Maps of Malaria Hotspots to Save Lives

30 September 2014

Major Progress in Malaria Fight

Malaria is one of the world’s biggest killers. In 2010, an estimated 660,000 people lost their lives to the disease – most of them children in Africa, where a child dies from malaria every minute.

Until recently, however, it was difficult to access information about the locations of Africa’s malarial hotspots or how they are influenced by the weather there. Information about the continent’s malaria distribution was scattered across published and unpublished documents, often gathering dust in libraries.

But now, thanks to a digitised malaria mapping database that brings together all available malaria data, the disease no longer has the ‘blind killer’ status of past decades. MARA – Mapping Malaria Risk in Africa – was launched in 1996, with initial support of US$10,000 from the WHO’s Special Programme for Research and Training in Tropical Diseases to map information on malaria prevalence across Africa. The project’s first phase (1997-1998) aimed to produce an accurate atlas of malaria risk for Sub-Saharan Africa.

The project was set up as a pan-African enterprise, not owned by any specific organisation but coordinated by South Africa’s Medical Research Council, in the spirit of open collaboration.

A group of scientists, based at institutions across Africa and Europe, worked together on the project. Further funding came from donors including Canada’s International Development Research Centre, the Wellcome Trust, TDR and the Multilateral Initiative on Malaria (MIM), and the Roll Back Malaria Partnership. African institutions contributed through expertise, staff time and facilities.

Five regional centres – each using a standardised data collection system, were established across Africa. French-speaking West had an office in Bamako, Mali, while English-speaking West had a base in Navrongo, Ghana. Yaoundé, Cameroon hosted the Central Africa office; Nairobi, Kenya hosted the East Africa post and Durban in South Africa became home to the Southern Africa centre.

The project built expertise among local malaria control staff to enable them to reference the collected data, and it trained epidemiologists, medical doctors and researchers. In total it trained: 33 people to use GIS (geographic information systems) and databases, 23 to study climate change effects on the spread of the disease and 45 to interpret the results for people who might want to use them. Eight people got master’s degrees and PhDs on malaria.

The mapping project tracked down information on malaria prevalence from both published and unpublished sources to identify malarial mosquito hotspots, disease prevalence and the weather conditions that fuel transmission.

The MARA database contains more than 13,000 malaria prevalence surveys collected over 12,000 locations: with 37 per cent in Southern Africa, 33 per cent in West Africa, 25 per cent in East Africa and five per cent in Central Africa. The data remains live but no new material is being added.

The project then disseminated this information to national and international policymakers, distributing 3,000 poster-sized malaria distribution maps to malaria control programmes, health departments and research institutions in malaria endemic countries.

Whereas previously the absence of centralised records had made choosing appropriate solutions very difficult, the new data systems help countries identify transmission periods, implement control programmes and tailor control measures according to individual contexts – which also saves valuable resources. Rajendra Maharaj, director of the Malaria Research Unit at South Africa’s Medical Research Council, says the project has a strong legacy in the support it provides for the planning of malaria control programmes.

Konstantina Boutsika, an epidemiology and public health researcher from the Swiss Tropical and Public Health Institute (Swiss TPH), in Basel, Switzerland, where the database is now hosted, says the original maps are still available as downloads from the MARA website, as is a CD-rom developed by South Africa’s Medical Research Council to enable easy access to MARA project data.

Boutsika, who has been at MARA’s helm from 2006, says a project highlight is the first accurate assessment of the malaria burden in Africa, which has been made possible by advances in geographical modelling. “We can now give useful answers with regards to malaria,” she says.

MARA has made its results available through the technical reports published regularly on its website in both English and French.

The programme’s main beneficiaries have been identified as scientists, malaria control programme staff and local communities.

Maharaj says the scheme helps alleviate disease and death, especially in children and pregnant women, and has contributed to the efforts to reach the sixth Millennium Development Goal on combating HIV/AIDS, malaria and other diseases.

MARA was also one of 700 projects – selected for their exemplification of practical solutions to challenges – presented at the EXPO2000 world fair in Hanover, Germany. The programme owes its success to its strong team of investigators from participating organisations, Maharaj says: “The big lesson was inter-country collaboration, which is essential for malaria control”.

