ICMDA HIV Initiative - Eurasia

Global Fund - 10 Years of Impact

2012-01-26T16:56:00.001Z

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Good video to illustrate what the Global Fund has achieved in one decade - and the enormous amount still to be done!

Eurozone Crisis setting back global health advances

2012-01-25T11:26:00.000Z

Today is the 10^th anniversary ofthe founding of the Global Fund forHIV, TB and Malaria. This was aninitiative promoted by then UN General Secretary Kofi Annan in 2002 to putsignificant funding into fighting the three biggest communicable diseasesafflicting the developing world.

Sadly, it is a tenth anniversary with quitea shadow cast over it. After nearly a decade funding a steady increase inprovision of treatment, care and prevention initiatives in all three diseases,the Global Fund had received pledges and projected contributions of $11.7billion in 2010 for the time period 2011-13, but subsequently several donors(mainly form the EU, and in particular the Eurozone) have reneged on theirpledges or delayed in coughing up the promised cash as the wrestle with theirown economic crises. The Fund is still disbursing some $10 billion ofpreviously approved grants between 2011 and 2013, but no new grants will be made until 2014 unless some or all thepreviously promised funding arrives. This means that in the Democratic Republic of the Congo for instance,28,000 people with HIV who were meant to start life-saving treatment by 2014may now be unable to.

The irony of this is that the BritishGovernment hadfound the Global Fund to be one of the most effective, transparent andaccountable mechanisms for funding effective treatment and prevention thatwas saving lives on a major scale. So much so it had agreed todouble its funding last year (although the UK has also drastically cut back itsbilateral funding for HIV & AIDS at the same time) In fact, the GlobalFund is being widely recognised as one of the most effective mechanismsfor delivering the MillenniumDevelopment Goals (certainly with respect to the fourth goal, which was toreduce the spread of these three diseases, and to see number of infected anddying decrease significantly by 2015).

Now, the MDGs and the Global Fund are notwithout their critics, and others have seen corruption and inefficiency orskewed priorities where some have seen transparency and effective resourceallocation. TB HIVand malaria are not the only major health problems facing developing countries. Other illnesses, particularly non-communicable disease such as diabetes and cancer,as well as less fatal but no less debilitating parasitical diseases are major but still largely neglected issues. And by focussing so much money and energyinto a few illnesses, wider health issues were in danger of beingneglected. Wehave not been above agreeing with these reservations in this blog. However,there can be no major doubt that the funding crisis facing the Global Fund willmean millions will not get on to treatment programmes, and that this willinevitably cost lives.

Other recentresearch has shown that in all areas, funding for health relateddevelopment is in decline, despite clear evidence that it works. The problem is that somany donor nations are in severe economic decline, and that other issuessuch as climate change, food and water security and sustainable economicdevelopment have become more fashionable. In this instance at least it is the fickleness of donors and the public ofwealthy nations that looks set to wreck progress on the health of the poorrather than feckless developing countries frittering away aid. The Coalition Government here in the UK, muchto its credit, has been one of the few to buck this trend, but even it isfacing an increasingly hostile climate of public and press opinion against itspolicy on overseas aid, and increasing political opposition from within thegoverning Tory party itself.

But the evidence is there to see. Maternaland infant mortality are reducing, the rates of HIV infection and AIDS relateddeaths are going down dramatically, and similar stories can be told around somany global health issues. And in many ofthese it is national initiatives resourced by the Global Fund that have plaid asignificant role.

We may need torethink how we fund and support the development of health systems in thedeveloping world in the long term, but we cannot just sit back now andwatch a decade of progress collapse. Itis a mark of our humanity what we do with our resources when time gets tough.If we forget our neighbour in need when times get tough, what does that say ofus?

The Winner of the 2011 Dignity and Right to Health Award

2012-01-09T11:14:00.002Z

It is the great privilege and pleasure of the ICMDA HIVInitiative to announce that Dr. Olive Frost is the most worthy winner of the International Christian Medical and Dental Association(ICMDA) HIV Initiative Dignity and Right to Health Award for 2011.

The Award isgiven to individuals for excellence, outstanding leadership and compassion inresponding to the HIV/AIDS epidemic.

Weacknowledge the excellent and faithful work of the other 2011 nominees - Dr.Saira Paulouse in Delhi, and also the comprehensive and continual growth of theministry of Andi and Sheeba Eicher from Thane - Mumbai and their organizationwhich is called Jeevan Sahara Kendra. Both ministries and their programs areexemplary.To read more of their work click on 2011 DRH Nominees

Thestory of Dr Olive Frost is quite unique. Olive, a retired obstetrician and gynaecologist from North Wales is now well into her seventies and hasfor many years been working quietly as "a humble plodder" in her ownwords, in several countries in Central Asia where humanitarian work isimportant, and where there is an emerging just and compassionate responseto those who struggle with the disease caused by HIV. She has sown many seedsand though small, there is an emerging growth of many new programs. Theseprograms are often led by women in situations where there have been manydifficulties. Yet through a powerful commitment to stand with the stigmatized and discriminated, the power of humanitarian responses are being demonstratedin an important way in several countries including Kyrgyzstan, Tajikistan andUkraine.

Olivehas worked for nearly twelve years across several Central Asian republics. Inthat time she has worked on the challenges and issues of women and teenagers'health, sexual health and HIV prevention training in various communitygroups. In all of these countries there are now autonomous non-governmentorganisations (NGOs) working with the wider community, and two of the firstleaders have gone on to form NGOs of their own. Olive has always take asupportive role, and has contributed to the development of independentmovements and organizations that are carrying on the work.

Thecommunity groups in all settings have been at the heart of Olive's worksince she began, and continue to be the main route through which widerprevention and care and support is offered to the wider national communities.

In thecontext of Central Asia Olive has focused on inspiring and encouraging aresponse from community organisations. This has included involvement andleadership of a task group aimed at equipping and informing community leaderson HIV AIDS since 2006. In particular this has led to seminars and conferencesheld within Central Asia for leaders and workers to be informed regarding HIVand AIDS and envisioned as to involvement and a response. Olive hastaken a lead in arranging and teaching at these.

In herwork in Central Asia and beyond through the impact of her wide travel andteaching connected to maternal and child health Olive has been seen to empowerPLWHA. As an older female doctor Olive has been well respected within CentralAsia and has been able to advocate gender equality in response to theepidemic.

Olivehas sought to involve other key players in Central Asia including ACET as wellas other local NGOs. We can be greatly encouraged by this important andinspirational work!

We aremost grateful to Dr James Tomlinson for this nomination.

We congratulate Dr. Olive Frost and salute her for the commitmentand devotion she demonstrates in and through all that which she has done andcontinues to do for the plight of those living with HIV & AIDS. Theworldwide family of the ICMDA joins in congratulating her, giving praise andthanks to God for such models as this which bring transforming HOPE and LIGHTinto otherwise desperate situations.

Each year the ICMDA HIV Initiative Committee calls for nominationsfor this Award. Nominees are sought who live a life which 'does justice,loves kindness and walks humbly with God' (Micah 6:8).

Previous winners are: Dr Biangtung Langkham (2006 - India), Prof Ruth Nduati ( 2007 - Kenya)and Dr Geoff Foster (2008 - Zimbabwe),Dr Stephen Watiti (2009, Uganda)and the joint winners of 2010 Dr Gisella Schneider (Germany) and Dr JosephKwong Leung Yu (Taiwan).

Faith Healing and it's impact on AIDS

2012-01-06T16:34:00.001Z

At the start of 2012, it is worthstopping to reflect where we got to in 2011.

First the good news – new HIV infectionsare down, deaths are down, and the number of people on antiretroviral treatmentis up. TheUN High Level Meeting on AIDS in New York last June committed the world togetting 15 million onto antiretrovirals by 2015, and to zero new infections, zerodeaths and zero AIDS related stigma by 2020. Hilary Clinton at a recent speech committed the US to work towards an AIDSfree generation, with the recent research findings that antiretrovirals are akey element in reducing new infections forming one of the planks in thatcommitment.

In October a UKConsortium meeting at Lambeth Palace reiterated the important role of faithbased responses to HIV. In short, it hasbeen a year where the science, the statistics and even the political will seemto have been blowing the right way for once.

However, that is not the complete story. For on the downside, fundingis rapidly disappearing, making the likelihood that these high leveltargets will be met less and less likely (especially around access totreatment). There are also worrying signs that faith is not always good news inthe fight against AIDS.

These two stories should come as no surprise – the economicdownturn has hit the whole aid industry hard, and is going to make sustainingmajor drives to increase accedes to treatment, care and prevention politicallymore and more difficult.

And that faith is not always good news is not news for manywho feel that religious people and institutions have been discriminating againstpeople with HIV for years, perpetuating stigma. This situation has changed a lot, and continues to change, but we knowthat many people of faith still find it hard to deal positively with HIV. But it is a more specific issue that is ofcurrent concern.

Recentnews stories have highlighted the role of religious healers (particularlyfrom African Pentecostal and Charismatic Christian traditions) who have been encouragingpeople with HIV to stop treatment because they claim that God had healed themof HIV. Many of these people hadsubsequently grown very ill, and some have died. That this happens in many developingcountries has been documented for some time. But there is now growing evidencethat it is a problem here in the UK as well, where the fastest growing churchesare African led and Pentecostal in flavour.

Whether because they are charlatans out for money or (as I suspect in the majority ofcases) well meaning but misguided, pastors and religious leaders in manytraditions are claiming that God has healed a person, and then getting them toritually dispose of their medication as a sign of their belief in theirhealing. The consequences are a seriousthreat to the well being and even the life of the individual, and a potentialthreat to public health.

Stopping ARVs can lead to a rapid rebound in viral load,threatening a collapse in the immune system, but also rendering the individualmuch more infectious to sexual partners as well as to their unborn and newbornchildren. Furthermore sudden cessation of treatment can lead to viral drugresistance, limiting future treatment options for the individual and anyonethey may subsequently infect.

There is plenty of evidencethat faith has a part in the healing process. We know that a sugar pill can have similarefficacy in stopping pain as an analgesic, if the patient believes it is a realpain killer. The trust and faith that apatient places in a doctor, nurse or care team can have a big impact on theirsubsequent recovery. And it is true that people often cope better withdebilitating conditions when they have been prayed for, or had other interventionsthat appear to have no basis in science, but in which the individual hasfaith.

If, like me, your world view accepts a God who intervenes inthe physical world to effect cures, the fact that prayer can affect healthcomes as no surprise. But even if youonly accept this as a pscyho-neuroimmunological response, it is still not to bediscounted. There is a mounting body ofresearch on the impact that religious belief and practice (especially within awider faith community) can have in have in preventing illness and promotingrecovery, whether or not you accept the existence of miracles.

But to take the leap of taking someone off of medicationwith no medical verification is highly suspect. Such an approach works on an assumption that God does not work throughmedical interventions and that only miraculous healings are valid. This is, needless to say a position that isnot taken by Christians, Muslims, Jews or other major faith groups, who have forcenturies held that medicine is not only valid in treating illness, but that theskills and learning that facilitate it are a gift from God.

In short, this practice is based on a misunderstanding ofboth science and orthodox theology. Notall Pentecostal and African lead churches follow this practice – the majoritywould always encourage people to take prescribed medication and only come offit on the advice of their doctor. However, there are undoubtedly some churches that do encourage people tostop treatment in an unplanned and inappropriate manner. This is not unique tothis particular Christian tradition either - there are anecdotal reports ofMuslim faith leaders and traditional religious healers who are also encouragingtreatment cessation, although the evidence of the scale of this in anyreligious community in the UK or elsewhere is still very sketchy.

