Global HIV/AIDS project E-bulletin

On World AIDS Day 2009, the TUC organized a seminar to highlight and celebrate the role of trade unions in defending the interests and rights of affected colleagues and their communities and explore ways of enhancing their achievements. The theme of World Aids Day 2009 was 'I want to live my rights. The seminar explored the many things that still can be and should be done to ensure that those affected can live their rights in the workplace. The seminar, chaired by Lord Bill Morris, was opened by Kay Carberry, TUC Assistant General Secretary, who detailed the workplace initiatives supported by the TUC in Africa, emphasizing the significance of the ILO Recommendation on HIV/AIDS and the World of Work to be adopted at the ILO Conference in 2010. .

Mike Foster, Parliamentary Under-Secretary of State for International Development, stressed the importance of workplace initiatives in combating HIV/AIDS. The Minister stated that, 'trade unions are the unsung heroes in the global effort to reduce HIV and AIDS.' He also pledged support for the work carried out by the TUC in the fight against the pandemic in Africa. The participants also heard from David Burrow MP, Chair of the All-Party Parliamentary Group(APPG) on HIV/AIDS http://www.appg-aids.org.uk who informed them of the APPG's awareness of the impact of AIDS on developing countries and that it attached great importance to the global efforts at prevention. He pointed to the stigma and discrimination associated with HIV/AIDS and praised the work done by the trade union movement in the fight against it.

Daniel Owusu Boatey, HIV/AIDS Project Co-ordinator at the Ghana Trades Union Congress, made a presentation on the outcomes of a workplace initiative funded by the Bill Morris Testimonial Fund for HIV/AIDS through TUC Aid. Daniel informed the participants that awareness raising at the workplace level, carried out in collaboration with the Timber and Woodworkers' Union (TWU) had been a success. Union officials trained under the Project had taken the message to the shop floor and 1,157 workers attended Voluntary Counselling and Testing (VCT) clinics. He pointed out that 43 workers had tested positive and they had been referred to hospitals for further tests, treatment, care and support. It was found that the prevalence rate among the workers in the timber and forestry sector was found to be higher at 4.3% than the national average of 1.7%.

Dr Syed Asif Altaf, HIV/AIDS Co-ordinator referred to the vulnerability of transport workers throughout the world, explained simple ways of awareness raising and minimising the risks of infection and underlined the importance of the use of condoms.

After the speaker's contributions and questions from the floor, there was a panel discussion conducted by Andy Harvey, Education and Training consultant, Eleanor Briggs, Assistant Director, Policy and Campaigns, National AIDS Trust, Gertrude Hambira, General Secretary, General Agricultural and Plantation Workers Union of Zimbabwe, Nick Sigler, Head, International Relations, UNISON and Simon Dubbins, Head, Internationalal Relations, Unite.

The ITF welcomes the lifting of a long-standing ban that has prevented individuals with HIV/AIDS from entering the US since 1987. The new rule allows people living with HIV/AIDS to enter the US and comes into effect immediately.
 
All people living with HIV face potential obstacles when seeking to travel. Since the beginning of the HIV epidemic, governments and the private sector have implemented travel restrictions with regards to HIV positive people wishing to enter or remain in a country for a short stay (e.g. business, personal visits, tourism) or for longer periods (e.g. asylum, employment, immigration, refugee resettlement, or study). Whatever the reason, HIV-related travel restrictions raise fundamental issues regarding the human rights of non-discrimination and freedom of movement of people living with HIV in today’s highly mobile world. In the year 2000, the World Tourist Organization estimated that there were 698 million international arrivals worldwide. The majority of these people are travelling for short periods of time, e.g. for tourism, business, conferences, family visits. With regard to longer-term mobility, the International Organization for Migration (IOM) estimates that some 175 million migrants currently live and work outside their country of citizenship, i.e., 2.9 per cent of the world’s total population.

HIV/AIDS is of particular concern for ITF unions as transport workers are more vulnerable due to the conditions and nature of their work. The ITF also recognises that workers living with HIV can now lead long and productive working lives. This is why the ITF family has been working to fight stigma and discrimination associated with HIV/AIDS at all levels for a number of years now. The lifting of this ban is a positive step in the right direction and is also in line with internationally recognised guidelines on HIV/AIDS and human rights.

Recently the youth committee of the National Union of Seafarers of India (NUSI) in collaboration with village council organized a HIV AIDS Awareness Campaign at  Nhava Village to generate awareness amongst seafarers, their family members and also the general public.  A large number of members, their families and villagers took part in the programme.

India has a population of one billion, around half of who are adults in the sexually active age group. HIV emerged later in India than it did in many other countries. Infection rates soared throughout the 1990s and since then infection has been reported in all states and union territories. The spread of HIV in India has been uneven. Although much of India has a low rate of infection, certain places have been more affected than others. HIV epidemics are more severe in the southern half of the country and the far northeast. The highest HIV prevalence rates are found in Andhra Pradesh, Maharashtra, Tamil Nadu and Karnataka in the south from where most of the NUSI members come.

