War on AIDS: Money nightmare seems set to return

AFP, MEXICO CITY - "Save someone's life and you have a burden for life," goes the proverb, and its truth seems horribly apt for the campaign against AIDS.
After years of battling for funds and anti-HIV drugs for needy people in poor countries, activists are finally making headway.
But the 17th International AIDS Conference that ended here Friday has highlighted the dilemma of this success: the more lives you save, the more the bill goes up.With no cure or vaccine in sight, and with the lifeline comprising a regimen of powerful drugs that must be taken daily, the money crunch is doomed to return -- and with a vengeance."It is extremely improbable that we will have the structure and financial ability to take on all the people who require ART [antiretroviral therapy] and then treat them for life," Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID), warned on Wednesday.In 2007, 8.1 billion dollars were mustered to fight HIV/AIDS in the developing world, home to 90 percent of the 33 million people with the human immunodeficiency virus (HIV), according to the UN agency UNAIDS.That effort is already a Herculean advance compared with the start of the decade, yet even so, less than a third of the 9.7 million poor people whose immune systems are so impaired by HIV that they urgently need the drugs have access to them.At the current pace of scaleup, 22 billion dollars will be needed in 2015 just to get antiretrovirals to eight million infected people.And that's just the minimum.If the world is serious about achieving universal AIDS drug and care access by 2010, a goal enshrined by the UN General Assembly in 2006 and endorsed by the Group of Eight (G8), the bill rises almost exponentially.The cost of universal access would be 42.2 billion dollars in 2010, five times 2007's expenditure -- and in 2015 it would be a whopping 54 billion dollars, to keep 21.9 million infected people alive."If you add the current 35 billion that is being spent in the developed world, you're talking at that time [about annually needing] almost 90 billion dollars, in a continuous fashion," Seth Berkley, head of the New York-based International AIDS Vaccine Initiative (IAVI), told AFP."And that doesn't even take into account complications with secondary resistance to drugs and other issues."With no cure in sight, the pendulum of debate is swinging from treatment to prevention to stop the tally of infections from rising further.One of the big focuses of the conference was on how to reinvigorate grassroots work.This often-overlooked business involves promoting safe sex among young people, ending coercive sex for women and easing stigma against gays, intravenous drug users, sex workers and other groups where the virus finds fertile ground for leaping into the wider population.By far the brightest news from the conference was about male circumcision.Surgical removal of the foreskin decreases the risk of contracting HIV by 65 percent, according to the latest data from a US-led study in Kenya.Those findings, three and a half years after the project began, compared favorably with 60 percent protection measured at the two-year mark.This extraordinary evidence will put pressure to launch a broad campaign of circumcision among men in sub-Saharan Africa, where two-thirds of the world's HIV population resides.Experts warn, though, that such a campaign has to be thoroughly prepared and financed, as botched operations and cultural or religious resistance could cause the whole strategy to backfire disastrously.Veteran AIDS campaigners, questioned at the conference by AFP, agreed that there seemed to be a lull in a war that has claimed more than 25 million lives since the disease emerged in 1981.Stephen Lewis, former UN special envoy for AIDS in Africa, attacked what he called "a kind of curious passivity among the international AIDS establishment" after the achievements in money-raising and drug access over the past two or three years.He believed that "generational change" would come, as younger people would take the baton handed on by the men and women in their fifties and sixties who had been fighting AIDS for two decades or more -- a sign indeed that the world is in for the long haul in combating this peril.

Special Notes :1)

Aids prevention startegies involve curative and preventive steps. Money will never be sufficient for all cases of HIV/AIDS. The emphaisis on spending funds only for drugs may have to be changed to spending funds on preventive interventions, and developing vaccine. Money falls short of providing drugs for 2nd line tretament. It fell short in the campaign 2 by 5 intiative, and will be short in any future such startegies. Available funds will never catch up the requirement, therefore higher percentage may be spent on preventive strategies, in future.