These practices are not something that can be challenged byjust presenting the science behind ARVs and the evidence of their efficacy. Theworld view of these faith leaders does not give primacy to scientific evidenceper se. Instead we need to start with challenging these religious leaders torethink their theology from within their own faith and using their ownscriptures, and this can only be done by other leaders from within theirtradition. If they can be encouraged bytheir peers to see that science and medicine are also God given, only then canwe hope to persuade them that the science is worth looking at and to betrusted.

At the same time, we need to help the health professions tounderstand the world view, belief systems and values of patients coming from avariety of faith backgrounds. Assuming that your patient shares with you thesame understanding and values about health, illness, aetiology, medicine,drugs, compliance, etc. is dangerous. We need to help train healthprofessionals to bridge this gap in understanding, and to get allies within thefaith traditions to work alongside them to communicate with patients.

But above all, we must challenge these healers. Some of them could be allies in our responseto HIV, but at the moment are working against us. But just condemning them will drive themfurther underground – instead we (faith leaders, faith based organisations,secular NGOs, governments) all need towork together to tackle this head on.

Keeping Faith with HIV & AIDS

2011-10-18T20:10:00.001+01:00

Religious, secular, governmental and international bodies came together at Lambeth Palace this week to discuss the impact and relevance of faith based responses to HIV and AIDS.
In the face of an ongoing financial meltdown in the West, and collapsing economies in many developing nations, the sustained global effort to tackle the HIV pandemic has recently looked in doubt. This is ironic, because for the first time since AIDS was recognised in the early eighties, there is good news.

The global effort to turn back the pandemic is working. New infection rates are down, more people than ever are on treatment, and as a result the death rate from AIDS related causes is decreasing.

It was with this in mind that the question: ‘Why does faith have a role in the response to his pandemic?’ was tackled. If Richard Dawkins in his latest book is to be believed, religion in any form should play no role in public life and civil society.

However, the reality is that most of the world’s poor have a religious outlook on life, and for them the spiritual dimension is as real and relevant as economic targets and indicators are to the World Bank. The spiritual dimension lies at the heart of all faith based responses to HIV, and it is one of the distinctive approaches we can bring.

A report launched at last Monday’s conference called for the global community to recognise and support the role of faith based groups and communities in their response to HIV. Faith based organisations can often access groups inaccessible to other organisations, and can affect change in attitudes and behaviour by reference to scriptures and theology – routes not open to secular bodies.

But it is a hard message to get across. Most aid agencies, major donors, governments and UN institutions come from a largely secular, Western mindset, in which faith is relegated to the private sphere. While that perspective is slowly changing, it is also true that some religious leaders and groups hold strongly conservative opinions that put them in diametric opposition to the views of the wider international community.

And while some of this is down to shaky theology and can and should be challenged, and some is down to a misunderstanding and confusion over the use of language (which also can and should be overcome), sometimes it is because there are fundamentally different values between the religious and secular worldviews. There are times when we have to agree to disagree and go our separate ways. But there are times when we can and should work together for the greater good.

Research suggests that while faith based responses and health interventions are not necessarily better or worse than more secular ones, they are often more valued and appreciated by people in developing nations. Often, the key difference is that the spiritual needs of the individual or community is being addressed. This is the other ‘added value’ that we can bring.
But also, as HIV starts to slip off the global agenda and as funding for treatment, care, support and prevention faces cuts, it is vital that those at the coalface get support. Many faith communities are dealing with HIV and AIDS on a day-to-day basis. The Christian church in particular has, in all its varied forms, a presence in so many of the communities affected by HIV and AIDS in Africa in particular, often dealing with the reality of its own congregations and leaders living with HIV and AIDS.

If the global community begins to forget the struggles faced by these communities, then the wider, global church cannot and must not.

Is Treatment Becoming the New Prevention Fad for HIV & AIDS?

2011-07-15T13:16:00.001+01:00

Two new studies (one in Kenya and Uganda, the other in Botswana) were published this weeksuggesting that administering HIV antiretroviral (ARV) drugs to the general population could reduce the risks of HIV transmission by 60-70%.

In May we reported on a study that showed this worked for reducing infection rates between sero-dsicordant couples (i.e. where one is HIV+ and the other is uninfected). These newer studies however, suggest that making ARVs available to the general population in communities where there is a high incidence of HIV infection could dramatically reduce the rate of infection overall.

There are big questions about the reality of turning this into a realistic and ethical prevention strategy. Firstly, it does not always work – an earlier study (FEM-PrEP) using the same drug as the Botswanan study (Truvada) showed no impact. The reasons for that disparity are unclear, but may have to do withadherence – i.e. the benefits disappear if the drugs are not taken consistently.

Secondly, there is the cost – ARVs are still not cheap, and making them available to uninfected people when the majority of those with an AIDS diagnosis worldwide cannot get access to them raises real questions about affordability and the ethics of how aid money is distributed. In other words, given limited funding, do you invest in helping those who are already ill, or in stopping some of those who might get ill from becoming infected?

Thirdly, is it ethical to make available drugs (with all their side effects) to otherwise healthy people? Especially if, in doing so there is a risk that we could undermine other proven strategies such as partner reduction (so called ‘zero grazing’), abstinence and condom usage?

Using HIV antiretroviral therapy as a prevention strategy is rapidly gaining a body of supporting evidence. This is good news, as the argument for getting more people on to ARVs worldwide is boosted – it not only saves the lives of the infected, but reduces the rate of new infections. This gives added weight to efforts to get 15 million people living with AIDS on to ARV by 2015.

At the same time, if this happens at the cost of the massive gains in more comprehensive prevention strategies, we could find ourselves back peddling on the progress made in prevention initiatives over the last two decades. These initiatives have shown that not only behaviour change and treatment are important, but community engagement and awareness, government commitment and a partnership with civil society, including the churches, is vital.

Let us hope that the global community proceeds wisely with its growing tool box to tackle the HIV & AIDS pandemic, and does not forget the hard learned lessons of the last three decades.

this post originally appeared on the blog of the Christian Medical Fellowship UK

A surprisingly upbeat end to the UN high level meeting on AIDS promises renewed global action

2011-06-17T11:16:00.000+01:00

UN meetings and political declarations are often perceived as wordy and irrelevant. But every now and again these high level meetings do come up with statements that shape the actions of governments and aid agencies for years to come. The Millennium Summit of 2000 was one of these occasions, when the Millennium Development Goals were agreed. The UN General Assembly Special Session (UNGASS) High Level Session Declaration of Commitment on HIV and AIDS last week may well be another.

Those present from British NGOs and faith organisations had feared yet another fudge, but instead we got a commitment to getting 15 million people on HIV antiretroviral treatment by 2015. Granted, the commitment was only to ‘work towards’ that target, and there was no detail on how it would be funded or sustained. However a target has been publicly agreed, one to which governments and the UN can and should be held accountable.

There were other positives, in particular a lot of discussion and acknowledgement of the importance of faith based responses (even if they get little mention in the declaration text). There was also recognition that thirty years of responding to HIV means the global community has learnt a lot about how to deal with a major international health issue – learning that needs to be shared and used in other health issues.

But the big surprise was saved for the Secretary General, Ban Ki Moon who announced that the high level targets were to be what is becoming known as the ‘Three Zeroes’ – zero new infections, zero AIDS related deaths and zero stigma by 2020. These may be impossible targets to achieve, but as the saying goes, ‘aim for the stars and you may reach the moon’. And more significantly, it is the first target to be publicly announced by the UN that takes any of the Millennium Development Goals past 2015.

Of course, the devil will be in the detail of how these targets get turned into actions, but they do give us some specifics with which to hold our own governments and global bodies accountable.

an earlier version of this post originally appeared on the Blog of the UK Christian Medical Fellowship - www.cmfblog.org.uk

HIV & AIDS treatment as the new Prevention Tool: new findings should be treated with caution

2011-05-18T16:46:00.000+01:00

News broke in the morning of Friday 13th May 2011 of the results of a ten year study by the United States National Institutes for Health (NIH) into the impact of early antiretroviral treatment (ART) for people living with HIV infection on reducing their risk of transmitting the virus to their sexual partners. Setting up two groups of 800-900 serodiscordant couples (i.e. where one was HIV+ and the other was not) from different countries around the world, one group was treated with ART while still healthy, with high CD4 white cell counts and no clinical symptoms, while the other group were treated according to current clinical guidelines. Both groups were given advice on safer sex to reduce risks of infecting the HIV negative partner.
Six years into the study it was stopped because the results were so dramatic. The chances of HIV transmission amongst those on early ART were 96% less than amongst the control group.

The results were so startling that it led Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) to say “This breakthrough is a serious game changer and will drive the prevention revolution forward. It makes HIV treatment a new priority prevention option.”

It is heartening news when any study shows that a single intervention can have such a significant impact on something as life threatening as the transmission of the Human Immunodeficiency Virus, and we should be cheered to see a long held maxim – that HIV treatment is a key prevention tool – at last have some strong evidence to back it up.

However, we should perhaps treat these results with some caution. As the NIH points out, after six years a total of 39 cases of HIV infection were found among the previously uninfected partners of HIV positive study subjects. Of those, 28 were linked through genetic analysis to the HIV-infected partner as the source of infection. Seven infections were not linked to the HIV-infected partner, and four infections are still undergoing analysis. So in at least seven cases, HIV was acquired from another source – probably another sexual partner, or through IV drug use.

In other words, for a small minority of at least seven people in this study, the fact that their partner was or was not on ART had nothing to do with their acquisition of HIV infection – it was their own personal behaviour that was the risk factor. And this illustrates the danger of jumping onto a single intervention. It is widely recognised that faithfully married wives are often most at risk of HIV infection in many parts of Africa and Asia, because their husbands are sleeping around – it is their husband’s behaviour that puts them at risk, not their own. Intermittent use of condoms only with ‘non-regular’ sex partners is another route by which HIV gets transmitted, particularly in parts of southern Africa, where it is not uncommon for men and women to have more than one regular sexual partner who would be considered ‘safe’ enough not to warrant condom use – ART would make only a marginal impact in such a situation.

In short, the danger is that in focusing on one bit of genuinely good news, we can forget that HIV prevention is about multiple interventions – human behaviour is not so easily put in boxes, especially when it comes to sex. Focusing on condoms or male circumcision or delayed sexual debut alone does not make for an effective HIV prevention strategy, as countless years of research as shown. They all play a part, for sure, but investment in strategies to encourage behaviour changes – especially to encourage sexual abstinence outside of and mutual fidelity within a lifelong relationship – effective treatment and care, strategies to combat stigma and fear, and to equip and mobilise communities to respond together, are all needed. The twofold danger with the reaction to this finding could be a myopic focus by funders on ART as the main prevention tool, or of people on ART believing that they are not an infection risk and behaving in a manner that would put themselves and others at risk.

And there is a third danger. This study was stopped after six years – so we do not know of the long term consequences of early ART. What of the impact on viral resistance and the limitations this will bring to later treatment option? Will more resistant viral strains be transmitted by those on early ART? And will the funding be sustainable to keep people on ART for the rest of their lives.

Christian responses to HIV continue to emphasise a wide ranging, socially responsible and sustainable response to HIV and AIDS, recognising that our behaviour and choices as individuals, societies and as a global community have an impact on one another. We should greet the news that there is a new tool in the prevention arsenal as a positive development, but not take our eye off the ball with the other interventions and our own long term commitment to tackle this awful pandemic.

This post originally appeared on the official blog of the UK Christian Medical Fellowship

ICMDA HIV INITIATIVE 2010 DIGNITY AND RIGHT TO HEALTH AWARDS - more details of the joints winners

2010-12-13T14:08:00.000Z

The joint winners of the 2010 Dignity and Right to Health award are Dr Gisela Schneider from Germany and Dr Joseph, Kwong Jeung Yu from Taiwan.