It has not all been smooth sailing, however. The main challenge was the collection of non-digitised data, explains Maharaj.

“But this was overcome by teamwork, whereby malariologists from all walks of life worked within ministries, academic and scientific institutions to source data that was stored in archive boxes, university libraries and government storerooms,” he says. And Boutsika adds that obtaining funding to sustain the programme was difficult because harmonising various databases required a heavy investment.

When funding for research ran dry in 2006, the project was given a new lease of life by the Bill & Melinda Gates Foundation and Swiss TPH, and moved from Durban to Basel, where phase II was launched. In 2009, the software team at Swiss TPH merged the MARA databases from phases I and II and developed a new web interface.

Since then, the MARA database has been in the public domain accessible to registered users and can be downloaded in different formats. Boutsika says researchers individually continue to collect data in Africa and use the MARA database as a sounding board.

[Courtesy AllAfrica News]

Liberia: Ebola Hits Family – Personal Stories

International news reports about Liberia leave the impression of overwhelming irrationality in response to the Ebola crisis. It’s true that fear has provoked unfortunate incidents. But many Liberians are working hard and courageously – despite the lack of an international response that would supply the equipment and medical help to stem the virus.

Ebola hit close to home – hard – this month. Two members of my church – one a nun and the other a social worker who had been under 21-day quarantine and observation – both died.

My cousin Enid, an emergency nurse with the health ministry, was under surveillance as well, after coming into contact with an Ebola patient. She was assigned to Kakata, a densely populated trading town in Margibi County, where several health workers had already died and health facilities didn’t have enough personal protective supplies. Our family was worried about her.

Now, she, too, has died. On her Facebook page a few weeks ago, she posted, “Ebola has hit Margibi again. More health workers are being affected this round 2 and some are even dying. Oh God have mercy.” Our family and friends will remember that she caught the virus trying to save others. Rest In Peace, Enid.

But personal losses aren’t stopping Liberians from trying to help ourselves and each other. Whatever you hear about the situation, you should know that people may be frightened, but most of us are working hard to stop the virus.

Ebola has become a household word. When the first case was reported in the northern Lofa area in late March, the chief medical officer, Dr. Bernice Dahn, warned that “the disease is reported to be spreading along the border” Liberia shares with Guinea and Sierra Leone.

Almost every Liberian citizen now knows what Ebola is. Many believe that the virus is real and are taking preventive measures, while others are in denial. But these people who are denying the existence of the Ebola virus in the country still follow the preventive measures, which baffles me.

“I don’t understand some Liberians”, said one of my friends, Derek Berlic. When I asked him why, he said, “Some people go around saying that the virus isn’t real, but yet still they join us and wash their hands and use sanitizers as frequently as those of us that believe that the virus is real.” He said it pleases him when he sees these individuals taking preventive measures, because it signals that somewhere in these people minds, they believe the virus is real, even if they don’t want to admit it.

Most churches have joined the fight against Ebola by carrying on awareness campaigns, talking about it during sermons and placing buckets of water at entrances of the church buildings for members to wash their hands before entering for service. Both Christian and Muslim religious leaders have called on all Liberians to pray for the country – and, at the same time, to take their own preventive measures.

Supermarkets, shops and other business centers are following suit. The three mobile phone companies in Liberia have been using SMS to sensitive their subscribers by sending daily text messages about the virus. Across cities and towns, Liberians have organized themselves in various communities and are promoting awareness.

It seems that almost every Liberian has now become his or her ‘brother’s keeper’ by carrying on sensitization in taxis, clubs, and market places – wherever they find themselves. On Facebook, many Liberians have made their profile pictures Ebola related and their statuses feature awareness messages on a daily basis. Liberian groups on Facebook discuss the situation.

Liberians in the diaspora have organized themselves into mini-groups to send aid, such as gloves and other personal protective equipment, back home to fight this deadly disease. The Liberian ambassador in Washington DC, Jeremiah Sulunteh, announced that the embassy had established an account for those who want to donate.

The alarmingly high death rate from the Ebola virus among health workers has left citizens wondering how they will get medical care for many common illnesses, which can be deadly also, such as malaria. Bodies of suspected Ebola victims being left in the streets or in houses adds to the anxiety.