The NUSI youth committee members also organized a one-act play underlining the importance of educating the villagers about the deadly disease.  This was a very important part of the exercise to make the awareness programme more effective. NUSI Youth Committee members also carried out banners and charts bearing messages to educate people about preventive measures to prevent the spread of the disease. A visit to families in the nearby areas was also organized to reach out to more people and awareness materials were also distributed among them.

When HIV/AIDS first emerged in 1981, nobody could have predicted how the epidemic would spread across the world and how many millions of lives it would change. Already, in just twenty-seven years more than twenty-five million people have died of AIDS-related diseases. According to the recent UNAIDS report, the epidemic has stabilized globally, albeit at an unacceptably high level, but in many countries the numbers affected continue to rise. Gains have made in access to treatment, especially for pregnant women, but the stark truth is that for every two people who go onto antiretroviral medication five more are newly infected.

World AIDS day gives us the opportunity, each year, first to remember those who've died as a result of AIDS or whose lives have been changed by the disease. Second, it helps us focus on where we are and how we can respond more effectively. The ITF remains committed to action to combat HIV/AIDS in the workplace to help million of its members in their fight against the deadly infection, to ensure a rights-based approach of the interventions, to advocate for strong privacy and confidentiality safeguards and to ensure equitable access to services.

Fourth year running, the ITF is continuing its long-term campaign on HIV/AIDS with a specific focus on challenging stigma and discrimination at workplaces. ITF affiliates all over the world were active during World AIDS day, 2009 and implemented different activities. When we are producing this bulletin, more then 60 affiliates from 27 countries have already sent us reports of their activities. We expect more affiliates will soon send us reports. Following are few of their activities:

Centro de Jefes y Oficiales Maquinistas Navales of Argentina in collaboration with the nautical college organised discussion sessions on HIV/AIDS. They showed ITF documentary, “Highway of Hope” in different workplaces.

Maritime Union of Australia (MUA ) organized rallies across the country. The national youth conference of MUA, which held on December 1-3, 2009 highlight the HIV campaign and also passed a resolution on HIV/AIDS.

Bangladesh Railway Employers League put on ITF posters in workplaces. They produced handbill for distribution among workers. They also published articles in daily newspaper on the importance of dealing HIV/AIDS at workplaces.

ITF affiliates in Barbados organized a seminar for about 80 shop stewards with a focus on stigma and discrimination.

In Belgium, Belgische Transportarbeidersbond (BTB) put on campaign materials in their workplaces. They also organized discussion sessions

ITF affiliates in Botswana have a pool of trainers and they organized education session for workers at workplaces to highlight challenging stigma and discrimination specially HIV positive workers.

Asociacion Nacional de Servidores Publicos del Instituto Nacional de Vias Anseinvias, from Colombia organized discussion session for workers and their families.

Sindicato de Trabajadores por Establecimiento del Aeropuerto Internacional El Salvador de la Comision Ejecutive Portuaria Autonoma (SITEAIES) organized education sessions for members and encouraged them to go for VCT.

Ethiopian Transport and Communication Workers Trade Union Industrial Federation (TCWTUIF) organized a seminar to disseminate survey finding on HIV/AIDS in transport sector. They published special newsletter and organized Video show and experience sharing sessions based on success stories. They also mobilzed  workers for VCT. Women committee of the union were actively involved in the implementation of the activities.  

Ghana General Transport Petroleum and Chemical Workers Union organised a discussion session with employers, government agencies and other relevant stakeholders on the importance of working together in preventing HIV/AIDS infection and provide care and support. They published pamphlets on HIV/AIDS.

Clerical and Commercial Workers Union in Guyana organised special discussion sessions to promote voluntary counselling and testing (VCT) and participated in National week of testing. They will also distribute condoms at work place.

ITF affiliates in India including Adarsho Auto and Taxi Drivers Union, Forward Seamen Union of India; Southern Railway Mazdoor Union (AIRF) organized discussion sessions for workers and family members.  Private Motor Transport Workers Union organized educational activities for members. They put on stall in important public places to distribute awareness materials. Transport and Dockworkers’ union, Mumbai organized awareness function (Skit) for port & dockworkers. They put on ITF posters at work places. Transport and dockworkers union, Kandala organized awareness stall at port premises and railway hospital. They organized health camp for truckers coming to port. N. F.Railway Mazdoor union organized a procession where leaders and members paraded around the railway head quarter.  They also organized a seminar at the union premises on fighting stigma and discrimination.

Kesatuan Pelaut Indonesia(KPI) organised special seminars for outgoing seafarers. They will also put on ITF posters at workplaces.

Kenya Railway Workers Union organised special VCT session to  promote testing and breaking silence. They organized discussion session on fighting stigma.