Dr Gisela Schneider has worked for many years in West Africa, East Africa and now more recently in Europe. Working in multiple settings she has been and continues to be a strong advocate and role model for many through her excellence in several fields of the HIV challenge, including clinical work, community engagement and mobilisation, and teaching. Dr Schneider is an exceptional person who has demonstrated an incarnational ministry in Gambia and Uganda and now continues to seek to bring Christian healing and compassion to people in many other countries through the work of Difaem, the German Medical Missionary Association. Gisela continues as a great role
model for all. Her work in the many fields of HIV medicine and community responses has been of the highest calibre.

Dr. Joseph, Kwong-Leung Yu has done excellent work in both his home country of Taiwan and also for many years in the nation of Malawi. He energetically worked at setting up a model of how to eliminate discrimination and stigmatization of HIV/AIDS in the public domain. He actively participated with PLWHA groups to encourage and ensure the enhancement of public awareness. Dr Yu is an exceptional person whose ministry is growing. He now represents Kingdom values in many other countries as well as continuing to serve the people of Malawi as Director of the Rainbow clinic. He has established and strengthened a comprehensive multi-level program in an area of great need in Northern Malawi working closely with government and local church communities. A journal article on the challenges facing Malawi prisoners spoke to us of a Christian man with a great heart to better the lives of those who are marginalised and rejected by many.

It is a great honour and priviledge for the ICMDA to recognise and acknowledge the exceptionally inspiring service and witness of Drs Schneider and Yu to the glory of God the Father, Son and Holy Spirit.

We pray for God's presence to be ever with them both.

Previous Award winners

2006 - Dr Biangtung Langkham (India), 2007 - Prof Ruth Nduati (Kenya), 2008 - Dr Geoff Faster (Zimbabwe) and 2009 - Dr Stephen Watiti (Uganda).

Joint Winners of 2010 Dignity & Right to Health Award #WAD

2010-12-01T11:57:00.001Z

After much discussion and prayerful reflection, the 2010 Dignity and Right to Health award of the ICMDA HIV Initiative is to be jointly awarded to Dr. Joseph, Kwong-Leung Yu of Taiwan who has worked for many years in Malawi and Dr. Gisela Schneider of Germany who has worked for twenty years in the Gambia and many years in Uganda.

Dr Gisela Schneider - Gisela has worked for many years in West Africa, East Africa and now more recently in Europe. She has worked in multiple settings and has been and continues as a strong advocate and role model for many with her excellence in several fields of the HIV challenge including clinical work, community engagement and mobilisation and teaching. Dr Schneider is an exceptional woman who has demonstrated an incarnational ministry in Gambia and Uganda and now continues to seek to bring Christian healing and compassion to people in many other countries through the work of Difaem, the German Medical Missionary Association. Gisela continues as a great role model for all. Her work in the many fields of HIV medicine and community responses has been of the highest calibre.

Dr. Joseph, Kwong-Leung Yu has done excellent work in both his home country of Taiwan and also for many years in the nation of Malawi. He strongly tried to set up an example of how to eliminate the discrimination and stigmatization of HIV/AIDS in the public. He actively participated with PLWHA groups to encourage and ensure the enhancement of public awareness. Dr Yu is an exceptional man who ministry is growing and he now represents Kingdom values in many other countries as well as continuing to serve the
people of Malawi. He has established and strengthened a comprehensive multi-level program in an area of great need in Northern Malawi working closely with government and local church communities. A journal article on the challenges facing Malawi prisoners spoke to me of a Christian man with a great heart to better the lives of those who are marginalised and rejected by many.

It is a great honour to have both Dr Yu and Dr Schneider join the ranks of earlier nominees and winners of the Dignity and Right to Health award of the ICMDA HIV Initiative.

Three nominated for the 2010 Dignity and Right to Health Award

2010-11-25T11:46:00.000Z

Given to individuals and organisations for excellence, outstanding leadership and compassion in responding to the HIV/AIDS epidemic, the ICMDA HIV Initiative Dignity & Right to Health Award this year has three nominees:

1. Dr Gisela Schneider – nominated by Dr Vicky Lavy. Gisela has worked for many years in West Africa, East Africa and now more recently in Europe. She has worked in multiple settings and has been and continues as a strong advocate and role model for many with her excellence in several fields including clinical work and teaching.

Gisela’s work has been focused on developing community based responses that are integrated with government, church, hospital, training institutions, etc. Has an emphasis on building capacity by getting all stakeholders (e.g. churches, hospitals, families) to work to their strengths in addressing HIV.

2. Dr. Joseph, Kwong-Leung YU – nominated by Dr. Herng-Der Chern, M.D, Ph.D. This nominee has done excellent work in both his home country of Taiwan and also for many years in the nation of Malawi. "Dr. Yu has been working in Malawi for 5 years. He strongly tried to set up an example of how to eliminate the discrimination and stigmatization of HIV/AIDS in the public. He actively participated the need group with the enhancement of public awareness."

3. Dr .Geoff Foster (Zimbabwe) nominated by Dr S. W. Hynd – Geoff, a paediatrician, has an outstanding record as a clinician, researcher, writer and advocate for the rights of orphans in Zimbabwe and beyond.

Interviewing processes are continuing. The award winner will be announced prior to World AIDS Day, December 1 2010.

The 2009 winner Dr Stephen Watiti, Of Uganda, continues his important clinical work with the Mildmay group in Kampala, and his important work in media and in advocacy for the rights of HIV infected and effected people.

What is Distinctive about Faith Based Healthcare & Advocacy?

2010-09-22T09:06:00.000+01:00

The following is just a brief summary of some discussions held in London yesterday by the Faith Working Group.

It was noted that working with the UK's Department for International Development (DFID) presented some singular challenges for Faith Based Organisations (FBOs) and Faith Communities (FCs), and in particular getting them to understand the distinctives within faith based responses to health needs such as HIV.

Two members of the group highlighted how internationally, through President Obama, WHO, the Partnership Unit of UNAIDS and others, faith has become a key issue in international health and development circles, but this has had relatively limited traction in the UK. The difficulty is not just one of evidence of a tangible difference made by FBOs, it is also one of world view and culture – most donors are driven by managerial, input/output approaches to health and development, whilst most FCs and FBOs come from a different world view, that is usually more relational, community, behaviour/lifestyle and values oriented. As a consequence most FBOs either buy into the donors world view for the sake of funding (and run the risk of losing their distinctive faith dimension in the process, becoming indistinguishable from secular development agencies) or they bypass donors and strategic bodies, operating independently, but keeping their faith based distinctives.

If we are going to engage with DFID (which seems to be where the FWG could make a singular contribution - there already being much work on engagement between faith and other bodies being done elsewhere), then we need to enter into a dialogue with them, and explore with them the specific dimensions that faith brings to the table that are distinctive, both in approach, practice and impact.

In light of the Pope’s recent visit to the UK, and his speeches that challenged the churches in the UK to be more engaged with society, and challenging society to allow space for faith and belief in the public square, alongside the positive speech from David Cameron (and other voices within the coalition, such as Baroness Warsi) it would suggest that, in the UK at least now is the time to make such an engagement.

World AIDS Conference – Vienna
Those who had been in Vienna in August reported back. Some encouraging advocacy with Pharma – encouraging more of the big drug companies to sign up to the Patent Pool, and some good networking opportunities. The big issue seemed to be the increasing emphasis, from USAID and the Obama administration on health systems strengthening rather than AIDS as a unique focus, and how this was feeding through into wider strategy and funding priorities from other major donors.

The Ecumenical Pre-Conference was really multi-faith, only one day, and as a result far too broad, large and brief to be of much value. African voices were not much heard (the focus seemed to be more on intravenous drug users , commercial sex workers and men who have sex with men), and there was an overall feeling that the whole conference is now so large that it is of very limited value for the vast majority of participants.
Question marks were being raised about the value of the 2012 Washington D.C Conference, although there were plans to restore the faith based pre-conference to three days. See earlier posts reporting back from various other faith groups at the Vienna Conference for some wider perspective

Faith Based Advocacy
In a wide ranging discussion on the theme, several key points were raised.

Faith leaders have a huge impact on behaviour, and FCs on the whole put an emphasis on ‘orthopraxis’ (right behaviour) as much as they do on ‘orthodoxy’ (right beliefs). As a consequence, being able to talke to faith leaders in their own terms and own language to help them see the value they can bring to tackling HIV by promoting behaviour change can be highly effective and reaching a whole community. And often those communities are ones that secular groups find it hard to access – e.g. Muslim women in rural areas.
Advocacy to governments and international bodies can only come from our engagement on the ground – seeing the issues ‘at the coal face’, and so being able to present real cases and real solutions gives us a very strong voice. But advocacy that just changes policy and not behaviour of individuals or practices within a community is of very limited value.

However, many FCs, FBOs and religious leaders are anxious about advocacy because it can seem political and confrontational, and in some cases, e.g. where a certain FC is a marginalised or persecuted minority, it could rightly be perceived as dangerous. However, there are ways of addressing these concerns and going back into tradition, scripture and the spiritual dimension to address advocacy needs.

One story was recounted of getting a group of Ethiopian church leaders together to start to self identify needs in their communities and what they could do to address them. Without prompting they identified female genital mutilation (FGM) as not only a problem to be addressed, but one that they as male church leaders had overlooked. This led to a spontaneous act of public repentance, a lengthy prayer meeting followed be discussions on actions that could be taken to change attitudes to FGM, and subsequently they have been active in working to end the practice in their communities ever since. They could see the need, could see from scripture that this was one they needed to address and there was a leading of the Holy Spirit to change. This is not the sort of advocacy a secular group would have felt comfortable or able to facilitate, but it was one that a Christian organisation was able to.

AHPN shared how they were now working with Christian and Muslim leaders of the African Diaspora in the UK to address HIV and other health issues amongst the African expatriate communities of Britain, and were already seeing the huge influence of these leaders in changing behaviour and attitudes.

It was agreed that these discussions were opening up some of the areas where the British faith communities and FBOs should start a dialogue with DFID and the British Government.

Religious activists leave AIDS conference worried about funding but committed to continue efforts

2010-07-28T11:03:00.001+01:00

In the last of our items feeding back on the 18th International AIDS Conference, we present the feedback from Ecumenical Advocacy Alliance, who were the official coordinators of the Faith Based Responses to HIV & AIDS represented at the conference.

While faith based organisations (FBOs) and faith community responses to the pandemic seem to have been well represented, well listened to and more integrated into the main programme at this conference than in previous years, there has been a real sense that the tide has turned in turns of international funding commitments, and that we will be ploughing on with our work, doing more with fewer resources than before.

There are also cries for more coordinated responses from faith communities at future conferences and summits on HIV & AIDS so that we can bring our voice ever more clearly to the public debate on AIDS strategy.

So - doing more with less and making ourselves heard better seem to be the main challenges coming from the EAA - from CHAA a recognition that the Western, secular discourse on AIDS is missing the realities on the ground that faith based responses deal with day-to-day, and from ICMDA a question mark over the current, highly individualistic and Western emphasis on a rights based approach to care and prevention.

As Bishop Yvette Flunder, senior pastor of the City of Refuge United Church of Christ in San Francisco said "this work is not for wimps”!

Report on XVIIIth International AIDS Conference #AIDS2010

2010-07-27T15:23:00.001+01:00

The XVIIIth International AIDS conference in Vienna, Austria told a story of measured progress in responses to the challenges of the epidemic. There were encouraging news on the development of microbicides, early signs of lives saved by the PMTCT programs and better more informed science that indicated that there may be further major steps available.

The conference was titled “Rights Here, Rights Now”. Obviously there was a major emphasis on a human rights response to the epidemic. Yet there was correspondingly much less on the importance of partnerships. The role of faith based organisations was little voiced, even though in many countries they provide approximately half of the health services.