In this situation, it’s hard to prevent suspicion and misinformation. There were stories of some individuals going around putting dangerous chemicals such as formaldehyde in wells in various communities. The result is that Liberians had to worry about poisonous chemicals being put into water sources as well as about the Ebola virus; but Police Director Col. Chris Massaqoui has since denounced the rumor. He said the police found no evidence that the stories were true.

The president of Liberia, Madam Ellen Johnson Sirleaf, has addressed the nation multiple times, including announcing a three-month state of emergency. She said, “Under the State of Emergency, the Government will institute extraordinary measures, including, if need be, the suspension of certain rights and privileges.”

The government has passed a regulation for only three persons to sit in the back of a taxi to avoid close contact, but even at that, one can’t possibly avoid touching or rubbing against other passengers. On a daily basis, securing transport is a rush-and-fighting thing, which involves considerable contact with other people who are also trying to get a taxi or bus. In my case, the trip to work usually takes two different commercial vehicles. So movement from place to place has become worrisome. Still, people have no choice but to do it.

And there are positive things every Liberian can do. So this is how I spent my weekend. With the organization Girls As Partners, I managed to reach out to ten different churches in the Gardnersville area of Monrovia, giving them buckets, chlorine and soap so their members could adhere to one of the Ebola preventive measures – washing hands. We also gave out leaflets containing facts about Ebola and its prevention.

We’re in the rainy season now, and we had to walk through small rivers to get to some churches, but it was really fun reaching out to others. Would you believe someone was brave enough to ask me whether I had a political motive for doing this? Nevertheless, I say let’s all be our brothers’ and sisters’ keepers and kick Ebola out of Liberia!

[Courtesy AllAfrica News]

Pakistan: Unsafe drinking water causes disability among children worldwide

9 April 2014 KARACHI:

Toxically germ-infested unsafe drinking water is causing different form of disability among children globally, mainly caused by teratogens. 

The excessive use of medication and consuming polluted water results in the development of abnormal cell tissue in unborn as well as newly born babies particularly during foetal growth, yielding a multiplex of physiochemical defects in the foetus. Improper and untreated disposal of sanitary water and untreated industrial waste is resulting in contamination of sub soil water threatening the nature. 

Principal Investigators of South Asian Association for Regional Cooperation (SAARC) Sector’s Academic Alliance for Subsoil Water Toxicity Research Initiative Prof Qadhi Aurangzeb Al Hafi and Pro-Vice Chancellor of Dow University of Health Sciences (DUHS) Prof M Umar Farooq were of the view this was the first time Pakistani researchers’ study has been recognised at United Nations (UN) and Pakistan takes the historic edge of launching the first ever model of Terato-kinetc Research in the recorded history of medical sciences.The groundbreaking research document has been primed for over 1,700 international esteemed universities of the globe, in accordance with the UN mandates and conventions on the subject. 

The first categorical research model was demonstrated at Higher Education Commission (HEC) Pakistan in continuum of the multi academia polygonal scientific colloquia the UN ‘International Observance Day for Disability’, at Dow University of Health Sciences Karachi followed by its academic sessions and scientific symposia at Punjab University and Higher Education Commission of Pakistan. The multi-academic colloquia consist of 9 scientific orientations, 17 confluences, 10 symposia and 19 demonstrations worldwide. 

[Courtesy of Daily Time]

YAOUNDÉ, 26 March 2014 (IRIN) – Three new polio cases have been confirmed in Cameroon over the past two weeks, making it the country’s first outbreak since 2011 and causing alarm among health officials who link the virus’s spread to weak vaccine campaign coverage and displacement following violence in neighbouring northeastern Nigeria and the Central African Republic (CAR).
Cameroon has confirmed seven polio cases since 2013. Just one case is enough to instigate emergency country-wide vaccination measures under the national health policy. It last experienced a polio outbreak in 2009, the strain also identified in Nigeria and Chad.

The World Health Organization (WHO) has said the virus is at a “very high risk” of crossing borders, and one polio case of the same strain as in Cameroon has just been confirmed in Equatorial Guinea, which saw its last case in 1999.