Namibia Transport and Allied Workers Union and Federation organized seminar in every workplaces where they have membership in collaboration with employers. They published special newsletter.

Nepal Yatayat Mazdoor Sangh conducted education sessions thought out the country. They also put on posters and stickers at different workplaces.

Pakistan Transport Workers Federation in collaboration withy Pakistan Labour Federation (PLF) and of World Asian Workers Organization (WAWO) organised a seminar on the importance of dealing HIV/AIDS at workplaces. 

Youth group of Syndicat National des Travailleurs de la Marine Marchande (SNTMM), Senegal organized discussion sessions and rally to observe the day.

In Sierra Leone, 5 ITF affiliated unions (Seafarers, Dockers, Fishers, Road Transport and Waterfront unions) hold meetings and discussion sessions at the seafarers welfare centre. 

South Africa Transport and Allied Workers Union(SATAWU) in collaboration with employers organized programme to promote VCT and to enrol members into ARV.

National Union of Seafarers Sri Lanka organized advocacy meeting to discuss about the importance of having multisectoral approach to combat HIV/AIDS in maritime sector. They put on ITF posters at workplaces and distribute condoms. 

ITF affiliates in Thailand will put on ITF campaign materials in different workplaces.

Syndicat des Travailleurs du Port Autonome de Lomé (SYNTRAPAL) ITF affiliate in Togo organized awareness campaign on reducing stigma related to HIV/AIDS and other STIs. They organized special VCT session

Tokyo office of the ITF took part in the special HIV/AIDS exhibition organized by the Japan National Trade union centre. They displayed ITF publication/campaign materials on HIV/AIDS. They also organized a photo exhibit of ITF’s affiliates in action for HIV/AIDS activities. 

Ugandan Amalgamated Transport and General Workers Union (ATGWU) organized number of programmes at different wellness centres that they run in partnership with Solidarity Centre and North Star Foundation. 

Marine Transport Workers' Trade Union of Ukraine organized seminar in Maritime academy. They put on ITF campaign materials in port, seafarers centre and other workplaces. 

Zambia bus and taxi Workers Union organized education programme at workplaces.

Created in 2001 by Kofi Annan, the Global Fund, according to many public health experts, is the most innovative, far-reaching, results-driven health financing mechanism in the world. Globally, it provides two-thirds of the external financing for TB and malaria, and a quarter of the financing for HIV/AIDS. During its recent board meeting in Addis Ababa, Ethiopia, the Global Fund to Fight AIDS, Tuberculosis and Malaria approved $2.4 billion for the three diseases for the fund's 9th round of grants, bringing the total amount of approved funding since its inception in 2001 to $18.4 billion for 144 countries. 

The Global Fund Board also announced the launch its next round of grants in May 2010. This round of funding will be considered for approval at a Board meeting to be held some time between November 2010 and January 2011. According to Global Fund Executive Director Michel Kazatchkine “Countries are showing that they are able to effectively turn large amounts of money from donors into prevention, care and treatment of AIDS, TB and malaria, which in turn will save millions of lives.”

The 18^th International AIDS Conference will be held in Vienna, Austria from July 18-23, 2010. “Right Here, Right Now” is the theme of the conference. This theme emphasizes the central importance of protecting and promoting human rights, including the rights of women and girls, as a prerequisite to a successful response to HIV. The right to dignity and self-determination for key affected populations, to equal access to health care and life-saving prevention and treatment programmes, and the right to evidence-based interventions driven by science, rather than politics, are all incorporated in this urgent demand for action. 

Given the 2010 deadline for universal access set by world leaders, AIDS 2010 will coincide with a major push for expanded access to HIV prevention, treatment, care and support. With a global economic crisis threatening to undermine public investments, the conference will help keep HIV on the front burner, and is a chance to demonstrate the importance of continued HIV investments to broader health and development goals. AIDS 2010 is also an opportunity to highlight the critical connection between human rights and HIV; a dialogue begun in earnest in Mexico City in 2008.The selection of the AIDS 2010 host city is a reflection of the central role Vienna has played in bridging Eastern and Western Europe, and will allow for an examination of the epidemic’s impact in Eastern Europe.

The AIDS 2010 programme will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. A variety of session types – from abstract-driven presentations to symposia, bridging sessions and plenaries – will meet the needs of various participants. Other related activities, including the Global Village, satellite meetings, exhibitions and affiliated events, will contribute to an exceptional opportunity for professional development and networking. Following the success of the pilot programme at AIDS 2008, the XVIII International AIDS Conference will provide or facilitate hubs (centres) where selected sessions of the conference will be screened, to increase the access to the conference programme. The conference expects to bring together political and community leaders, scientists, HIV programme managers, trade unionists, media personnel, people living with HIV and other at risk groups from all over the globe for the presentation of important new scientific research and for productive, structured dialogue on the major challenges facing the global response to AIDS.  