A human rights framework has been helpful in many areas in acting as an umbrella that has allowed many groups to move forward. Yet it now seems to have over extended its clam for adherence. While there was discussion of the risk of ideologically driven responses to the disease, there was little recognition of the limitations of the ideology of human rights. An ideology is a set of aims and ideas that directs one's goals, expectations, and actions.

Human rights affirms an individualistic response to treatment options. The individual is assumed to have agency. And while this may well resonate in international conference settings, it often is little understood in rural village settings, where the individual has little power to bring about needed change, and where the power of fear greatly overwhelms externally derived science and knowledge.

For those who hold to a Christian ideology that has made enormous contributions to the provision of health services throughout the world, our response to an exclusively human rights approach needs to be carefully considered. A human rights approach, in one form seems to affirm that a commercial sex worker can only best become a human rights empowered sex worker. There is a deficiency in vision, a restriction a limitation to a human rights ideologically driven approach to disease. Christianity offers so much more.

Michael Burke

ICMDA HIV Initiative

Collision of Worlds at Vienna’s World AIDS Conference

2010-07-26T16:45:00.001+01:00

Rev Alan Bain of the Christian HIV/AIDS Alliance: writes a blog post from his time at the recent World AIDS Conference in Vienna.

Commenting on the cultural programme and the emphasis of the conference, Rev. Bain says

the schizophrenic attitude to the disease here in the West, where our loss of long dead pop stars and the almost glamorous dimension of AIDS now takes higher priority than 40 million infected people living with HIV throughout the world.

The big challenge for Christian responses to AIDS was given by UNAIDS’s Deputy Executive Director, Ms Jan Beagle who cautioned for faith groups to stay engaged.

“You are the advocates and practitioners. You have the networks on the ground and you can energise social movements... the poor still die while the rich live. Global AIDS is at tipping point. Although we have seen a 17% drop in AIDS infections worldwide we still reach only a fraction of those infected. For every one treated a further 5 are infected and still, 5,500 people die of AIDS each day.” The real barriers, she said, are not technical or medical but political and cultural. “We need political courage to break the trajectory of AIDS.” she concluded.

Read the full post at www.chaa.info

‘Back the banker’s tax’: International Aids Conference | The Robin Hood Tax

2010-07-26T12:45:00.000+01:00

‘Back the banker’s tax’: International Aids Conference | The Robin Hood Tax

With reference to our earlier post about the Financial Transaction Tax campaign At the World AIDS Conference on 23 July 2010 the UN Special Envoy for Innovative Finance called on world leaders to ‘back the banker’s tax’ – referring to the IMF’s recommendation to create new taxes on banks – and to ‘fill the gap ‘, referring to the 70% gap in people accessing lifesaving HIV antiretroviral medicines.

Given the scale of the funding gap, and the scale by which several European nations and the USA bailed out banks during the crisis of 2008, it would seem both an effective and just measure. However, there seems to be a reluctance in several major powers to move forward on this issue, so now is a good time to engage with the Robin Hood Tax campaign where you live and change the minds of governments the world over.

HIV Initiative at ICMDA World Congress

2010-07-15T12:35:00.001+01:00

This July the ICMDA HIV Initiative had the privilege to present a seminar at the ICMDA World Congress in Punta del Este, Uruguay. Winners of the 2006 and 2009 ‘Dignity and Right to Health Awards’ Drs Biangtung Langkham & Stephen Waititi. Both spoke eloquently of their long experiences in tackling HIV in (respectively) India and Uganda.

The issue of harm minimisation as opposed to harm elimination was discussed at some length – in particular the issue of whether Christian organisations should be involved in distributing condoms to commercial sex workers – on the one hand this seems to condone behaviour that is not just dangerous but morally wrong, but on the other hand, as we know that they will be plying their trade whatever we say, we should at least seek to minimise their risks, and in so doing earn their trust and the right to help them find other ways of earning a living. The issue extends to clean needle exchanges for IV drug users, and working with other individuals and groups who engage in high risk behaviours.

We hope to bring further news and reports from the World AIDS Conference and other international news in the coming months

Boston Globe Examines How PEPFAR Budget Pressures Are Affecting AIDS Clinics In Africa - Kaiser Global Health

2010-04-13T09:04:00.000+01:00

Boston Globe Examines How PEPFAR Budget Pressures Are Affecting AIDS Clinics In Africa - Kaiser Global Health

Depressing news that the Obama administration's downward pressure on PEPFAR funding is now impacting patient treatment programmes amongst the poorest communities.

We stated back in February last year that we would wait and see if Obama would match Bush's impact on HIV & AIDS care - the jury is still out, but the verdict is looking less favourable just over one year into his presidency.

Robin Hood Tax

2010-02-10T10:14:00.002Z

Excellent video explaining the basic idea behind a miniscule tax on bank transactions that could have a huge global impact, including increased access to treatment and care for people living with HIV & AIDS in the developing World

See http://robinhoodtax.org.uk/ for more information - and if you are outside the UK, news will be coming out in the coming days and weeks of campaigns in Europe and the US

Winner of ICMDA HIV Dignity & Right to Health Award 2010: Dr Stephen Waititi

2009-12-01T10:15:00.002Z

It is the great privilege and pleasure of the ICMDA HIV Initiative to announce that Dr. Stephen Waititi is the most worthy winner of the International Christian Medical and Dental Association (ICMDA) HIV Initiative Dignity and Right to Health Award for 2009.

The Award is given to individuals for excellence, outstanding leadership and compassion in responding to the HIV/AIDS epidemic.

We are most grateful to Ms Stella Kentutsi of the National Forum of PLHA networks in Uganda (NAFOPHANU) for her nomination.

We congratulates Stephen and salute him for the commitment and devotion he demonstrates in and through all that he has done and continues to do for the plight of those living with HIV & AIDS. The worldwide family of the ICMDA joins in congratulating him, giving praise and thanks to God for such models as his which bring transforming HOPE and LIGHT into otherwise desperate situations.

Each year the ICMDA HIV Initiative Committee calls for nominations for this Award. Nominees are sought who live a life which ‘does justice, loves kindness and walks humbly with God (Micah 6:8) and who:

· Demonstrate significant impact at local and wider level

· Empower others in integrated community responses

· Facilitate church integration and participation in best practice models of care

· Demonstrate excellence in full community involvement and empowerment of People living with HIV and AIDS (PLWHA)

· Works, facilitates and advocates for gender equality

· Links well with government and other agencies in a comprehensive approach to the epidemic.

Previous winners are: Dr Biangtung Langkham (2006 - India) , Prof Ruth Nduati ( 2007 - Kenya) and Dr Geoff Foster (2008 - Zimbabwe).

HIV Dignity & Right to Health Award - Call for Nominations

2009-09-28T07:51:00.003+01:00

The Dignity and Right to Health Award aims to model, mobilise and encourage creative and sustainable ways that enhance the dignity and human rights of people and communities living with HIV/AIDS epidemic and affected by the epidemic.

The Committee of the ICMDA HIV Initiative are pleased to announce a call for nominations to to the 2009 ICMDA "Dignity and Right to Health Award".

The Dignity & Right to Health Award is an activity of the International Christian Medical and Dental Association HIV Initiative. The award provides an essential opportunity to recognise, support and publicise the most outstanding role models and champions acting to stop this global epidemic. It is positioned as an important symbol for ensuring that voices from diverse communities and countries are acknowledged.

The Award will be given to individuals for excellence, outstanding leadership and compassion in responding to HIV/AIDS. The process will seek nominees who demonstrate the following:-

significant impact at local and wider level,
empowers others in integrated community responses,
facilitates church integration and participation in best practice models of care
demonstrates excellence in full community involvement and empowerment of People Living With HIV and AIDS (PLWHA)
works, facilitates and advocates for gender equality in community participation and response to the epidemic
links well with government and other actors in a comprehensive approach to the epidemic
models creative and compassionate responses that inspire many to similarly enhance the dignity and human rights of people infected and affected by the epidemic
does justice, loves kindness, and walks humbly with their God [Micah 6:8]

The 2006 winner Dr Biangtung Langkham continues his inspiring work in India where he works in a HIV epidemic especially supporting intravenous drug users and commercial sex workers.

The 2007 winner Dr Ruth Nduati of Kenya continues her inspiring work advocating for and providing best practice services for women, children and their families in Kenya, Africa and internationally.

The 2008 Winner, Dr Geoff Foster continues to work as a paediatrician in the challenging situation of Zimbabwe. Geoff continues to play a significant role in protecting dignity and rights of children.

The call for nominations for the 2009 Dignity and Right to Health Award of the ICMDA HIV Initiative has commenced. Nominations are requested to be submitted by November 2, 2009. The 2009 winner will be announced in preparation for World AIDS Day, December 1, 2009.

For nomination forms and detailed award criteria please email team@icmdahivinitiative.org

Obama & Global Health

2009-02-20T12:22:00.011Z

The inauguration of Barak Obama as US President has largely been seen as a positive change around the world. But what Obama's Presidency will mean for the world's poorest and most vulnerable people is still somewhat ambiguous.

Two major breaks with previous policy have gone almost unnoticed by the outside world. The first was the forced resignation of Ambassador Mark Dybul, the controversial head of Bush's $48 billion President's Emergency Plan for AIDS Relief (PEPFAR) the day after Obama's inauguration.

The second came a couple of days later when Obama signed the Executive Order overturning the even more controversial so-called 'Mexico City Policy', originally passed under President Reagan, which prevents US aid to overseas organisations that provide or even discuss abortion related services.

PEPFAR has always courted controversy – for pumping billions of dollars in to programmes for just one disease, for promoting abstinence only prevention programmes, for not funding family planning services (or at least those with any abortion related agenda under the Mexico City Protocol), and for being seen by many lobbyists as being driven by a conservative, and evangelical Christian agenda. Others criticised it for being bi-lateral, arguing that the funds would have been better funnelled through the multilateral Global Fund for AIDS, TB & Malaria

Dybul's resignation was thus seen by some commentators as a symbolic head on a platter to many of these lobby groups, possibly at the instigation of Dybul's newly inaugurated boss, Hilary Clinton (or by those close to her).

But in reality, PEPFAR has been far more effective and broad based than many of its critics give it credit for. So far it has got 2.1 million HIV+ people in 15 countries on to antiretroviral therapy (ART), distributed 2.2 billion condoms (giving a lie to the charge that its prevention strategies were abstinence only focussed), and gave access to prevention of mother-to-child anti-HIV therapy (PMTCT) to 1.2 million women. And only 7.4% of its budget has gone to abstinence only programmes (indeed, new protocols agreed in December would mean more funding going to a wider range of sexual health and education initiatives geared at HIV prevention). It has made errors, but has learnt from them, has moved away from being top down to being more responsive to local needs.

Multilateral approaches may have suffered from less funding as a consequence, and there are other criticisms to make. But in Africa, many see PEPFAR as Bush's lasting and most valuable legacy.

Obama has committed to honour the December 2008 PEPFAR act which would pump nearly $50 billion in to HIV prevention, care and treatment over the next five years. And more of that money will now probably go to family planning services that will undoubtedly save lives – the link between good family planning services and reducing HIV rates among women and children in particular is strong. That some of those services will go to promoting and providing abortion is, however, a cause for concern, and may divert funding from initiatives that are proven to be effective.

And while national programmes that promote delayed sexual debut, partner reduction, fidelity, effective condom usage, voluntary testing and counselling, etc, continue to be effective in reducing rates of new HIV infections and increasing access to early ART interventions, we wait to see if the new head of PEPFAR (whoever she or he will be) will continue to prioritise effective, evidence based programmes, or will she/he succumb to the pressure of ideologues of either side to promote their own agendas.