Special Notes :2)

I feel pesimistic about the future. Rich countries are experienced financial crisis. Low resources setting are expanding the ARV coverage in areas where infraestructure is not good yet as to provide monitoring. As a consecuence, patients are failing several months or year before to change to second line, and at this time the virus usually is multidrug resistant. It is difficult to afford second line regimens because all drugs are protected by patents. Mexico declared that in 6 year will be difficult to warranty universal coverage with the current HIV drug prices, this situation will be enormeously worse in low resource settings. Viral load monitoring and price reductions are need to expand the second line treatment to everyone. Brazil provide an example in how to negotiate ARV prices, but is is not enough for most places in the world. In any way. Pharmaceutical industry in never loossing monew by price reductions. Don be confused. MONEY IS NOT THE MAIN PROBLEM. THE PROBLEM IS DISTRIBUTION. IN A WORLD WHERE SOMEBODY IS SPENDING IN TOURIST FLIGHT INTO THE SPACE THE SAME AMOUNT OF MONEY THAT COULD COVER 1.500 YEARS OF ARV ANYBODE CAN TELL THAT THERE ARE NO MONEY. We need to define priorities (pharmaceutical profits or lives), strategies (which first line and second line), escential standar of care (takin HIV as an excuse to improve Health access), and operational strategies (favouring the drug manufractur in most affected countries)Other proposals includes MSF patent pool, one interesting mechanism where the patents of several drugs are bought to the Pharmaceutical industry and then negotiated in pool. Regional mechanism of price reductions are also need. We need to reduce the poverty, increase the quality of health care in order to fight against HIV.

Wonderful picture of rainy season

Children rowing a boat in a water body brimming in Keraniganj, on the outskirts of the city. They are busy picking up water lilies and sometimes sprinkling water on each other oblivious to the fact that they themselves are painting a wonderful picture of the rainy season. Photo: Syed Zakir Hossain

AIDS fight needs religious leaders

Says Marina Mahathir
Involving religious leaders is an essential measure to address HIV/AIDS issue in Muslim countries, said visiting human-rights activist Marina Mahathir on Tuesday, reports bdnews24.com.Mahathir, a member of the International Steering Committee for the Asia Pacific Leadership Forum on HIV and AIDS, was sharing her experience on awareness campaigns at the city's Independent University of Bangladesh (IUB). The seminar titled 'HIV/AIDS: Facing the Challenges' was the first in a series of seminar to be held countrywide, Professor M Omar Rahman, pro-vice-chancellor of IUB, said in his welcome note. Explaining the perils of running campaigns on such sensitive issue as AIDS in Malaysia, Mahathir said their major challenges were social and religious sensitivity and the mindset of people toward AIDS victims. "Back in 1993, when I started to work, Malaysians thought that only drug abusers and sex-workers could catch AIDS," said the daughter of Malaysia's former prime minister Mahathir Mohamad. She underlined the need for the right approach to confront the problem being a sensitive issue. They had worked closely with the Alems and Ulamas to develop a series of training workshop for Imams at the grassroots level to build awareness, said Mahathir. "And they (Imams) took it very much positively as they were already facing the problem from the locality they belonged to," she added. Mahathir, who is also a journalist, told the seminar that the problem of HIV/AIDS could be tackled in different angles but the best way was 'faith-based angle'. Speaking on