During the 17^th International AIDS conference in Mexico City, which was held in August 2008, 40 trade unionists from 20 countries representing the International Trade Union Confederation and the Global Union Federations took part and made a significant contribution to the debate and emphasized the role of workplace-based action in combating HIV/AIDS. They were engaged with international institutions, NGOs and community-based organisations in policy dialogue and explored possibilities of close collaboration with them. The world of work emerged as a major theme at the conference. The Conference highlighted the impact of AIDS on the productive population of some of the world's most vulnerable economies, as well as the need for successful mobilization of the workplace as an entry point for AIDS responses.

This year we expect that a large number of trade unions leaders and activists will also participate in the conference. You can submit your abstract online based on your programme experience by visiting www.aids2010.org. As the conference organizers are committed to making AIDS 2010 accessible, they are offering financial assistance to community groups, marginalized communities, people living with HIV and AIDS globally. We strongly encourage you to apply for a scholarship. You can also submit your application for scholarship by visiting www.aids2010.org. The last date for submission of abstract and scholarship application is 10^th February 2010. The ITF will also try to secure funding from other sources to bring affiliates to Vienna. 

A brand new drop-in centre has been launched on the India-Nepal border, providing truck drivers with essential HIV/AIDS services. The centre, the only health provider in the area, is part of the cross border initiative of the ITF's South Asian HIV project. It is designed to reach out to those working on the 2000 trucks that cross the border every day.

The drivers and their assistants will have access to essential counselling services and information on sexually transmitted infections and HIV/AIDS. Workers at the centre will distribute condoms and refer people who require blood tests or other medical services to a nearby clinic run by the Family Planning Association of Nepal. Meanwhile the ITF-affiliated union and project partner, the Independent Transport Workers’ Association of Nepal, is backing up the centre’s services by providing an information telephone hotline and raising awareness of HIV through outreach work. A women’s health programme will also be initiated in the coming months. The centre’s services are also open to the local community.

Countries in the South and South Asia are facing a very fast growing pandemic. Epidemiologically the region is also important because the rate of HIV infection varies a lot in different countries; in India the total number of positive people is around 3 million, in Nepal the number is 75,000 whereas the total number of positives in other countries like Bangladesh, Sr? Lanka and Pakistan is only a few thousands. A porous border interconnects the countries in South Asia where both legal and illegal migration is high. This means infection can travel very quickly from one country to another.

A strategic combination of private sector know-how and technologies with public sector expertise and funding could lead to improved health and a more efficient AIDS response in West and Central Africa. This was the message from a workshop recently held in Ghana focusing on the role of the private sector in Global Fund processes that brought together 60 companies, 10 national business coalitions tackling HIV and employers federations, as well as trade unions and development partners from all over West and Central Africa. The workshop was organized at the initiative of UNAIDS and with the support of the Global Business Coalition on HIV/AIDS, TB and Malaria (GBC), the Global Fund to Fight AIDS, TB and Malaria (Global Fund), the International Labour Organization (ILO), the German Development Cooperation (GTZ), and Partenaires contre le Sida (PCS).

If we work together to ensure that the resources, know-how, and technologies of the private sector are strategically combined with public sector funding and expertise, we can significantly improve the health and well-being of people in West and Central Africa, and around the world,” said John Tedstrom, GBC’s President and CEO. “By sharing best practices, and collaborating with the Global Fund to ensure that help is delivered to the areas of greatest need, we may finally have the ability to slow down and eventually defeat AIDS, TB and malaria.” During the lively discussions, participants shared ideas and identified opportunities to partner with the Global Fund both as fund recipients, and as co-investors, in order to scale-up community HIV, TB and malaria programmes. Businesses also discussed how to deploy their resources, skills and expertise to support oversight and governance of the Global Fund mechanisms and processes at the local level. Technical support providers described how and where private sector actors could obtain relevant support at each of the various stages of the Global Fund processes.

The Minister of Health of Ghana, Benjamin Kumbuor gave a keynote speech at the event. He highlighted the importance of working hand in hand with the private sector to support the implementation of HIV, TB and malaria programmes, and that Ghana serves as a good example of this. According to the Minister, the momentum seen in his country should extend across the continent and serve as catalyst for greater impact in reducing the social and economic burden of these epidemics. It also means working collectively to yield greater return on investments and more impact on the ground. UNAIDS agrees. “We need smarter investments in the AIDS response, to ensure that we can achieve more with less,” said Léopold Zekeng, UNAIDS Country Coordinator in Ghana. “As long as there are five people newly

infected for every two people starting HIV treatment, we will not change the trajectory of the epidemic. The Global Fund is a strategic and responsive investor in AIDS, and UNAIDS is working in close partnership supporting the Fund’s full grant cycle – from the development of AIDS grant proposals, to programme implementation, to monitoring and evaluation.”