Cameroon has put in place emergency measures to try to contain the virus, but weak or non-existent monitoring in the cross-border areas with Nigeria and CAR is seriously hampering any national efforts, said Paul Onambelle, a doctor at the Cité Vert district hospital in Yaoundé.

The estimated 100,000 refugees in Cameroon who have fled violence in Nigeriaand CAR make control efforts even harder, said Elisse Clarisse Onambany of the National Expanded Program on Immunization (EPI), who insists refugee children must be included in any immunization campaign, “which means the supply and resources needed must increase”, she said. Half of the refugee population is made up of children aged 11 or under, according to the health authorities.

Immunization in the Far North Region has been extended to include some of the children in the Nigerian refugee population, but thousands of children are still not being accessed because of insecurity in the border area with Nigeria, families being continually on the move, and difficult terrain, said Maria Enjema, a nurse at Far North district hospital of Maroua. “Despite continuous effort by the government to reduce the risk of polio in the north, it is very difficult for health workers to reach all the children, particularly those living along the borders with Nigeria because of the high risk [of Boko Haram-related violence] involved,” she told IRIN.

Meanwhile, ongoing polio campaigns have not always successfully reached the 90 percent of children (aged 0-5 years) needed to eliminate the disease. Some 43 percent of children in Cameroon have not received the three doses required for immunity, and 30 percent have never been vaccinated, said health officials.

The government and partners issue regular polio campaigns for children aged 0-5 in the three northern regions: Far North, North and Adamawa, where the risk of infection is high, but cultural resistance in these areas has limited campaign efforts, said Onambany. “People have different beliefs when it comes to maternal care. Some communities with various religious standpoints on the vaccine say the body is sacred and does not need any chemical to feel better, while some Cameroonians see it as some sort of a public plot.”

Onambany said lack of resources also limited ongoing polio campaign coverage.

Many parents do not understand or believe that three oral vaccinations are required and so they drop out after the first or second round.

Loveline Penda, a mother of five in Yaoundé, told IRIN: “The numbers of vaccines keep increasing and I doubt sometimes what the difference will be if my child does not take a vaccine. Sometimes I miss out but I don’t have to worry because I just believe that my child will be fine.”

The government must take cultural resistance and lack of understanding more seriously and “work to change people’s opinions and knowledge [on polio],” said Idris Haman, a researcher at the University of Yaoundé.


Cameroon health officials are expanding the region-specific immunization campaign nationwide in April, May and June 2014, with the help of partners, said Onambany.

The National EPI will also soon launch an intensive awareness-raising campaign about the vaccination.

“The upcoming campaigns will ensure that the quality of campaign is improved by reaching children three times. We will also intensify communication and sensitization effort so that no family is left untold of the dangers of missing out vaccinations,” Onambany told IRIN.

Over recent years the government has stepped up its surveillance and response to polio, working through networks of trained staff in district hospitals, as well as with community-based monitoring networks and NGO partners. Without support from development partners like WHO and the UN Children’s Fund (UNICEF), containment issues would be lagging far behind, said the EPI.

But unless surveillance steps up across borders, the risk that the polio virus could continue to spread remains a top concern, said Onambelle.

[Courtesy of IRIN Africa]

Mental Health in Africa

As African countries strive to meet the UN Millennium Development Goals (MDGs) by 2015 and plot a new development agenda thereafter, health experts are gathering evidence across the continent to make a case for a greater focus on its millions of mentally ill.

Experts say investing in mental health treatment for African countries would bolster development across the continent, but national health priorities have been overtaken by the existing MDG structure, which has specific targets for diseases like malaria and HIV, placing them higher on countries’ agendas than other health issues.

“Everyone is putting their money in HIV, reproductive health, malaria,” says Sheila Ndyanabangi, director of mental health at Uganda’s Ministry of Health. “They need also to remember these unfunded priorities like mental health are cross-cutting, and are also affecting the performance of those other programmes like HIV and the rest.”

Global experts celebrated the passing of a World Health Assembly action plan on World Mental Health Day in May, calling it a landmark step in addressing a staggering global disparity: The World Health Organization (WHO) estimates 75-85 percent of people with severe mental disorders receive no treatment in low- and middle-income countries, compared to 35-50 percent in high-income countries. The action plan outlines four broad targets, for member states to: update their policies and laws on mental health; integrate mental health care into community-based settings; integrate awareness and prevention of mental health disorders; and strengthen evidence-based research.