Bangladesh, she said numbers of HIV-positive people are still low. "So don't miss the opportunity; you need to act fast as it would be more cost-effective now", she added. She emphasised pressuring the government in making available drugs needed for AIDS-infected people. Mahathir also met with home adviser MA Matin and later told reporters that she was satisfied with the rights of women and HIV/AIDS situation in Bangladesh. Bangladesh was in a very good condition in these two sectors, she said. The use of secondhand syringes needs to be stopped since it was the one of the influential mediums of spreading AIDS, she said. The human-rights worker said her country did not use such syringe. She was accompanied by other delegates and Bangladesh Centre for Development, Journalism and Communication (BCDJC) chairman and daily Amader Shomoy editor Nayeemul Islam Khan. She arrived in Bangladesh early Monday on a six-day visit at the invitation of BCDJC to give a talk on a seminar on media and gender equity. She is scheduled to visit to Chittagong Wednesday, the home ministry sources said.
Involving religious leaders is an essential measure to address HIV/AIDS issue in Muslim countries, said visiting human-rights activist Marina Mahathir on Tuesday, reports bdnews24.com.Mahathir, a member of the International Steering Committee for the Asia Pacific Leadership Forum on HIV and AIDS, was sharing her experience on awareness campaigns at the city's Independent University of Bangladesh (IUB). The seminar titled 'HIV/AIDS: Facing the Challenges' was the first in a series of seminar to be held countrywide, Professor M Omar Rahman, pro-vice-chancellor of IUB, said in his welcome note. Explaining the perils of running campaigns on such sensitive issue as AIDS in Malaysia, Mahathir said their major challenges were social and religious sensitivity and the mindset of people toward AIDS victims. "Back in 1993, when I started to work, Malaysians thought that only drug abusers and sex-workers could catch AIDS," said the daughter of Malaysia's former prime minister Mahathir Mohamad. She underlined the need for the right approach to confront the problem being a sensitive issue. They had worked closely with the Alems and Ulamas to develop a series of training workshop for Imams at the grassroots level to build awareness, said Mahathir. "And they (Imams) took it very much positively as they were already facing the problem from the locality they belonged to," she added. Mahathir, who is also a journalist, told the seminar that the problem of HIV/AIDS could be tackled in different angles but the best way was 'faith-based angle'. Speaking on Bangladesh, she said numbers of HIV-positive people are still low. "So don't miss the opportunity; you need to act fast as it would be more cost-effective now", she added. She emphasised pressuring the government in making available drugs needed for AIDS-infected people. Mahathir also met with home adviser MA Matin and later told reporters that she was satisfied with the rights of women and HIV/AIDS situation in Bangladesh. Bangladesh was in a very good condition in these two sectors, she said. The use of secondhand syringes needs to be stopped since it was the one of the influential mediums of spreading AIDS, she said. The human-rights worker said her country did not use such syringe. She was accompanied by other delegates and Bangladesh Centre for Development, Journalism and Communication (BCDJC) chairman and daily Amader Shomoy editor Nayeemul Islam Khan. She arrived in Bangladesh early Monday on a six-day visit at the invitation of BCDJC to give a talk on a seminar on media and gender equity. She is scheduled to visit to Chittagong Wednesday, the home ministry sources said.