For the first time, scientists say that an investigational vaccine has modest potential for protecting people against HIV infection, the Associated Press reports. “ The vaccine, a combination of two previously unsuccessful vaccines cut the risk of becoming infected with HIV by 31 percent in the world’s largest HIV vaccine trial of more than 16000 volunteers in Thailand.”

The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) are optimistic about the results. The study results, representing significant scientific advance, are the first demonstration that a vaccine can prevent HIV infection in a general adult population and are of great importance. The RV 144 HIV vaccine study results, revealing a 31.2% vaccine efficacy in preventing HIV infections are characterized as modestly proactive. However, these results have intensified new hope in the vaccine research field and promise that a safe and highly effective vaccine may become available for populations throughout the world who are most in need of a vaccine.

Ten years after the first ITF union based pilot project on HIV was started in Uganda, the ITF Road Transport Section held its first international conference in Africa. Since 1999  the section has encouraged unions to set up programmes to educate members and employers. The Section had joined with the International Labour Organisation and the International Road Transport Union (employers’ organization) to develop a training manual for the road transport industry with specific educational materials for employers, managers, unions and workers.

Romano Ojiambo-Ochieng, General Secretary of the Amalgamated Transport and General Workers’ Union of Uganda reported on the development and understanding of unions as to the best methods of educating and supporting their members. Some unions now have protective clauses on HIV/AIDS included in their collective bargaining agreements. Many unions have developed relationships with non-governmental organisations to set up educational programmes. These programmes often include cooperation with railway and docker unions.

The international nature of the pandemic was noted by unions from France, Thailand and Paraguay. ITF was congratulated on its efforts but unfortunately it is reported that there are still parts of the world where unions are not recognising the increasing number of HIV positive people. However in his summary, Eddie Dickson, Assistant Secretary Inland Transport Section noted the positive approach by many unions in confronting the pandemic.

The 9^th Congress on AIDS in the Asia Pacific region, which took place on 9-13 August in Bali Indonesia, brought together more than 3,000 participants from 65 countries including trade union leaders. The International Trade Union Confederation (ITUC) Asia Pacific region, Global Union Federations (GUFs) including the ITF and its affiliates got involved in the conference and actively participated in different plenary sessions, symposiums, workshops, poster presentations and satellite meetings to prevent the spread of HIV/AIDS in an effective and sustainable way.

Under the theme of “ Empowering People, Strengthening Networks”, the Congress envisioned a vibrant community of empowered people, linked by strong networks that reach across Asia and the Pacific and beyond to mobilize a holistic and effective response, based on the latest best practice and scientific evidence, to the specific and cross-border challenges of the HIV epidemic faced by countries in the region.

In the workplace, stigma and discrimination are identified as major barriers for  workers infected with HIV. They are often blamed for their condition, discriminated against in employment and threat with job lose. Trade unions believe that workplace intervention is the key element to deal with HIV/AIDS in the workplace. The intervention can be made in the form of workplace programmes including giving accurate and relevant information on HIV/AIDS and educating workers to understand and reduce the risk of transmission. Such information and training could be integrated into the existing education and human resources policies and programmes as well as occupational safety and anti-discrimination strategies.

ITF took part in a symposium “Reaching clients of sex workers through workplace interventions” organized by the ILO. To reach the drivers of concentrated and low prevalence epidemics in Asia and the Pacific, it is critical to target those groups that are most at risk of acquiring HIV and most affected by the epidemic.  Most-at-risk populations in Asia and the Pacific include men who have sex with men, IDUs, sex workers and their clients.  Sex workers and their clients require HIV prevention, as well as care and treatment services. However, coverage of targeted interventions for sex workers and their clients has been too limited in reach to significantly reduce incidence rates.  Challenges to expand programming include a lack of respect for sex workers' rights, a criminalization of sex work, difficulty in reaching sex workers and their clients, low levels of HIV awareness and poor access to relevant services.During this session, we highlighted the importance of considering HIV/AIDS as a workplace issue because the workplace could be a major “entry point” for information, prevention and support programmes. We emphasised that transport workers are particularly more vulnerable to acquiring and transmitting HIV infection not only because of their behaviour but also due to the nature and conditions of their work. We also highlighted ITF’s work to help transport workers all over the world in preventing future HIV infection and to provide the necessary care and support to the already infected

Migrant workers were the topic of several presentations at ICAAP, ranging from a discussion of how migrants can be safe away from home, to an analysis of how the financial crisis may have an impact on labour migration and HIV. While migration is not a health risk in and of itself, the conditions of the migration process – how a migrant travels, lives, and works – can create specific HIV risks and vulnerabilities. ITF took part in a satellite session organized by the International Organization for Migration (IOM) on HIV and mobile workers in the maritime and transport sectors. Discussion on the recently created Global Partnership on HIV and Mobile Workers in the Maritime Sector received special attention in the session. The Global Partnership is an initiative dedicated to reducing the vulnerability of seafarers to HIV. The group brings together IOM, ITF, the International Committee On Seafarers' Welfare (ICSW), the International Labour Organization (ILO), the International Maritime Health Association (IMHA), the International Shipping Federation (ISF), and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

In the symposium on “ The impact of Financial Crisis on Labour Migration and HIV”,  Christopher Ng, Regional Secretary of UNI APRO gave a presentation on the impact of the crisis on the working conditions of migrants. He explained that the financial crisis has had a great impact. In his presentation he called upon governments to utilize various types of overseas workers funds to assist migrant workers and their families including access to HIV services in the country of origin and country of destination.