In order for the plan to be implemented, both governments and donors will need to increase their focus on mental health issues. As it stands, the US Agency for International Development (USAID), the world’s biggest bilateral donor, will only support mental health if it is under another MDG health priority such as HIV/AIDS. Meanwhile, mental health receives on average 1 percent of health budgets in sub-Saharan Africa despite the WHO estimate that it carries 13 percent of the global burden of disease.

“Mental health hasn’t found its way into the core programmes [in developing countries], so the NGOs continue to rely on scraping together funds to be able to respond,” Harry Minas, a psychiatrist on the WHO International Expert Panel on Mental Health and Substance Abuse and director of the expert coalition Movement for Global Mental Health, told IRIN. “Unless we collectively do something much more effective about NCDs [non-communicable diseases], national economies are going to be bankrupted by the health budgets.”

According to a May report from the UN Secretary-General’s High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, the MDGs have overseen the fastest reduction of poverty in human history. Yet it also acknowledges that they have done little to reach the world’s most vulnerable. The report says the MDGs were “silent on the devastating effects of conflict and violence on development” and focused too heavily on individual programmes instead of collaborating between sectors, resulting in a largely disjointed approach to health. Experts say without a more holistic approach to global health in the new development era, the world’s most vulnerable will only be trapped in that cycle.

“The MDGs were essentially a set of vertical programmes which were essentially in competition with each other for resources and for attention,” said Minas. “We’ve gone beyond that, and now understand we’re dealing with complex systems, where all of the important issues are very closely interrelated.”

Poverty and Mental Illness

In Africa, where many countries are dealing with current or recent emergencies, WHO sees opportunities to build better mental health care.

“The surge of aid [that usually follows an emergency]combined with sudden, focused attention on the mental health of the population, creates unparalleled opportunities to transform mental health care for the long term,” say the authors of the report Building Back Better: Sustainable Mental Health Care after Emergencies, released earlier this month.

In a study published in the Journal of Affective Disorders in July, researchers in northern Uganda – which, starting in the late 1980s suffered a two-decade long war between the government and the rebel Lords’ Resistance Army – monitored the impact of group counselling on vulnerable groups such as victims of sexual and domestic violence, HIV-infected populations, and former abductees of the civil war. It found that those groups who engaged in group counselling were able to return and function markedly faster than those who did not receive counselling, while reducing their risks of developing long-term psychiatric conditions.

“We need to be mentally healthy to get out of poverty,” Ethel Mpungu, the study’s lead researcher, told IRIN.

The link between mental illness and persisting poverty is being made the world over. According to a 2011 World Economic Forum report, NCDs will cost the global economy more than US$30 trillion by 2030, with mental health conditions alone costing an additional $16 trillion over the same time span.

“It really is around issues of development and economics – those things can no longer be ignored,” says Minas. “They are now so clear that ministries of health all around the place are starting to think about how they are going to develop their mental health programmes.”

Putting mental health on the agenda 

As mental health legislation is hard to come by in most African countries, Uganda is ahead of most on the continent with its comprehensive National Policy on Mental, Neurological and Substance Use Services, drafted in 2010. The bill would update its colonial era Mental Treatment Act, which has not been revised since 1964, and bring the country in line with international standards, but is still waiting to be reviewed by cabinet and be voted into law.

Uganda is also part of a consortium of research institutions and health ministries (alongside Ethiopia, India, Nepal and South Africa) leading the developing world on mental health care. PRIME - the programme for improving mental health care – was formed in 2011 to support the scale-up of mental health services in developing countries, and is currently running a series of pilot projects to measure their impact on primary healthcare systems in low-income settings.

Research shows that low- and middle-income countries can successfully provide mental health services at a lower cost through, among other strategies, easing detection and diagnosis procedures, the use of non-specialist health workers and the integration of mental healthcare into primary healthcare systems.

Although a number of projects have shown success in working with existing government structures to ultimately integrate mental health into primary health care, the scaling up of such initiatives is being hindered by a lack of investment, as the funding of African health systems is still largely seen through donor priorities, which have been focused elsewhere.