We will watch Obama with interest, as will all of the developing world, especially Africa. If he can live up to and exceed Bush's legacy on HIV/AIDS (and other health issues - Bush also launched a major initiative combating malaria) in much of the developing world, it will be good news for many. But fears and uncertainties must abound about the other forces that may move his hand in less helpful ways. Let us uphold him, along with all our leaders, in prayer!

an abridged version of this item will appear in the spring 2009 edition of "Triple Helix", the journal of the Christian Medical Fellowship (UK)

ICMDA World Congress 2010 First Announcement

2009-02-17T10:33:00.003Z

XIV ICMDA World Congress

Punta del Este - Uruguay
South America
Conrad Resort Hotel
4 - 11 July, 2010

Theme:
Priorities in professional practice.
Who are you working for?

Student and Junior Graduates World Conference
4-7 July, 2010

The next world congress of the International Christian Medical & Dental Association (ICMDA) moves to Latin America in 2010. HIV will form part of the conference programme.

More details will be coming out on this blog, the conference website - http://www.icmda2010.org

and on the ICMDA HIV Initiative website http://www.icmdahivinitative.org

Christian HIV & AIDS Alliance UK February 2009 Newsletter

2009-02-13T12:07:00.006Z

Welcome to the online version of the CHAA February 2009 News Letter.

Upcoming CHAA Meetings:

Prayer Day -14 March 2009 at Johnson House, 6-8 Marshalsea Road, London SE1 1HL from 10:30 - 14:30 - this will be a day of facilitated prayer for all CHAA member bodies, and we encourage all CHAA members organisations to send news, items for prayer and wherever possible representatives.

CHAA Members Meeting - 30 April 2009 also at Johnson House, 6-8 Marshalsea Road, London SE1 1HL - more details to be sent round

Further information will also be published on the CHAA Website

1. Second Draft of UNAIDS Framework for Working With Faith Based Organisations & Communities
After eight months of consultation with faith based organisations and faith communities, and re-drafting, the second draft of the UNAIDS framework for working with FBOs, churches, faith communities and religious leaders. This has arisen out of many months of discussions by FBOs and religious leaders and organisations about how they think UNAIDS can best work with the "faith sector" in HIV & AIDS prevention, care and treatment. Sally Smith of UNAIDS has spearheaded the consultation, but the text is largely the work of many faith organisations over the course of 2008.

The next steps in finishing this document are:
1: send feedback to Sally [ SmithS@unaids.org ] by February 25th
2: Final edits 3-7 March
3: Further discussions with UN Cosponsors, FBO Cosponsors & UNAIDS Global Coordinators for final approval
4: Publish & distribute in April/May

If you are interested in seeing this document and contributing to the consultation process, please email CHAA for a copy

Please feed comments directly to Sally Smith by 25 February

2. Call for evidence on access to HIV medicines from the UK All Party Parliamentary Group on AIDS
The All Party Parliamentary Group on AIDS is aware that as progress is made on HIV testing around the world and as mortality rates of those with HIV improve and resistant strains develop, the availability of appropriate, affordable medication will be a long-term and ever-growing issue.

It is aware of the huge task ahead if we are to meet the Millennium Development Goals on treatment and also of the need to sustain those achievements in the years beyond.
We are therefore asking for evidence from NGOs, companies and individuals with special knowledge or experience around access to or the supply of HIV medicines. This evidence will form part of a longer project to raise Parliamentary and Government awareness of the issue and may contribute to a report later in the year. It will also help inform our interactions with external agencies such as UNAIDS and the World Health Organisation.

If you would like to respond to this call for evidence, please contact the APPGA:

Email: oakeshottv@parliament.uk
Tel: +44 (0) 20 7219 3809
Fax: +44 (0) 20 7219 4126

The deadline for submissions is 9am on Monday 23rd February 2009.

3. Joint Learning Initiative on Children and HIV/AIDS Calls for New Directions for Aids Policy in Severely Affected Countries
The Joint Learning Initiative on Children and HIV/AIDS (JLICA) launched its report “Home Truths: Facing the Facts on Children, AIDS, and Poverty” on 10 Feb. The report summarizes two years of research and analysis of AIDS-related policies, programmes and funding and their effectiveness in addressing the needs of children. It calls for change in global, regional and national responses to the epidemic, including greater emphasis on strengthening families and communities to enable them to give children the care and support they are uniquely suited to provide. The report also recommends new approaches to address the simultaneous impacts of HIV, poverty, food insecurity and social inequality that many countries confront today.

The report can be downloaded in full from here. -

4. Theologians open conversation on HIV prevention
A "groundbreaking book that wrestles with the complex and sometimes controversial intersection of belief and HIV prevention" is now available from the Ecumenical Advocacy Alliance. HIV Prevention: A Global Theological Conversation comes out of a remarkable consultation held in early 2008 of 35 leading Christian theologians and practitioners, including people living with HIV, from five continents and many church traditions. The book is an essential resource for church leaders, theologians, teachers and strategists who are committed to a positive, informed and compassionate engagement with HIV prevention.

“This ‘conversation’ explored in a loving and enlightening way one of the most difficult challenges of the AIDS pandemic, that of prevention,” states Enda McDonagh, Emeritus Professor of Moral Theology, St. Patrick’s College, Ireland.

Archbishop Desmond Tutu, in recommending the publication, emphasizes, “Every church leader, pastor, preacher, theologian, should take the first step towards joining A global Theological Conversation by reading this groundbreaking new volume on HIV prevention. Then take the second step…begin your own theological reflection and engage others in the discourse of life.”
As Michel Sidibé, executive director of UNAIDS states, “The more religious communities can openly and respectfully discuss the faith and realities that effective HIV prevention has to address, the more progress we can make in reducing the spread of HIV and envisioning a world without AIDS.”

HIV Prevention: A Global Theological Conversation, edited by Gillian Paterson, 168 pp., is available in English, French and Spanish. The book can be downloaded or single print copies can be ordered for free from the EAA

For more information contact Sara Speicher, sspeicher@e-alliance.ch, +44 7821 860 723.

5. "Where is the Good Samaritan today" - United Bible Society HIV Resource
The booklet "Where is the Good Samaritan today" combines basic information of HIV and AIDS appropriate biblical passages. This resource booklet, which is written by Konstanse Raen from Norwegian Bible Society, has been received by enthusiasm by the national Bible Societies and the churches everywhere it has been presented in Africa. It was first published in 2004 in English and French together with Kinyarwanda. However, the national Bible Societies took quickly up translation into other national languages. In 2008 the booklet is available in ca 30 languages, like Swahili (two versions), Kirundi, Luanda, Amharic, Tigray, Oromo, Fulfulde, Pidgin, SiSwati, Lingala, Tchiluba, Kituba, Kikongo, Ewe, Kabye, Dioula, Tagbana, Baoulé, Yacouba, and more are being translated.

For more information, contact the United Bible Society's HIV/AIDS desk at the Area Service Centre in Nairobi: info@ubs-afrsc.org & online at http://www.ubs-goodsamaritan.org/1043

Further Resources:

Geoff Foster Accepts ICMDA Dignity & Right to Health Award

2008-12-13T10:25:00.004Z

Dr Geoff Foster, a paediatrician in Zimbabwe, was selected from a number of other highly regarded and most worthy nominations for the 2008 award. The award is made annually to persons for excellence, outstanding leadership and compassion in responding to the HIV/AIDS epidemic. Dr Foster has graciously accepted the award on behalf of all those with whom he works

A full profile of Dr Foster can be downloaded at www.icmda.net , and further details are available at www.icmdahivinitiative.org

Zimbabwe Cholera Appeal
At the same time, as Zimbabwe faces a new epidemic of cholera, ICMDA has launched an appeal to get medical supplies to doctors from the Christian Medical Fellowship of Zimbabwe who are responding to the epidemic.

World AIDS Day 2008

2008-12-01T08:21:00.004Z

This year is the 20th World AIDS Day - and as such is a time to give us pause for thought. At one level it seem like we are loosing the war - HIV infections are increasing, with no sign globally of a slow down, deaths from AIDS related illnesses remain alarmingly high, and so many of the world's poorest people have no access to treatment, care or education on how to avoid infection.

But we have also seen in the last five years one of the biggest mobilisations of resources in human history to reverse this trend, an have seen some countries where rates of new infection are in decline, numbers on treatment climb rapidly, and mortality rates drop dramatically. So, in the midst of gloom there are an increasing number of pockets of light.

But we are now in the early stages of what will probably prove to be a major and possibly prolonged global recession - so the worry inevitably is, can this response even be sustained, let alone scaled up so that the few good news stories become many? That may be the biggest cause for concern in the next two to five years. And even if we can keep the scale up of AIDS related funding, what will happen to other areas of development funding to aid poverty reduction and improvement of basic medical and educational services? Services that are going to be essential in seeing the up-scaling of AIDS funding actually having an impact on the ground.

How can equity and justice be maintained in the midst of economic turmoil? - that will be the key question in the coming year - and the answers we find and put in to practice could be the difference between life and death for millions.

The Churches have a role to play here - speaking up for justice and equity for the poor communities where they are based and minister, mobilising resources independently of governments and major donors, setting up models of best practice in care, treatment and prevention through church hospitals, local clinics, church schools, community projects and the like. Church leaders are speaking out this year in an increasingly high profile manner - but more needs to be done. Churches are being encouraged to see HIV as a spiritual and practical challenge that we are called to respond to by God. But more can be done to empower and envision churches. Leadership is the key, and the principle theme for this year's World AIDS Day.

So let this 20th Anniversary World AIDS Day be the point where we stop, reflect on what we have learned from the past, then put all our energies in to finding a result for the future.

Winner of the ICMDA Dignity & Right to Health Award 2008

2008-11-26T14:07:00.005Z

It is with great pleasure and a deep sense of privilege that the ICMDA HIV Initiative Interviewing/Selection panel announce the winner of the 2008 Dignity and Rights to Health Award.

Dr Geoff Foster, a Paediatrician in Zimbabwe, was selected from a number of other highly regarded and most worthy nominations. The award is made annually to persons for excellence, outstanding leadership and compassion in responding to the HIV/AIDS epidemic.

We share with you the profile of Dr Foster:

1.Significant Impact locally, regionally and internationally.
Geoff recognized in 1987 that HIV was a devastating exploding epidemic when he saw, within a few weeks, many infants dying of AIDS at the Mutare government hospital . He began a crusade which continues through today to alert the world through publications, speaking, and demonstrating personal concern as a pediatrician in Zimbabwe. In my opinion none else has been more effective in bringing to the world’s attention the plight of children affected by HIV/AIDS and break the silence and hopelessness of Pediatric AIDS.

Below are a sample of his contributions:

A review of current literature on the impact of HIV/AIDS on children in sub-Saharan Africa (2000)
by Geoff Foster and John Williamson

Where the heart is: Meeting the psychosocial needs of young children in the context of HIV/AIDS (2006)
by Linda Richter, Geoff Foster and Lorraine Sherr
Also see: Bernard van Leer Foundation

Under the radar: Community safety nets for children affected by HIV/AIDS in poor households in sub-Saharan Africa (2005)
by Geoff Foster

Where the heart is: Meeting the psychosocial needs of young children in the context of HIV/AIDS (2006)
by Linda Richter, Geoff Foster and Lorraine Sherr
Also see: Bernard van Leer Foundation

2.Empowers others
Geoff created an NGO called FACT-now completely led by Nationals-he remains on the board-to be a channel for resources and to advocate within Zimbabwe for HIV in children and in their mothers. He has also worked extensively with community based groups particularly those within the faith communities to bring care and prevention to the village level.

In particular he has worked with the CBO/NGO ‘Farming God's Way’ to bring agricultural enterprises appropriate for orphans and the poor/vulnerable to enable survival in the critical condition that Zimbabwe finds itself today.

The church is the avenue that Dr. Foster sees as the primary strategy of delivering prevention and care to children in Africa-he has shown it can be done in the midst of complete government failure and actual policies that promote HIV spread and human degradation.

As noted above, Geoff with FACT, work primarily at the community level to bring programs for HIV prevention--and population survival in the absence of government/international programs.