It is estimated that a total of 2.5 million people living with HIV in India. Prevalence remains high among sex workers, and is growing among injecting drug users and men who have sex with men. Targeted prevention efforts among sex workers in the southern states have seen some success, but prevention is often complicated by the varied nature of commercial sex and law enforcement. The combination of injecting drug use and paid sex could see increasing numbers of people infected. Interventions for men who have sex with men remain limited.

Only an estimated 10% to 20% of people living with HIV in India know that they have the virus. Many do not know where to get a HIV test. Despite rising infection rates in the general population, the perception remains that HIV is largely restricted to sex workers, truck drivers and injecting drug users. Discriminatory treatment means that many people living with HIV conceal their status and many are deterred from seeking care.

There is an alarming increase in HIV/AIDS cases in West Bengal state. According to the state AIDS prevention and control society (WBSAP&CS), 0.5% of the state population belonging to the age group between 15 years and 49 years are carrying the virus. Welfare for Indian Seamen Everywhere (WISE) a trust run by Forward Seamen Union of India with funding and technical support from the West Bengal state AIDS prevention & Control Society (WBSAP&CS) is implementing a HIV/AIDS prevention and care programme for seafarers and other migrant workers in West Bengal. The main features of their programme include BCC activities like peer outreach, discussion sessions on stigma and discrimination and the importance of being tested and knowing HIV status, street dramas, talk shows in important places, distribution of BCC materials including condoms and referral for voluntary counselling and testing (VCT). If any seafarer reported HIV positive, the union provides them with support. Some of the positive seafarers are working with the union as peer outreach workers.  

More than 4 million people in low- and middle-income countries were receiving antiretroviral therapy (ART) at the close of 2008, representing a 36% increase in one year and a ten-fold increase over five years, according to a new report released recently by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector highlights other gains, including expanded HIV testing and counselling and improved access to services to prevent HIV transmission from mother to child.

"This report shows tremendous progress in the global HIV/AIDS response," said WHO Director-General Margaret Chan. "But we need to do more. At least 5 million people living with HIV still do not have access to life-prolonging treatment and care. Prevention services fail to reach many in need. Governments and international partners must accelerate their efforts to achieve universal access to treatment."

Treatment and Care

Access to antiretroviral therapy continues to expand at a rapid rate. Of the estimated 9.5 million people in need of treatment in 2008 in low- and middle-income countries, 42% had access, up from 33% in 2007. The greatest progress was seen in sub-Saharan Africa, where two-thirds of all HIV infections occur. Prices of the most commonly used antiretroviral drugs have declined significantly in recent years, contributing to wider availability of treatment. The cost of most first-line regimens decreased by 10-40% between 2006 and 2008. However, second-line regimens continue to be expensive.

Despite recent progress, access to treatment services is falling far short of need and the global economic crisis has raised concerns about their sustainability. Many patients are being diagnosed at a late stage of disease progression resulting in delayed initiation of ART and high rates of mortality in the first year of treatment.

Testing and Counselling

Recent data indicate increasing availability of HIV testing and counselling services. In 66 reporting countries, the number of health facilities providing such services increased by about 35% between 2007 and 2008. Testing and counselling services are also being used by an increasing number of people. In 39 countries, the total reported number of HIV tests performed more than doubled between 2007 and 2008.

Ninety-three percent of all countries that reported data across all regions provided free HIV testing through public sector health facilities in 2008. Nevertheless, the majority of those living with HIV remain unaware of their HIV status. Low awareness of personal risk of HIV infection and fear of stigma and discrimination account, in part, for low uptake of testing services.

Women and Children

In 2008, access to HIV services for women and children improved. Approximately 45% of HIV-positive pregnant women received antiretroviral drugs to prevent HIV transmission to their children, up from 35% in 2007. Some 21% of pregnant women in low- and middle-income countries received an HIV test, up from 15% in 2007.

More children are benefiting from paediatric antiretroviral therapy programmes: the number of children under 15 years of age who received ART rose from approximately 198 000 in 2007 to 275 700 in 2008, reaching 38% of those in need.Globally, AIDS remains the leading cause of mortality among women of reproductive age."Although there is increasing emphasis on women and children in the global HIV/AIDS response, the disease continues to have a devastating impact on their health, livelihood and survival," said Ann M. Veneman, UNICEF Executive Director.