400 Years of DHAKA : Glory of Jamdani glimmers amid winds of change

Once adored by the Sultans and Nawabs, Jamdani, the descendant of ancient fine muslin cloth, still remains the pride of Dhaka. Yet, with all its fame and glorious journey through centuries, the splendid cloth faces a few stumbling blocks that threaten its existence. Historically, the area around Dhaka and Narayanganj has always been the hub of handlooms. The surrounding area grew the finest quality cotton, Karpash, the key ingredient for weaving Jamdani.Besides, the aesthetic senses of the royal patrons helped Jamdani weavers make the embroidered fabrics with eye-catching design. Still the villages in Rupganj, Araihazar, Sonargaon, Shiddhirganj and other places around the Shitalakhya remain the main Jamdani-making belt. Weavers in many other places in the country and in West Bengal tried to make Jamdani, but what they made were not comparable to that made by the weavers of Dhaka. “It is the exceptional weaving technique…the embellishment of splendid loom-embroidered motifs makes Jamdani so exquisite,” said Ruby Ghuznavi, managing director, Aranya Craft Ltd, who is doing research on traditional fabrics. “It is said that the silted waters of the Shitalakhya river gives the air a unique dampness and a perfect temperature early in the morning, giving a certain quality to the yarn. In the olden days, the artisans worked on the loom only around daybreak,” she added. Jamdani is hand-woven in old-fashioned bamboo looms set up in a shallow trench. One specialty of Jamdani loom is that it does not make any sound while weaving. Artisans use a throw shuttle locally known as maku to weave the intricate fabric. With the choreography of a nifty hand the throw shuttle goes from one end to the other, interweaving the threads, creating and recreating the motifs with precision.In the beginning it was produced only in whites, later with black, grey and straight golden line borders. Colours appeared in the 19th century, Ruby said.“A very remarkable feature of Jamdani is the designs are never sketched or outlined. Jamdani designs are made while the fabric is still on the loom, inserted by hand during the process of weaving, producing the effect of embroidery,” she explained. Another important character of Jamdani sari is the motifs, mostly floral, are of geometric shape, and the sari is embossed with the design often in a diagonal form. Traditional variety of motifs include 'Butidaar' in which a spray of small floral patterns ornate the sari. When the floral patterns diagonally spread all over the fabric it is called 'Tercha'. Ornamentation with a network of floral motifs is called 'Jhalar or Jaal' as it spreads like a net. Then there is Phulwar and the one with large flower called the 'Toradar.' Most prized among all motifs is the 'Panna Bazar' or the 'Thousand Emeralds'. Artisans later used names such as Corolla Buti, Dhaner Sheesh, Bansh Phool, Puna Phool, Bagher Pa, Ichadar and many more. “These motifs are basically the weavers' insight of the nature, the simple things of everyday life,” Ruby said. “Another unique feature of the motif is that there are no human or animal figures in Jamdani. This is probably because it was always worn by Muslim royalties and woven by Muslim weavers,” she added. Neatly cut yarn from the finest quality Karpash is the key element to weave a perfect piece of Jamdani. In the olden days only young women below the age of 18 used to cut the yarn with their soft fingers. The most appropriate time for making the yarn is early morning as the air then carried the highest moisture. The wonder cotton Karpash is long gone. Today the weavers buy yarn from the market and use chemical dyes instead of herbal dyes. And they have also surrogated cotton with silk that completely changed the nature of Jamdani. Today the market is abundant with the gleaming version of half silk Jamdani. After a glorious journey through centuries Jamdani craftsmanship is considered an endangered trait. Experts' doubt how long the glory would last as the product is losing its originality. The magic fabric exists through many modifications.“Jamdani is losing classical patterns due to intervention of modern designers. They are experimenting with the fabric and its motifs these days changing the originality and weavers are just following orders because they have to survive,” said Shahid H Shamim, director, Prabartana, who works on Jamdani and other fabrics. Shamim said one of the main problems with Jamdani is that it cannot be produced cheap as the intricate process of weaving requires a very long time. Price of yarn and colour is always on the rise. The high price of Jamdani discourages many consumers. Besides, after being transformed into half-silk product, it has become very tough to maintain today's Jamdani. Half silk disintegrates easily, washing becomes difficult and at the same time use of silk makes the product even costlier. “When you change the basics then it is no longer a Jamdani. Jamdani had always been cotton based,” Shamim said. The main Jamdani-making belt is now threatened as the river Shitalakhya is encroached and the riverbank is congested with factories and mills. The water, which changed its course over the years for encroachment and many other reasons, is polluted. The area no longer produces the fine Karpash cotton, the wonder behind the magnificent fabric. The survival of Jamdani artisans has become difficult with many inconveniences in their life, which is another reason why Jamdani faces the risk of extinction, Shamim said.Although many non-government organisations, designers and fashion houses are patronising the industry, the artisans still struggle to survive. A good piece of Jamdani sari needs the sweat and labour of around two months but the weavers are often deprived of fare wages and their share of profit as they do not have direct access to market. The marketing system is still controlled by the middlemen, who often form informal cartels. Many artisans are now switching to other occupations for better life. Weavers no longer want their next generation to get involved in the profession that was once so proudly nurtured by their forefathers.According to a survey by Bangladesh Small and Cottage Industries Corporation (BSCIC), now there are only around 5,500 artisans in the Jamdani villages, where once the entire community was associated with Jamdani craftsmanship. “The most gruesome part of this industry is that the loom owners are now using child labour to curtail the cost,” Shamim pointed out. “It is posing a threat to the age-old traditional industry as these children do not belong to original Jamdani artisan family. They come from many surrounding districts,” he added. He alleged that these children have to work as bonded labour for 10 to 12 hours a day. For them it is just another job that helps them survive. “A child from original Jamdani makers' family on the other hand inherits the heritage and has the skill and creativity in their blood,” Shamim noted.