We thank the ICMDA HIV Initiative standing committee for its dedication to the cause of holding so prominently before us all the in the ICMDA the reality of HIV/AIDS and its effects in our world.

Dignity & Right to Health Award: 2008 NomineesPart 2

2008-11-26T08:11:00.004Z

Today we present the remaining two nominees for the ICMDA Dignity & Right to Health Awards 2008.

----------------------
Dr Peter Okaalet, Kenya

Impact at local and wider level
Peter acknowledges that his role in his immediate family is irreplaceable, where he sees he has a key role as a mentor and a model. He sees his relationship between he and his wife is his basis for leadership in the church. Peter joined MAP in 1996. He addresses issues of HIV, AIDS and poverty. His mission is to provide total health through the work of MAP international in east Africa, west Africa, Asia and Central America.

He teaches at the Haggai Institute in Nairobi, Singapore and Hawaii.

Empowers others in integrated community responses
As well as the above Peter is involved with MAP in active training of community health workers, training of pastors, and in the development of HIV curricula for theological colleges. In Kenya nd in six other countries. MAP trains community health workers who are at the interface between community and hospital – some of these workers are employed and others are volunteers. Map Partners with the Kenyan government in responses to HIV. Peter sees that Christians often fill the gaps that are not currently addressed by government.

Facilitates church integration and participation in best practice models of care
By participating in meetings with groups such as Micah network, Peter is able to disseminate within the MAP network, and more widely information on best practice models. Peter shared that churches are facilitated when they know where gapes in services are present, we know what we do and we know what others do.

Demonstrates excellence in full community involvement and empowerment of People Living With HIV and AIDS (PLWHA)
Peter has always worked closely with PLWHA, with TASO in Uganda before his work with MAP in Kenya. Peter commented that “the wearer of the shoe knows where it pinches most” Peter sees not only do PLWHA have an important role in storytelling, and also they have an important role directing and reflecting on strategy. MAP has a policy that strongly supports employment of PLWHA.

Facilitates and advocates for gender equality in community participation and response to the epidemic
Map is intentional in including boys, girls, men and women in all that they do. In a patriarchal culture, Peter shares that men do take time to understand the role of women. Theologically we know it is not good for man to be alone. MAP has a gender aware employment policy. Peter acknowledges that sixty per cent of those who are HIV infected in Africa are women.

Links well with government and other actors in a comprehensive approach to the epidemic
MAP is the chief facilitator for FBOs within government negotiations on HIV and AIDS. MAP has fulfilled this role for many years. MAP is represented on many agency boards that deal with HIV. The Kenyan Muslim community has adapted the MAP model.

Models creative and compassionate responses that inspire many to similarly enhance the dignity and human rights of people infected and affected by the epidemic.
MAP International staff belong to many churches. MAP International materials have been translated form English into Swahili, French, Portugese, Hausa and Amharic.

Does justice, loves kindness and walks humbly with God
Peter referred this answer to the MAP mission statement. MAP’s guiding principles, vision and mission are steeped in scripture. MAP’s motto is “Health and Hope for a Hurting World”.
See http://www.map.org/site/PageServer?pagename=who_Main

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Dr Gisela Schneider, Germany

Impact at local and wider level
Programmes developed during the nineties in Gambia had a measurable impact in reducing stigma, increasing Christian engagement in a predominantly Muslim country, improved quality and length of life before the absence of ARVs, and emerging signs of an impact in HIV prevention. Programme was well integrated into the Gambian Government’s HIV services.

Empowers others in integrated community responses
Gisela’s work has been focused on developing community based responses that are integrated with government, church, hospital, training institutions, etc. Has an emphasis on building capacity by getting all stakeholders (e.g. churches, hospitals, families) to work to their strengths in addressing HIV.

Facilitates church integration and participation in best practice models of care
Strong emphasis on church involvement and empowerment - helping churches to identify the contribution that they can make to a coordinated response to HIV & AIDS, encouraging integrations of both churches and FBOs with Government health programmes

Demonstrates excellence in full community involvement and empowerment of People Living With HIV and AIDS (PLWHA)
Strong emphasis on developing local ownership and leadership, and it is very often PWLHA and their families that have been at the forefront of this.

Works, facilitates and advocates for gender equality in community participation and response to the epidemic
Gisela works very closely with women on the ground, and has being doing work in DRC in particular on helping churches to self identify gender roles and issues in general relation to health and to HIV in particular

Links well with government and other actors in a comprehensive approach to the epidemic
This programme encourages integration of church and FBO services with wider government and civil society health systems and social engagement.

Models creative and compassionate responses that inspire many to similarly enhance the dignity and human rights of people infected and affected by the epidemic.
The initial programme that ran for over a decade in Gambia was handed over to in other local leadership in 2004, and immediately there was interest in training people in the lessons learnt from Uganda. This led to another two year project that is now locally led, and the new, wider ministry of extending this training to other nations and contexts.

Does justice, loves kindness and walks humbly with God
Strong theological root to this work – it’s main emphasis is on living out the gospel in who you are, then in what you do, and finally in what you say. It is based on a theology of salt and light, engaging even with corrupt systems to model God’s Kingdom in practice. This is what Gisela has imparted to her staff, her partners on the ground, church leaders and FBOs. It is about doing what you do the best you can to serve God where and when you are faithfully.

We shall be announcing the winner in time for World AIDS Day, but all five nominees are people who have made a significant impact in their nation and the wider world in establishing and developing effective responses to HIV & AIDS from within their faith communities.

Dignity & Right to Health Award: 2008 Nominees Part 1

2008-11-25T08:21:00.007Z

We, the ICMDA HIV Initiative team, have received five nominations for the Dignity and Right to Health Award 2008. The following five individuals were nominated -

Rev Gideon Byamugisha – Uganda

Dr Mukwege – DRCongo

Dr Geoff Foster - Zimbabwe

Dr Peter Okaalet – Kenya

Dr Gisela Schnieder – Germany

All nominees are acknowledged as demonstrating excellence and authenticity in keeping with Micah 6:8. They are excellent role models for us all.

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Rev. Canon Gideon Byamugisha, Kampala, Uganda

Canon Gideon Byamugisha is an ordained priest in the Church of Uganda.
In 1992, he became the first African religious leader to openly declare his HIV-positive status. He has since devoted his life to an AIDS ministry which has taken him to over 40 countries in sub-Saharan Africa and many other parts of the world.

Work
Gideon is driven by a passion for the dignity and rights of all people, especially those marginalised, stigmatised and discriminated against because of their HIV-positive status. He has played leading roles in the Church of Uganda's AIDS program, the Uganda AIDS Commission, World Vision International, the Ecumenical Advocacy Alliance, special conferences of the United Nations, and in founding the African Network of Religious Leaders living with or Affected by HIV and AIDS.

Impact
Gideon has successfully challenged AIDS-related stigma, denial and discrimination within and outside the church. He has corrected wrong and misleading information about HIV and AIDS, and provided accurate and relevant information in a clear, easily understandable manner. He has spread awareness of the multi-sectoral dimensions of the AIDS pandemic, especially the ways in which people's choices are influenced by poverty, gender discrimination, cultural practices and sexual violence. He argues that HIV and AIDS are both preventable and manageable.

He calls upon people to spread hope about HIV through peer education, counselling, home-based care, practical help and prayer, pointing to an array of outstanding work with which people can engage.

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Denis Mukwege, Bukavu, DRC

Dr Denis Mukwege is a gynaecologist, who is working in Bukavu, South Kivu, Eastern Congo. He trained in France but went back to DRC many years ago to serve at a mission hospital in a rural area of South Kivu. 10 years ago he had to flee this region and his hospital was burnt down in the war. Dr Mukwege did not return to France but started a new hospital in Bukavu. He opened a maternity unit, but his first operation was not a caesarean section, but a woman who was destroyed by war – raped by soldiers and with large injuries to her genital organs. Dr Mukwege saved her life and restored her dignity once again.

Since that day he has not stopped fighting for the survival of women in the community. He developed an excellent centre for women who were raped, 3600 women are treated at this centre per year. He trained young doctors in this type of surgery and care and developed a psycho- social support network for the women who often could not return home into their villages because of war. He never was afraid to operate on women whether they are living with HIV or not. His work and testimony reaches far not only South Kivu, but all of DRC and on a global level.

He did not only assist women but he started to advocate for the right of the women and families in the villages of South Kivu whose life is at risk because of external forces who exploit the land for coltan, gold and other minerals. Dr Mukwege speaks up and he says: “We do not want money we need peace in our country”.

Impact at local and wider level
At local level Dr Mukwege has made a huge impact on the lives of women who are raped or are suffering from VVF, many of whom are HIV positive. In addition he has worked as an advocate for peace in DRC on an international level and has spoken for the many women whose life stories are too sad to tell.

Empowers others in integrated community response In post war Congo, it is not easy to do community work. But Dr Mukwege started a psycho-social service for the women at Panzi hospital. With mobile teams he now reaches rural areas with services for women. In addition as the head of the ECC (Eglise du Christ du Congo) medical work, he mobilises churches and communities to get involved in the healing ministry of the church. He is head of a health zone in Bukavu and coordinates the church health services in 22 health zones throughout South Kivu.

Facilitates Church integration and participation
Dr Mukwege is an elder in the church (CEPAC) in Bukavu. He is very much aware of the importance of the integration and participation of the church in the healing ministry and recently started a new approach of envisioning the church to participate in this ministry.

Empowerment of PLWHA
Dr Mukwege does not only work with PLWHA but he works with all women who are sexually assaulted, many of whom are HIV positive. They are actively involved in the care and recovery process and many of his counsellors and workers are women who have recovered from such trauma.

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Dr Geoff Foster, Zimbabwe.

Significant Impact locally, regionally and internationally.
Geoff recognized in 1987 that HIV was a devastating exploding epidemic when he saw, within a few weeks, many infants dying of AIDS at the Mutare government hospital . He began a crusade which continues through today to alert the world through publications, speaking, and demonstrating personal concern as a paediatrician in Zimbabwe. In my opinion noone else has been more effective in bringing to the world’s attention the plight of children affected by HIV/AIDS and break the silence and hopelessness of Paediatric AIDS.

Below are a sample of his contributions:

A review of current literature on the impact of HIV/AIDS on children in sub-Saharan Africa (2000) by Geoff Foster and John Williamson
Where the heart is: Meeting the psychosocial needs of young children in the context of HIV/AIDS (2006) by Linda Richter, Geoff Foster and Lorraine Sherr Also see: Bernard van Leer Foundation
Under the radar: Community safety nets for children affected by HIV/ AIDS in poor households in sub-Saharan Africa (2005) by Geoff Foster
Where the heart is: Meeting the psychosocial needs of young children in the context of HIV/AIDS (2006) by Linda Richter, Geoff Foster and Lorraine Sherr Also see: Bernard van Leer Foundation

Empowers others
Geoff created an NGO called FACT-now completely led by Nationals-he remains on the board-to be a channel for resources and to advocate within Zimbabwe for HIV in children and in their mothers. He has also worked extensively with community based groups particularly those within the faith communities to bring care and prevention to the village level.

In particular he has worked with the CBO/NGO ‘Farming GOD’s Way’ to bring agricultural enterprises appropriate for orphans and the poor/ vulnerable to enable survival in the critical condition that Zimbabwe finds itself today.

Facilitates Church integration and participation
The church is the avenue that Dr. Foster sees as the primary strategy of delivering prevention and care to children in Africa-he has shown it can be done in the midst of complete government failure and actual policies that promote HIV spread and human degradation.

As noted above, Geoff with FACT, work primarily at the community level to bring programs for HIV prevention--and population survival in the absence of government/international programs.