Most-At-Risk Populations

In 2008, more data became available on access to HIV services for populations at high risk of HIV infection, including sex workers, men who have sex with men and injecting drug users.While HIV interventions are expanding in some settings, population groups at high risk of HIV infection continue to face technical, legal and sociocultural barriers in accessing health care services."All indications point to the number of people needing treatment rising dramatically over the next few years," said Michel Sidibé, Executive Director of UNAIDS. "Ensuring equitable access will be one of our primary concerns and UNAIDS will continue to act as a voice for the voiceless, ensuring that marginalized groups and people most vulnerable to HIV infection have access to the services that are so vital to their wellbeing and to that of their families and communities

According to data from the Tanzania HIV/AIDS Indicator Survey, the national prevalence among the sexually active populations (between 15 and 49 years of age) is reported to be 7. 0 %. The data shows more women (7.7 %) are infected than men (6.3%). The estimated number of people living with HIV and AIDS is 1.3 million. HIV infection is unevenly distributed across geographic area, gender, age, groups and social economic classes in the country. The percentage of the population infected by HIV ranges from less than three percent across most of the country to more than 44.4 percent in certain sub populations.

In Tanzania, transmission of HIV occurs mainly through heterosexual contact beginning in the early teen years and peaking before the age of 30. Since 1983, when the first three AIDS cases in Tanzania were reported, the HIV epidemic has progressed differently in various population groups. Early in the epidemic, urban populations and communities located along highways were most affected. According to the NACP HIV/AIDS/STD Surveillance Report No.11, 1996, the epidemic has rapidly spread to rural communities and in 1997, more than 10% of women attending antenatal clinics situated in some rural areas have been found to be HIV infected.

Due to an effective response from the government and civil society organizations, the epidemic has started stabilizing in Tanzania. ITF affiliates in Tanzania have been implementing education programmes for their members over a period of time. Recently dockers, rail and road transport unions organized a meeting to formulate a joint action plan. In the meeting, they also decided to work together to develop a workplace policy on HIV/AIDS

HIV infection rates among babies are significantly cut when mothers are given prolonged ARV treatment during breastfeeding, according to findings released at the International AIDS Society conference in Cape Town, South Africa.  The findings from the study showed that a stronger drug cocktail administered over a longer period reduced the risk of mother-to-child HIV transmission compared with the current WHO-recommended short-course ARV regimen.

The results of this study show an almost two-fold reduction in the risk of HIV transmission during the breastfeeding period and also show there is no short-term toxicity (to mothers or infants). The WHO is currently reviewing its 2006 recommendations on the use of ARVs in pregnant women, including during the breastfeeding period. New guidelines are expected to be published by the end of 2009 and will take into account emerging data.

Although Brazil is the epicentre of the HIV/AIDS epidemic in South America and accounts for more then 50 percent of all AIDS cases in Latin America and the Caribbean, Brazil’s response has been seen as a success story. While many countries have struggled to curb the spread of HIV and to care for those with AIDS, working alongside civil society groups, the Brazilian government has made aggressive efforts to minimise the impact of the AIDS epidemic. By the end of 2007, 730,000 Brazilians were living with HIV just over half the number that estimates in the previous decade had predicted.  The AIDS mortality rate has fallen considerably. The single most important element of the Brazilian HIV/AIDS response remains the free and universal provision of antiretroviral drugs (ARVs) starting in December 1996. 

According to a recent report of Health Affairs review, ,  "Brazil has been successful in its nearly 20-year effort to treat people living with HIV/AIDS, and generic ***** have been a large part of the solution."  The review examines Brazil's passing of "a law in the 1990s that guaranteed citizens free and universal access to drugs for HIV and AIDS treatment" as well as the country's production of generic HIV/AIDS ***** in public factories.

According to Amy Nunn, an assistant professor at Brown University and lead author, "Although Brazil's exact model might not be replicated elsewhere, it provides evidence that AIDS treatment is possible in a developing country. Other countries, particularly middle-income countries, have learned much from Brazil’s experience as they now negotiate deep discounts with pharmaceutical companies, benefit from tiered pricing structures, issue compulsory licenses, rely increasingly on generics, work with blossoming civil-society movements, implement new health infrastructure, and provide millions of people with AIDS treatment".

An Argentine maritime union has established a cooperation agreement with a hospital in a bid to raise awareness of HIV and AIDS and to promote the prevention message among seafarers. The ITF-affiliated union, Centro de Jefes y Oficiales Maquinistas Navales has reached an agreement with Muñiz Hospital in Buenos Aires, following an informal collaboration during which two seminars on HIV/AIDS were organised at the end of last year and in April this year. As part of the cooperation agreement doctors and professors based in the hospital will set up further seminars on HIV/AIDS aimed at seafarers to help prevent the spread of the infection.