“Billions of philanthropic dollars are being spent on things like HIV/AIDS or water or malaria,” said Liz Alderman, co-founder of the Peter C. Alderman Foundation (PCAF), which works with survivors of terrorism and mass violence. “But if people don’t care whether they live or die, they’re not going to be able to take advantage of these things that are offered.”

[Courtesy of IRIN]

Africa:Major Progress in Fight Against Malaria

24 December 2013
Geneva/ Washington DC — Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally and by 49% in Africa, according to the World Malaria Report 2013 published by the World Health Organization (WHO).

An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa.

The large majority of the 3.3 million lives saved between 2000 and 2012 were in the ten countries with the highest malaria burden, and among children aged less than five years – the group most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54%.

“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” says Dr Margaret Chan, WHO Director-General. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century.”

In 2012, there were an estimated 207 million cases of malaria, which caused approximately 627 000 malaria deaths. An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80% of malaria cases occur in Africa.

Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.

In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50% in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.

There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.

Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.

Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies – recommended for infants, children under five and pregnant women – has also been slow in recent years.

“To win the fight against malaria we must get the means to prevent and treat the disease to every family who needs it,” says Raymond G Chambers, the United Nations Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria. “Our collective efforts are not only ending the needless suffering of millions, but are helping families thrive and adding billions of dollars to economies that nations can use in other ways.”

International funding for malaria control increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012. Domestic funding stood at around US$0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to US$ 2.5 billion in 2012 – less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.

Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in four countries in south-east Asia, and insecticide resistance has been found in at least 64 countries.

“The remarkable gains against malaria are still fragile,” says Dr Robert Newman, Director of the WHO Global Malaria Programme. “In the next 10-15 years, the world will need innovative tools and technologies, as well as new strategic approaches to sustain and accelerate progress.”

WHO is currently developing a global technical strategy for malaria control and elimination for the 2016-2025 period, as well as a global plan to control and eliminate Plasmodium vivax malaria. Prevalent primarily in Asia and South America, P. vivax malaria is less likely than P. falciparum to result in severe malaria or death, but it generally responds more slowly to control efforts. Globally, about 9% of the estimated malaria cases are due to P. vivax, although the proportion outside the African continent is 50%.

“The vote of confidence shown by donors last week at the replenishment conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria is testimony to the success of global partnership. But we must fill the annual gap of US$ 2.6 billion to achieve universal coverage and prevent malaria deaths,” said Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “This is our historic opportunity to defeat malaria.”

[Courtesy AllAfrica News]

Draconian Law setback for Uganda’s HIV response

Kampala, 23 December 2013 (IRIN) -
The draconian Anti-Homosexuality Bill passed by Uganda’s parliament on 20 December would deliver a major blow to the response to HIV/AIDS if it was enacted by President Yoweri Museveni, activists have warned.
Those found guilty of homosexual acts can be jailed for up to 14 years under the new law, a sentence that increases to life in “aggravated” cases, such as those committed by an HIV positive person, or those involving minors, the disabled and serious offenders.

Civil society activists fear that high-risk groups such as men who have sex with men (MSM) and sex workers – whose HIV prevalence is 13.7 and 33 percent respectively – will see their already limited access to prevention and treatment further eroded.

Amnesty International called the law “a grave assault on human rights [which] makes a mockery of the Ugandan constitution.

“President Museveni should avoid the trap of scapegoating a vulnerable minority in the interests of short-term political gain,” said Daniel Bekele, Africa director at Human Rights Watch.

“He should recognize that this repugnant bill is of no benefit to Ugandans – that it only serves to jeopardize basic rights – and reject it.”

The United States government has also called for the bill not to be enacted.

Here is a selection of reactions from those working on the front-line of the response to HIV/AIDS:

Pepe Julian Onziema, programme director, Sexual Minorities Uganda (SMUG), a local rights group

“It’s with deep disappointment that I receive the news of the Anti-Homosexuality Bill passing in our Parliament.”

“If the bill is assented to, the Act would spell a major setback for Uganda’s gains against HIV/AIDS as it will compromise doctor-patient confidentiality, which will push affected LGBTI (lesbian, gay, bisexual, transgender and intersex) persons further underground for fear of prosecution.”