A Creed for the AIDS Pandemic

2008-11-17T13:10:00.005Z

The Christian HIV/AIDS Alliance have launched a “Creed for the AIDS Pandemic” designed to be read out in churches, on either Sunday nearest to World AIDS Day, December 1st. The aim is to help churches to remember the 2.1 million people who died from AIDS related illnesses last year alone, and to express support for those involved in the response to HIV and AIDS throughout the world.

CHAA member, the Salvation Army UK Territory, plan to launch the Creed in their churches for World AIDS Day 2008; Tearfund have written their own version inspired by CHAA’s Creed; Alpha International, Holy Trinity Brompton, and St Philip and St James Church, Bath, also both plan to use the Creed. Copies of the Creed were also distributed to Anglican Diocesan World Mission Officers and Mission agencies attending the recent Anglican, “Partners in Mission World Mission” conference.

CHAA developed the Creed as a step towards their vision to see a mobilised UK Christian Community responding to the Global pandemic.

The short Creed affirms Christian belief in God’s love to reach out to those infected and affected by HIV and AIDS whilst firmly rejecting the idea of the AIDS pandemic being God’s judgement on sinful behaviour. Its emphasis is firmly on the church being an agent of change, putting the responsibility on church members to reach out as Christ’s’ disciples to comfort the broken hearted, help the oppressed, care for orphans and widows and minister to the sick. The Creed is in bookmark format, designed to be signed and dated and kept as a reminder by church members as a commitment to be involved with the worldwide pandemic.

AIDS activist, Rev Alan Bain, Vice Chair of CHAA, and Vicar of St Philip and St James Church, Bath, said, “ At the World AIDS conference in Mexico City this year UN Secretary – General, Ban Ki Moon pointed out that an even greater effort is now required if the world is to meet the Millennium Development Goal of halting and reversing the spread of HIV by 2015. CHAA’s new Creed provides a reminder and an opportunity for churches to commit themselves to solidarity with the overseas church who have fought the pandemic for over 25 years, often in situations of abject poverty and deprivation.”

Chair of CHAA, Ken Pearson said, “The Creed for the AIDS pandemic is not new. It is being lived out every day by millions of Christians living with and caring for those affected by the pandemic. My prayer is that the Creed will reawaken the UK Church to our responsibility to share with them in their need.”

The full text of The Creed is as follows:

1. We believe that God loves the world and the proof of that love is the Lord Jesus Christ’s death on the Cross.

2. We believe that through the reconciling power of the Cross, God’s love seeks to embrace all people regardless of creed, colour, gender or sexual orientation and that the AIDS pandemic is not God’s judgement on sinful behaviour.

3. We believe that God has called the Church to be the agent of His love in this broken world.

4. We believe that Christ’s love compels us that we should no longer live for ourselves but for Him and that the Gospel calls us to care for our brothers and sisters in Christ and share in their sufferings and to do good to all people.

5. We believe that as stewards of the talents we have been given, we have a responsibility to use them to help all those affected by the AIDS pandemic.

6. We believe that, as Christ’s disciples, we are called to comfort the broken-hearted, help the oppressed, care for orphans and widows and minister to the sick.

7. Therefore, as God’s people, we covenant together to pray regularly, give generously, fight stigma, encourage one another, and share in fellowship with those affected by the pandemic.

The Christian HIV/AIDS Alliance is a network of 19 Christian agencies and churches praying and working together to serve and empower those affected by HIV and AIDS. Copies of the “Creed for the AIDS Pandemic” are available to order or by download on the CHAA website, www.chaa.info

HIV Call to Action from Evangelical leaders worldwide

2008-11-07T14:01:00.005Z

I have just read the HIV Call to Action adopted the World Evangelical Alliance General Assembly on October 29 in Thailand. This was drafted after their consultation with the Micah Network for Integral Mission. It also feeds in to the joint global campaign both networks are running around the Millennium Development Goals - the Micah Challenge.

I think it speaks eloquently of both God's heart and our responsibility as we are faced with the local and the global challenges that HIV & AIDS present to the world.

While we have not always acknowledged it, we recognise today that the Body of Christ, His Church, is living with HIV. With brokenness we admit that as Evangelical Christians we have allowed stigmatisation and discrimination to characterise our relationships with people living with HIV. We repent of these sinful attitudes and commit to ensuring that they are changed. We will follow Jesus’ example and identify with those who are affected (Matthew 9:12-13) as we intercede fervently for one another (Romans 8:26).

We recognize that as the current generation of young people in our churches enters adulthood and becomes sexually active we have not always provided a clear, biblical framework of human sexuality and life skills for their guidance and nurture. We are cognizant that we have been insensitive to the inability of women, children and the most marginalised to exercise real choices and that in many areas of the world marriage and gender-based violence are risk factors for HIV transmission. We apologise for this failure and resolve to model and teach the essential value of human sexuality within the bounds of God-honouring lifestyles. We also commit ourselves to listen with understanding to our children, youth, women, and the most marginalised – especially people living with HIV – so that we can work together for a healthy and safe future which will enable all people to live in the abundant life Jesus promised (John 10:10).

The HIV pandemic has reminded us that the health of all communities is connected to the health of the most vulnerable and marginalised in our societies. We commit as leaders to equip ourselves and our congregations to follow the footsteps of Jesus. Since ours is the ministry of reconciliation (2 Corinthians 5:18-19) we will seek to live out incarnational faith working in partnership with the most marginalised and vulnerable to HIV infection.

As a community of Evangelical Christians we believe that all people regardless of belief, identity, gender, ethnicity or health are created in the image of God (Genesis 1:27). Hence it is an essential element of our identity that we bear witness to the love of God for all people in word and deed, in private and in public. We therefore resolve to strengthen our theological reflection and practical action in our advocacy, respect for life and justice with dignity for all people. We realize that this resolution will profoundly challenge us as we deeply long to be a holy people who please God (1 Peter 1:15-16; Matthew 5:8). We reaffirm that we all live in and by the grace of God (Ephesians 2:8-9; Romans 5:1-2) and agapé love (1 Corinthians 13:1-8).

We commit to working in HIV prevention in partnership with others to halt and reverse the spread of HIV. In so doing we understand that there are many social drivers that contribute to HIV transmission and that no one group or organisation can do everything. We will therefore work alongside other sectors of society so that all people will know how to protect themselves from infection and have access to the services needed to do so.

We commit to playing our part in caring relationships – individually and corporately – working to mitigate the impact of HIV on individuals, families and communities and advocating for comprehensive HIV services in prevention, treatment, care and support. We will work towards universal access for these services for people living with HIV so that they become less vulnerable and are enabled to be meaningful contributors within the Church and society.

We commit to develop a comprehensive HIV strategy in collaboration with our member-networks, people living with HIV and other partners.

As a community of Evangelical Christians expressed globally, nationally and locally we will foster connections between parts of the Body of Christ. We will strive for practical solidarity and sacrificial giving among Christians – person-to-person, congregation-to-congregation, denomination-to- denomination, and country-to-country – in order that Jesus may be lifted up, the Father glorified and men and women brought into His saving grace through the life revolutionising power of the Gospel we preach (Romans 3:23-24; 6:23; Ephesians 5:8; Colossians 1:13).

An evening with Ugandan Canon Gideon Byamugisha

2008-09-29T20:31:00.002+01:00

Humble, yet courageous, Gideon was the first churchman to publicly declare his HIV+ status. Canon Gideon now has a worldwide ministry in drawing attention to the plight of AIDS sufferers and the work being done in their midst to bring them hope. Canon Gideon's ''Ambassadors of Life'' evening will inspire and challenge you with his unique blend of humour and pathos. Hear about innovative new strategies

Canon Gideon was a keynote speaker at the ICMDA world congress in Sydney 2006, and again at the ICMDA Eurasia Regional Conference in Schladming Austria in September 2008. He is supported through HealthServe Australia in the ICMDA HIV Initiative project. The Kilimanjaro Rehabilitation project will also be featured - where of those adults admitted with neurological problems such as stroke, over 20% are HIV positive.

Meet Canon Gideon in

· Brisbane Wednesday Nov 5

· Sydney Saturday Nov 8

· Adelaide Tuesday Nov 11

· Melbourne Saturday Nov 15

HealthServe Australia is collaborating with SIMAid in these dinners. More details of the dinners will be available later but put it in your diary NOW. For more details visit the CMDFA website

Day 2 – Part 1:Utilising Resources

2008-09-09T18:11:00.000+01:00

Day two focussed primarily on the issues of treatment and care, and responding to stigma. It has been especial privilege to have contributors from Kazakhstan, Ukraine, Belarus, Uganda and India, and the differences and commonalities between the experiences in these different nations in different regions of the world has been eye opening.

Treatment & Care in Resource Limited Situations

Dr Gisela Schneider spoke with great passion n the challenges of effectively treating people with late stage HIV infection. Quoting Colossian 3:17, she reminded us that caring for those living with HIV & AIDS is an act of worship to God.

The biggest challenge is that for all the work we have done in scaling up access to antiretroviral treatment [ART], the reality is that for every two people newly accessing ART, five are infected with HIV. We are not even running to stand still – and unless we scale up access to treatment dramatically over what has already been achieved, and start seriously investing in effective prevention, we are never going to get universal access. And it must be a combined strategy of treatment and prevention.

The reality is that effective treatment is not just about rolling out antiretroviral [ARV] drugs. Early diagnosis is key – so early testing is essential, which requires good voluntary testing and counselling. Good nutritional support is essential if ARVs are to be effective, along with effective diagnosis and treatment of opportunistic infections. We must have good palliative care, not just in terminal illness, but in controlling symptoms of opportunistic infections and managing the side effects of ART. Good psychosocial support is vital – community support, counselling and other forms of support to help the individual and their family deal with the pressures that are on them. You need well trained staff and volunteers to provide all of this support, as well as to deliver and monitor ART itself. Well trained clinical officers and nurses can deliver the majority of the care and treatment, you do not need lots of doctors, and this leads to a significant increase in capacity within health systems.

Once you have all of this, you are ready to start administering ARVs. First line treatment in most of Africa is usually with Nucleoside and Non-Nucleoside Reverse Transcriptase Inhibitors (in West Africa, where HIV2 is predominant, Protease Inhibitors are first line treatments). In Eastern Europe and Central Asia there was some debate over the best first line treatment.

In Africa the usual criteria to start ART was a CD4 count below 300 and a presenting Stage III AIDS defining illness. However, in practice, anyone with a presenting illness would go on to treatment, regardless of CD4 count.

While many thought ART would not work with poor, uneducated rural Africans, the evidence suggests that ART has reduced HIV related mortality by as much as 95% in rural Uganda, and other evidence suggests that compliance amongst Africans is significantly greater than among North Americans (85-99% in Africa versus 57-75% in the USA). Treatment support is vital – volunteer support in the form of treatment advocates are vital in reinforcing the message that compliance is like a marriage – you and your drugs are together for life!

Multi Drug Resistant TB (and more recently Extremely Drug Resistant TB) have become major problems for people living with HIV. But evidence suggests that much HIV infection is also being missed because people with TB are not being tested for HIV – the reality is that the two infections go hand in glove, especially in Africa and Asia.

Good monitoring and evaluation of treatment is essential – particularly early recognition of treatment failure. However, the big struggle is to get second line therapies – as most global funding is only for first line therapy. First line treatments can be as cheap as $92 per annum, but second line treatments are coming in at $600-1,200 per annum. There simply is not the funding for this, and it is becoming a major concern as more people are either being infected by resistant strains of HIV or are developing resistance after many years on ART.

The biggest future challenge is to start seeing people living with HIV and AIDS as part of the solution rather than the problem. They are the most effective educators, advocates and supporters and counsellors for the newly diagnosed. They are actors not passive recipients. The other major challenge is to start engaging heterosexual men in tackling the causes of gender based violence and the empowerment of women – if we are going to turn back the feminisation of the epidemic, we need the men to be part of the solution, not the problem. This is a key role that the churches can take on – re-educating men in their attitudes to sexuality and relationship with women from a truly Biblical basis.