The union already has a strong record on HIV/AIDS work, recently it successfully negotiated a collective bargaining agreement with ship-owners’ representatives that includes a clause highlighting the need to implement the International Labour Organization code of practice on HIV/AIDS and the world of work and other standards outlined by the Argentine government. The union also plans to produce a film on HIV/AIDS prevention.

Mujica Gustavo Andres from the union said: “Transport can contribute to the spread of epidemics and pandemics. That’s why prevention and education in our sector are fundamental tools in the fight to stamp out disease and deaths. The role of trade unions is fundamental, because a strong and united trade unionism not only improves the social conditions of the workers, but is also an essential factor in preventing the spread of HIV and AIDS.”

The Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have issued a new report on 2008 funding for the global AIDS efforts from the Group of Eight nations, European Commission (EC) and other donor governments. The latest annual report shows that overall commitments in AIDS funding from the developed world totalled US$ 8.7 billion in 2008, up from US$ 6.6 billion the previous year. Disbursements, which reflect actual resources made available in a given year and therefore provide a better measure of resource availability, rose even more rapidly, up 56 percent to reach US$ 7.7 billion in 2008.

Disbursements from the United States totalled US$ 4 billion in 2008, more than half of all disbursements and more than any other single country. The United Kingdom was the second largest donor, followed by the Netherlands, France, Germany, Norway and Sweden. Financing a sufficient and sustained response to the AIDS epidemic in low- and middle-income countries has emerged as one of the world’s greatest health and development challenges. International assistance from donor governments, through bilateral aid and contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as other financing channels, is a critical part of the response. Importantly, while the report provides the latest data available on donor funding, it reflects budgets largely set in place before the acceleration of the current global economic crisis, which may create new challenges to future funding.

Between 2002 and 2008, commitments and disbursements from developed nations each increased by more than five-fold. In 2008, donor governments disbursed US$ 5.7 billion bilaterally and earmarked funds for HIV through multilateral organizations, as well as an additional US$ 1.7 billion to combat HIV through the Global Fund to Fight AIDS, Tuberculosis and Malaria and US$ 265 million to UNITAID. When HIV disbursements are measured as a share of each nation’s gross domestic product, the Netherlands ranks first, followed by the United Kingdom, Ireland, and the United States.

Download the full report Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments in 2008

Malaria and HIV are 2 of the most common infections in sub-Saharan Africa and, to a lesser extent, in other developing countries. According to UNAIDS estimate, 1.9 million people were newly infected with the HIV virus in 2007. And according to the World Health Organization (WHO) about 3.3 billion people, half of the world's population are at risk of malaria. Every year, this leads to about 250 million malaria cases and nearly one million deaths. People living in the poorest countries are the most vulnerable. Malaria is especially a serious problem in Africa, where one in every five-childhood death is due to the effects of the disease. An African child has on average between 1.6 and 5.4 episodes of malaria fever each year. And every 30 seconds a child dies from malaria. The World Health Organization estimates malaria costs Africa $12 billion a year in health expenditures and lost productivity.

Recently popular Senegalese singer Youssou N’Dour initiated a programme to encourage families to sleep under mosquito nets to reduce the transmission of the disease. “You need to pay attention to what the population listens to the most in order to touch them and raise public awareness. We have all had family or friends who have died from malaria." singer-activist Youssou N'Dour told Global Post.  

Music is a powerful educational tool in Africa, where illiteracy levels are low, and the song was set to a lively tune and produced in Wolof, Serere and Pulaar, the three most common languages in Senegal. The song was distributed to radio stations and 1,300 health huts nationwide in the hopes of creating a grassroots education effort.

Botswana a small landlocked country in Southern African is one of Africa’s success stories. Since achieving its independence in 1966, Botswana has experienced dramatic economic growth. The HIV/AIDS epidemic, however, threatens to reverse Botswana’s political and socio-economic gains. In the twenty years since the first case of AIDS in the country was diagnosed, the virus has spread through the population at an astonishing rate. According to the UNAIDS estimate number of people living with HIV in Botswana is  300 000 with prevalence rate of  23.9%, the second highest in the world after Swaziland. Life expectancy at birth fell from 65 years in 1990-1995 to less than 40 years in 2000-2005, a figure about 28 years lower than it would have been without AIDS.  An estimated 95,000 children have lost at least one parent to the epidemic.

The ITF affiliates in Botswana is contributing to the national response to fight the epidemic. Botswana Railway Amalgamated Workers’ Unions is implementing HIV/AIDS programmes at workplaces. They have incorporated HIV/AIDS education into occupational health and safety training where they are promoting VCT to encourage members to know their HIV status as majority of HIV infected workers does not know their status.  The union has started a home-based care programme where union peer educators visit members’ homes to monitor the use of ARV’s. Union HIV/AIDS counsellors are given time off to sensitize the workers at the workplace. They have also initiated joint union/ management fund raising activities for the needy orphans.