Asia Russell, Director of International Policy, Health GAP

“This harmful and blatantly unconstitutional bill will deal a devastating blow to evidence-based efforts to end the AIDS epidemic in Uganda – a country that is almost unique among aast and southern African countries in that it has rising rates of new HIV infections. Why? Because existing criminalization provisions have meant prevention and treatment services aren’t reaching populations like MSM, who have much higher HIV prevalence.”

“Under this new bill, providing those services would now be illegal – we will see new infections continue to rise as populations get excluded further and further from life-saving treatment, prevention, information and support.”

Milly Katana, veteran activist and board members of the Global Fund to Fight HIV, Tuberculosis and Malaria

“Totally disheartening! It is one of those moments where as a country we move one step forward in realizing civil liberties and public health common sense, [then] we take 10 steps back.”

“The little achievements of the Ministry of Health starting to think of making services available to people who are most at risk of contracting HIV are put in total jeopardy. I hope the president, who has announced himself as a champion for HIV prevention by encouraging Ugandans to test for HIV and knowing their status, will see the non-wisdom in this Act and not assent to it.”

Alice Kayongo, Regional Policy and Advocacy Manager, AIDS Healthcare Foundation – Uganda Cares

“The effects of this (bill) will be felt in almost all sectors but most especially in the health sector and particularly for HIV/AIDS where over 80 percent of the AIDS response is funded externally.”

“Even with amendments, the proposed law will have an impact on the quality of healthcare and health education to be provided to gay people living with HIV for the fact that treating someone or providing them with HIV related information will be seen as a promotion act, yielding to imprisonment. While there have been indications of forward movement in this country’s AIDS response, we are at risk of losing so much of what we have gained in the recent past.”

“Evidently, with such developments in the political and legal environments, Uganda is miles away from attaining [the UN-backed target of] zero new HIV infections, zero AIDS-related deaths and zero discrimination. It will not be a surprise if Uganda’s prevalence rate stagnates around 7.3 percent in 2017. However, we still have some hope, His Excellency President Yoweri Kaguta Museveni should reject the passing of this bill into law and everything else will fall into place.”

Flavia Kyomukama, director of the Global Coalition on Women and HIV/AIDS in Uganda

“At a time when the country is trying to implement the national HIV prevention strategy that has underscored the sex workers and MSM as key in the reduction of the epidemic, the legislature thinks it’s a waste of time to have these people access services.”

“A mother, a teacher, a health worker, an employer is by obligation expected to report any LGBT within 72 hours of notice and confirmation that someone is LGBT.”

“How do I report my son? As a teacher how do I report my student who comes to me in confidence? And as a health aide how do I abuse the confidence of the patient? All of us are going to be imprisoned.”
“If the proponents of the bill claim homosexuality is a mental disorder, is it logical to [give] life imprisonment? The [logical] approach would be counseling and treatment.”

And here are some reactions from champions of the new legislation:

Simon Lokodo, Uganda’s state minister for ethics and integrity

“This bill is going to cater for the lacuna which has been existing in the current law and legal frameworks in Uganda concerning this unnatural act. Having passed this bill, a lot has been done to protect our children and innocent victims who would be lured into these western cultures and behaviours, which are totally unacceptable to us.”

“The law is going to condemn any recruitment, promotion and financing of the activities related to these malpractices.”

“On the threats from donors and development to withdraw their financial assistance over this bill, we don’t care and are not bothered at all. We prefer to lose that money than our culture and people.”

“We have an obligation as a sovereign state to protect our people against this unnatural act.

Michael Lulume Bayiga, shadow health minister

“I am happy and excited this bill was passed. We are waiting for the president to assent to it in order for it to become a law. I am particularly happy with the provision that bans the promotion of this cult (homosexuality). This provision will ensure this act will doesn’t take root in our country.”

“No health worker asks patients whenever they seek treatment from a health facility about their sexual orientation, unless he/her chooses to do so. For all the years I practiced medicine, I have never known any sexual orientation of my patients. There is no discrimination in the health service provision.”

[Courtesy of IRIN]