Day 1 – setting the scene

2008-09-08T16:39:00.000+01:00

Today's meetings were focussing on the big picture issues – global lessons learned (the very hardest of ways) over the last thirty years, especially in Africa.

Lessons Learnt from Africa

Revd. Cannon Gideon Byamugisha was the opening speaker – sharing some of those hard learned lessons – the most of basic of which is that care, treatment and prevention all fit together and cannot be tackled separately. Furthermore, each compliments the other. Gideon's approach has been christened SAVE – Safe Practices (this includes the sometimes derided ABC [Abstain, Be faithful, use Condoms], clean needle exchanges, prevention of mother to child transmission, etc, etc); Access to treatment (Universal Access for all by 2010); Voluntary, routine and stigma free counselling and testing; Empowerment of people and communities at risk of or living with HIV & AIDS.

Faith Communities and Global Responses

Joy Backory of UNAIDS gave an overview of the big picture from the UN standpoint, highlighting the importance of the 2001 UN Declaration of Commitment and the 2006 UN Political Declaration as commitment we as civil society groups can use to hold our governments to account for their actions to respond to HIV & AIDS – these are agreements that all UN member states have signed up to (see here for a report on the 2008 evaluation meeting on the progress towards achieving these declarations and commitments).

Key ways in which the faith communities and faith based organisations can have an impact is in breaking the silence on HIV & AIDS, speaking out against stigma and discrimination. We also have a key role in mobilising communities to respond – from primary health care to community education and support mechanisms for those affected.

UNAIDS is now establishing an ongoing working group on joint working with faith communities and FBOs, and developing an engagement strategy for use by all international bodies. The Global Fund for instance still has difficulties engaging with faith communities, and vice versa, as the large scale project funding is often at an operational level removed from the activities of all but the largest FBOs. However, in some countries faith communities are engaged with country coordinating mechanisms (CCMs) that act as conduits for Global Fund grants, and these good examples need replicating.

The key message is that the international response to HIV & AIDS needs faith communities, but we need to be willing and able to engage with the wider, global response

The Church in the Central Asian Republics: Challenges to an effective response

In the afternoon, we looked at the challenges for the churches in Central Asia in responding to the emerging pandemic there. In most countries of the region, the pandemic is mostly amongst intravenous drug users (IVDUs) and commercial sex workers (CSWs). Exact figures are hard to come by, as reporting is not well developed in some of the republics, and figures for Turkmenistan in particular are impossible to find. What figures there are almost certainly underreporting the scale of the problem. But roughly speaking Kazakhstan has a 3% HIV incidence amongst IVDUs, in Kyrgyzstan the incidence is only 0.8% among IVDUs, but soars to 5% of the prison population, many of whom are IVDUs. In Uzbekistan 30% of IVDUs are HIV+, while in Tajikistan it is 24% amongst IVDUs and 17% amongst CSWs. Government responses vary, but as HIV is an emergent problem and still confined to these 'at risk groups' it is not a major public health priority.

The churches are engaging with HIV in most countries of the region, but only in small pockets. Overall most churches do not see it as a spiritual or pastoral issue, and see it primarily linked to sin and worldliness, therefore not a legitimate issue for the churches to engage with. There is little or no worked out theology of AIDS or social engagement, and there are few resources available for churches on HIV & AIDS in Russian or other local languages.

Many churches have difficulties in working together – there is much distrust between churches and denominations. Furthermore, unless the pastor catches the vision, there is little chance of much being achieved as the work is very much led by pastors and members of the congregations (especially younger people) are not listened to or given room to develop their own ministries. In addition, the churches are mostly marginal or even persecuted, and thus not looked upon by government or wider society as a resource; if they reach out to affected people and communities they can face further hardships themselves.

However, the churches are often the only communities able to respond and help those affected. Churches are engaging with people living with HIV & AIDS because they are coming to the churches for help, having nowhere else to turn.

What can be done? Training of pastors in issues around sexuality, death, HIV & AIDS, drug use, stigma etc need to be part of seminary courses, and post graduate training is also needed for those already leading churches. Seeing people living with HIV as a resource, especially as educators (not just to peers, but to other church leaders and their congregations) will be key – especially to combating stigma and giving the pastors and their churches a vision to reach out to those affected. There are already national networks linking pastors and FBOs together, and these meet regularly across the region – at these meetings HIV is coming to the fore as a major issue. But it will take time for this to translate to a real transformation in the churches on the ground.

HIV Prevention in a Post-Christendom Culture

If the Central Asian Republics are post communist/post Muslim states, the problems of Western Europe are summarised in their being 'Post Christendom' – not post-Christian, but reacting against model of institutional Catholic and Protestant religion that has had long standing state approval. Richard Carston of ACET Ireland highlighted the challenge of engaging the church in prevention when it wants to keep its head down because society in Ireland now want to define itself as not being anything to do with traditional faith (especially, though not exclusively, Roman Catholicism). So the challenge is to couch prevention language that promotes Biblical values in language not associated with traditional religion. So the traditional answer to the question 'When will I lose my virginity' would have been 'only once you are married', whereas the approach ACET would take is to reframe the question – 'with whom will I enter a one-flesh relationship.'

The challenge is to tackle an increasingly heterosexual epidemic by mainstreaming the work, and standing alongside secular groups.

Aid to the poor falling behind

2008-09-05T14:54:00.005+01:00

As we start on Sunday to look at how we respond to HIV & AIDS as Christian health professionals in Eurasia, it is sobering to stop and note that efforts to tackle poverty (one of the main drivers and symptoms of the AIDS Pandemic) and improve access to healthcare (one of the main weapons in the war against HIV & AIDS) are falling woefully behind. As this article highlights, though there are some areas of progress, in reality the rich nations are maybe $30 billion behind target.

I remember the heady days of July 2005, the Gleneagles G8 Summit in Scotland, the 'Make Poverty History' campaign, and a real sense that change was in the air. This report is merely the latest set of figures that shows the rich are still not living up to our obligations and commitments to the poor. We are not going to make the 2010 universal access targets for HIV & AIDS treatment, care and prevention either, for similar reasons.

One of the challenges we face is not just to ask how best we can provide treatment, care and prevention, it is also to ask how we challenge the social and political systems that lock people out of these resources.

AIDS Slang

2008-09-04T17:36:00.001+01:00

Interesting Blog post - slang/colloquial terms for HIV, AIDS and related matters (mostly from Africa)

Five days to go

2008-09-02T10:07:00.002+01:00

Five days before the ICMDA Europe/Eurasia Regional Conference in Schladming, Austria. Just trying to sort out visas, ensure all the literature and resources arrive on schedule, and just generally get everything organised that has not already been put in place.

As ever, the logistical challenges of a conference can easily get in the way of the central priority - how are we supporting these doctors and others to give the very best care in often less than ideal circumstances to people living with HIV and AIDS? My main prayer is that we achieve that aim at least at this conference.

Following 2006’s Sydney HIV preconference, a Worldwide ICMDA HIV/ AIDS initiative/ network has been established [www.icmdahivinitiative.org]. As there is significant variation in the nature of the epidemics from region to region it was recognised early on that it was important for this network to become regionally focused in the same way in which ICMDA is developing regionally.

The HIV pre-conference in Austria 2008 is an opportunity to start a regional focus in Europe, Central Asia and the Middle East – areas currently not well represented, but where the HIV pandemic is accelerating at its fastest. In many nations in the region keep their HIV pandemic hidden, and remain in denial reminiscent of many Africa nations in the early to mid 1990s. It is also a region where the churches are often marginalised or even persecuted, and overt Christian responses are not always possible. The need to empower, equip and network those Christians who are responding to the pandemic is vital.

The main aims of the HIV & AIDS pre conference stream are:

1. Establishing regional links, especially in unknown places this far, i.e. Middle East, Eastern Europe. Find out what people are doing.

2. In a lot of places, it’s likely that people will be working in isolation – the pre conference will therefore aim at encouragement and empowerment, learning from each other, creating a space for people just to network.

3. Sharing skills and best-practice knowledge. Cautiously, aware of cultural / practice differences.

4. Creating a virtual network for Christian ministries, mission agencies, churches and health professionals responding to HIV and AIDS in the region.

We are hoping that around thirty five to forty delegates/speakers from the region will be attending (final figures are just coming through). Medical practitioners and students will get some subsidy from ICMDA, we will look to support others attending by other means. Target group for the conference will be Christian health professionals, mission agencies, indigenous ministries and Churches responding to the pandemic in their own nations or across part or all of the Eurasia region.

We will be posting updates on to this site regularly over the next week.

The Welcome Return of the "AIDS Heretics"

2008-08-29T16:20:00.006+01:00

Interesting review in Spiked this week, looking at Elizabeth Pisani's "The Wisdom of Whores" and James Chin's "The AIDS Pandemic: The Collision of Epidemiology with Political Correctness" two of the current generation of "AIDS Heretics". While the earlier generation of "heretics" questioned the science of HIV (and have now largely been discredited, although sadly not in South Africa), this new generation are attacking the accepted wisdom on HIV prevention.

One of the big challenges is that most HIV epidemics do seem to be confined to certain "risk groups" - i.e. gay and bisexual men, commercial sex workers, intravenous drug users, etc, etc. It is more generalised only in parts of the world (mostly Southern and Eastern Africa) where networks of stable, multiple sexual partnerships exist.

The problem with saying any of this is that it immediately becomes ammunition for those who would stigmatise and marginalise these groups even further than they already are - and cuts against a common belief that women are not promiscuous in the same way (or to a similar degree) that men are. It also puts in to question a lot of the HIV prevention strategies that have gone on for decades, and the way that funding is allocated by donors and international agencies. And there is undoubted resistance to such a challenge to the current orthodoxy, as I have catalogued elsewhere.

The reality is that we should welcome these "heretics" for making us think again about how we are undertaking prevention work. The great challenge before us is how we effectively slow and halt the spread of the pandemic, especially in high incidence countries. Asking these questions and looking again at what actually works is vital to the future effectiveness of any prevention strategies. We do not have to agree with all that the new "heretics" say or prescribe, but we can value the hard re-look at the facts that their diagnoses force upon us.

Welcome

2008-08-29T09:58:00.001+01:00

This blog will attempt to cover some of the issues in the HIV and AIDS arena that the members of the International Christian Medical and Dental Association are dealing with around the world - partcualrly looking at the engagement of faith, medicine and HIV/AIDS.

In the short term this will include a detailed report (at least day-to-day) from the Eurasia Regional HIV Pre-conference at the ICMDA Conference in Schladming, Austria this September (2008).

The aim of the HIV pre conference stream is to bring together Christians working in HIV & AIDS care, prevention and treatment across the region in order to learn from one another, explore new models of practice, look at how we influence our own churches and faith-communities to respond positively, and to strengthen networks of professionals working in the field

The ICMDA HIV Initiative grew out of the ICMDA International AIDS Preconference at Meroo, New South Wales in July 2006. It is a linked activity of the International Christian Medical and Dental Association. We are motivated by a belief in a loving God who cares about all the world's people regardless of health status, race, creed, colour or financial or social standing. We continue to encourage all Christian health workers, services, institutions, local congregations and communities to engage holistically in HIV and AIDS advocacy, education, prevention, care and treatment. We support the call for universal access to prevention and treatment as part of a right to health and dignity for all. To these ends, and other commitments highlighted in the Meroo Statement

The ICMDA HIV Initiative is involved in:

An annual Dignity & Right to Health Award that recognises Christian health professionals making a significant impact in care and treatment of people and communities affected by HIV

Running conferences and events within and outside ICMDA Programmes that seek to encourage, equip and empower Christian health workers involved in responding to HIV & AIDS.