugs, " says

Rafiq. He believes the use of injected drugs is most common among " the younger

drivers, some just out of their teens. "

While the drivers often seem to be at least vaguely aware of AIDS, they have

little real idea of how they can protect themselves from the virus. Many argue

that their way of life - the sex with both women and men and the drugs - are a

part of a culture of migrant workers in the country that has " been just the same

for decades. "

" We need some recreation, something to do to relax - otherwise how would we be

able to continue with the work we do? Women, sometimes 'hijras' or drugs offer

us this relaxation, " says Asif Jan, a 25-year-old trucker from Lahore.

Many also confess that rather than doctors, they turn to traditional healers, or

'hakeems', when they are ill or suspect they have contracted an STD. Several

hakeems based at tiny clinics on the Grand Trunk Road that winds its way up to

Peshawar are well known to the truck-drivers, who depend on their powders and

potions.

The lack of interaction with orthodox medical practitioners, coupled with a

somewhat confused understanding of the HIV/AIDS issue, means the truck drivers,

regularly seen gathered at roadside cafes near the truck terminal in Lahore, are

at high risk of infection.

Observes say an awareness programme targeting the group and its specific culture

is desperately needed to help reduce their vulnerability and save them and their

families from the dangers they face from HIV/AIDS.

kh/sc/jl

[ENDS]

3 - SOUTH AFRICA: Govt AIDS programme on course but people still dying

JOHANNESBURG, 14 November (PLUSNEWS) - South Africa's Ministry of Health has

confirmed that close to 6,000 HIV-positive people had died while receiving

antiretroviral (ARV) drugs since the government rollout began in 2004.

Health department spokesman Sibani Mngadi said the deaths were a concern, but

constituted just below 3 percent of the number of HIV-positive people accessing

treatment at government ARV sites during the same period.

" The number of people being treated with antiretroviral therapy through our

[government's] 'Comprehensive Plan on HIV and AIDS' has increased [by] 60,000 in

the past year to 235,378 by the end of September 2006, " he told IRIN/PlusNews.

He said there might be a number of factors resulting in the death of patients on

ARVs, but " they would all be just speculation " without the proper monitoring

systems in place.

Doctor Henry Sunpath, of McCord Hospital in the eastern port city of Durban,

disagreed with Mngadi and pointed out that the factors encouraging the deaths

were all too real.

" These could be anything from fear of stigma and discrimination from both family

and community to confusing information about the benefits of ARVs, as publicly

expressed by the Health Minister Manto Tshabalala-Msimang herself, " said

Sunpath.

Tshabalala-Msimang has consistently drawn international criticism for supporting

the views of well-known AIDS dissidents, and her controversial promotion of

remedies including garlic, beetroot and the African potato as effective means of

treating HIV/AIDS.

Sunpath's sentiments are shared by Dr Francois Venter, an HIV specialist at the

University of Witwatersrand in Johannesburg, who charged that " it is conflicting

views such as these which ... [motivate] scores of people who still turn down or

prematurely quit ARV therapy because they are too afraid of the exaggerated side

effects. "

Some side effects of ARV medication could be fatal, he said, but these were

easily avoided with the proper monitoring and care of patients, as were the rare

cases of lactic acidosis (a condition caused by the buildup of lactic acid in

the body) in patients using Stavudine (also known as Zerit or d4T), which is

included in South Africa's free programme.

Venter also pointed out that some could be caused by patients reporting to

treatment sites when they were already in the advanced stage of infection.

" This is why the government, together with civil society organisations, needs to

share a common goal in the effective rollout of ARVs to the huge numbers in

need, with no fatalities in the process, " Venter added.

The government is to reveal its revised 'Strategic Plan' in December, which will

guide the country's response to AIDS and ensure continuity of the current

strategies, as well as introduce additional interventions.

hh/he/oa

[ENDS]

This is non-reply e-mail. Please do not hesitate to contact us at

Mail@....

Principal donors: IRIN is generously supported by Australia, Canada, Denmark,

ECHO, Japan, Netherlands, Norway, Sweden, Switzerland, the United Kingdom and

the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

Tel: +27 11 895-1900

Fax: +27 11 784-6759

Email: Mail@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments