Category Archives: HIV & AIDS

Keep up AIDS funding in economic crisis

Msgr Robert Vitillo, Caritas’ special advisor on HIV and AIDS talks to the UN’s Non-Governmental Liaison Committee.

NGLS: CARITAS Internationalis has been engaged in the response to HIV and AIDS since the late 1980s. What have been some of the major difficulties your organization has encountered over the years in this regard? Where has the most progress been made?
Msgr Vitillo: Early challenges faced by Caritas included the fear and denial experienced by many in the Church, governments, and civil society with regard to the reach and impact of HIV. More recently, the denial has given way to “compassion fatigue” and questions about whether or not AIDS should continue to receive such priority attention by the global community.

NGLS: Where and in what manner does CARITAS Internationalis carry out its work in relation to AIDS? How does it engage with other faith‐based networks, or civil society at large?

Msgr Vitillo: The members of Caritas Internationalis are engaged in supporting or sponsoring HIV‐related programmes (of treatment, prevention, care and support) in 116 countries of the world. At the global level, Caritas Internationalis works at capacity‐building of its member organizations to deliver effective, efficient, holistic, integrated, and community-based programmes in response to the pandemic.

NGLS: What is CARITAS Internationalis expecting to come out of the HLM in the long term? What gains need to be made? How can political will be generated and sustained to achieve universal access to care, prevention and treatment for all?

Msgr Vitillo: Caritas is seeking action, not just words as a result of this High‐Level Meeting. Governments have made promises in the past, but they often seem to forget those promises. We must note the “treatment gap” – some 10 million people who need the medications at this time but do not have access to them, and some 800 children who die daily as a result of AIDS‐related illnesses. In democratic countries, political will reflects the concerns expressed by the electorate. Thus we need to sensitize the general public issues to these urgent issues – that is the goal of the Caritas HAART (Highly Active Anti‐Retroviral Therapy) for Children Campaign.

NGLS: In your opinion, what is the most urgent step that needs to be taken by the international community to combat the scourge of HIV and AIDS?

Msgr Vitillo: In my opinion an urgent step is that of sustainability. In the face of the global economic crisis and changing priorities, funds to support ARVs are falling or being flat‐lined.

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Looking back and moving forward on HIV and AIDS

By Rev. Msgr. Robert J. Vitillo, Caritas Internationalis, at the High Level Meeting on AIDS, UN Headquarters

It was not so difficult to wake up early in New York City since the streets there live up to their reputation of “never sleeping” – so I found myself out of my hotel and waiting outside the chain-locked gates of UN headquarters before 7am on 08 June 2011. I wanted to get a “head start” on the cue to register for the UN High Level Meeting on AIDS. Thus I was among the first people processed that day and, with my badge securely fastened around my neck, I proceeded to the section for non-governmental organisation observers, having obtained my ticket for a seat in this section even before 7AM! Then once again, I had to wait for the programme to start at 9AM. As one who enjoys “people watching”, especially in international environments, and well ensconced in my fourth floor balcony seat, I enjoyed observing the arrival of some 3000 delegates to this High Level Meeting, displaying a range of national costumes, business suits, as well as a surprising share of people in casual dress.

UN General  Assembly President called the meeting to order and extended a special welcome to the participants, including  30 Heads of State, He declared, “This High-level Meeting is a unique opportunity to reiterate our collective commitment and to step up our campaign against AIDS,” In fact, the dates of the meeting coincided almost exactly, but some thirty years previously, to the first diagnosis of AIDS among a small group of men in the USA (at that time, we did not yet know that thousands of others, mainly living in Eastern and Central Africa, also were suffering from this disease that destroys the immune systems of those living with it). At the same time, the event was convened to inaugurate the “last stretch” to achieve the pandemic-related Millennium Development Goals by their 2015 target date.

But Mr. Deiss did not limit his encouragement to governments – he also recognized civil society, including non-governmental and faith-based organisations, among the key stakeholders in efforts to eliminate HIV in the future: “I believe that if we are to succeed, it is essential for our actions to be based on a broad partnership in which governments, the private sector and civil society join forces and, together, play a greater governance role in efforts to combat the virus.”

Finally, in keeping with the UN principle of GIPA (Greater Involvement of People Living with AIDS), the UN General Assembly President identified people with firsthand experience of the virus as key stakeholders: “Universal access [to HIV prevention, treatment, care and support] implies social justice and social inclusion. Persons living with the virus must be stakeholders in every aspect of our effort. Their experiences and their stories are essential in developing an effective strategy for combating the epidemic.”

The Secretary General of the United Nations, Mr. Ban Ki-moon outlined a future road map for the global response to AIDS: to lower costs and deliver better programmes; commit to accountability; ensure that HIV responses promote the health, human rights, security and dignity of women and girls; and trigger a “prevention revolution,” harnessing the power of youth and new communications technology to reach the entire world. He maintained, “If we take these five steps, we can stop AIDS. We can end the fear. We can stop the suffering and death it brings. We can get to an AIDS-free world.”

Mr. Michel Sidibé, Executive Director of UNAIDS, began his address by reminding the assembled delegates about the fear and stigmatizing behaviour that was prevalent during the early days of AIDS but that persists to this day in many countries: “People were afraid of each other and there was no hope.  “This image should not disappear.  It is part of our history.”

He reviewed the progress achieved over the years: 6.6 million HIV-infected people have attained access to life-saving and life-extending anti-retroviral medicines; new infection rates have been reduced significantly in 56 countries, including 36 in Africa.

He expressed deep regret, however, that AIDS has become  a “metaphor for inequality,” and noted that 1.8 million people living in developing countries die from AIDS-related illnesses each year; 9 million people are still waiting for treatment; and that, in high-income, a new HIV-free generation is emerging, while, in low-income countries,  millions of babies still are acquiring the virus from their HIV-infected mothers.

In conclusion, he stated emphatically, “We are at a defining moment. It is time to agree on a transformational agenda to end this epidemic,” he said.  That agenda must achieve zero HIV infections, zero discrimination and zero AIDS-related deaths and it must become a reality.”

In additional to myself, other Caritas-related delegates to the UN High Level Session on AIDS include Mr. Joseph C. Donnelly, Head of CI Delegation in New York; as well as Ms. Finola Finnan and Ms. Anne-Marie Coonan, of Trócaire.

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Promoting Action: Caritas HAART for Children Campaign

By Rev. Msgr. Robert J. Vitillo, Head of Delegation to the UN in Geneva and Special Advisor on HIV/AIDS for Caritas Internationalis

Let’s begin with the good news –  of a child who gained access to anti-retroviral treatment (ART) at the Village of Hope, a programme in Tanzania that is assisted by the Vatican’s Bambino Gesù Hospital. However, there are other tragic experiences, too numerous to tell, of children who are diagnosed too late to benefit from such treatment.

Despite World Health Organisation (WHO) recommendations to test all infants with unknown HIV exposure and to start treatment for all HIV-infected infants under 12 months of age, access is still a grave problem in many parts of the world.

For example, in Myanmar, ART is available to only 1/3 of adults who need it, and there are no reliable estimates of infected children, let alone of those who need ART.  In fact, in that country, Caritas and other faith-based organisations (FBOs) still struggle to obtain preventative medications for opportunistic infections.

Pharmaceutical companies deserve recognition for having developed fixed-dose combinations  (FDCs), some of which are available at affordable prices. However, more effort must be placed on developing appropriate affordable formulations for second and third-line treatment regimens.

Caritas partner, Fr. John Toai, of  Vietnam, tells us that that most HIV/TB co-infected children at his Mai Tam Centre are forced to takes 9- 12 tablets per day. Often, these children are unable to eat after taking the medicines. The pills are hard to swallow and several side effects are reported. Some of these children cannot access paediatric dosages. According to Fr. Toai, attempts to cut up pills meant for adult use often result in under- or over-dosing.

In our attempts to simplify medication regimens, we need to address multiple infections, not only HIV … and then there is the need for food.

HIV testing and treatment is vital, but we can no longer maintain a “silo” approach to paediatric HIV care – we need integrated management of HIV, TB, and other opportunistic infections and point of service accessibility of testing and treatment. We also need to assure adequate nutrition and eliminate stigma and discrimination toward children who are living with or affected by HIV.

Access to medicines is a fundamental element of the child’s right to health under article 24 of the Convention on the Rights of the Child.

Caritas believes that governmental and political leaders, private enterprises, and civil society should account to the children of the world on how they  have fulfilled their responsibility to promote and  respect this right. We need to build up a global movement to ensure that all children living with HIV can be diagnosed early and then can be afforded access to the life- saving treatment that they so desperately need in order to live beyond their first or second birthday.

Caritas Internationalis, the Association of Pope John XXIII, and other Catholic Church-related organisations have been encouraging the UN Human Rights Council to adopt more focused and effective advocacy for the child’s right to health.

Caritas HAART for Children Campaign

  • To Scale up PMTCT (Prevention of Mother-to-Child Transmission of HIV
  • To Increase Development and Access of Paediatric Testing for both HIV and TB
  • To Increase Development of Paediatric Treatment for HIV and HIV/TB Co-infection

One way in which Caritas is attempting to fulfil this responsibility to promote Universal Access is through its HAART for Children Campaign that targets pharmaceutical companies, governments, and other policy- and decision-makers to increase development of and access to Paediatric “child-friendly” testing and treatment for HIV and TB.

The goal is to  save the lives of the 800 children who die each day from AIDS-related illnesses and to eliminate mother-to-child transmission of HIV by increasing access to and uptake of effective programmes for mothers who are living with HIV.

Caritas cooperates with the Ecumenical Advocacy Alliance and other faith-based organizations to achieve the goals of this Campaign. At the International AIDS Conference in Vienna, for example, Caritas Austrian delivered 20,000 Campaign signatures to the officials of the Austrian Foreign Ministry.

The Religious Brothers of the Edmund Rice Institute and the International Young Catholic Students have encouraged more than 1,000 students to write letters. Caritas India is training social work students to assess and report on access to child-friendly medicines in local communities.

Whenever I travel to Vietnam, I spend time at Fr. John’s Mai Tam Centre. Many of the children have arrived at the shelter too late to benefit from ART. I have held some of these children when their little bodies were burning with fever and their death was expected imminently.

Now, as a result of early diagnosis and careful treatment with anti-retroviral and TB medicines, the smiles of other children at the shelter give excellent witness to the benefits of HAART for children.

With your help, may our Caritas campaign  be successful in bringing such smiles to the faces of many more HIV-positive children in all parts of the world.

This entry was based on a presentation at “Faith-based Action to Achieve Universal Access” side event at UN High Level Meeting on AIDS 8 June 2011 in New York.

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Caritas co-sponsored event at UN HIV meeting

Caritas Internationalis General Secretariat and Caritas member representatives are attending the United Nations General Assembly High Level Meeting on HIV in New York this week, where they will be part of the launch a policy paper on the need for maintaining funding to tackle the pandemic in the wake the financial crisis.

The meeting, which takes place from June 8th – 10th, will review progress against commitments made in 2001 and 2006.

Although the global community has contributed more than US$32bn to achieve universal access to treatment for all those infected, these targets have not been met, particularly in the poorest countries.

Finola Finnan, Trócaire (Caritas Ireland) Programme Leader for HIV and AIDS and Chair of the Catholic HIV and AIDS Network (CHAN), will stress the need for countries to fulfil commitments already made, while also calling on further long-term commitments to extend treatment and support to the most vulnerable.

The CHAN paper ‘Keeping Commitments for HIV and AIDS: Access for all to Prevention, Treatment, Care and Support’ will be launched on Wednesday, June 8th, at a side-event to be attended by leading figures in the battle against HIV and AIDS, including Dr. Paul De Lay, Deputy Executive Director of UNAIDS.

Read the Catholic HIV and AIDS network position paper (CHAN Advocacy Paper)

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HAART for Children at AIDS conference in Vienna

 

 

On the way to the International AIDS conference centre in Vienna the underground fills up with more and more people, not surprising as there are supposedly 25,000 participants.

Somehow New York, as one of the most multicultural cities I’ve been too, comes into my mind. Today Vienna experiences an even bigger mix of nationalities.

Queuing for the entrance people approach me with a big sign that says “FREE HUG”. Not easy with the photo equipment backpack I am carrying. Tons of hugs are exchanged before the conference on Sunday evening officially starts.

At the conference there is one building for public access called the ‘GLOBAL VILLAGE’. It was supposed to open on Sunday at 5 pm only. But due to strong interest of the general public it had to open at noon.

One of the main topics we hear about at the plenary session that first night, is that the world needs to provide pregnant women living with HIV access to simple, inexpensive medicines that will prevent the transmission of the virus from mother to child.

In Europe and the United States, the rate of infection of children at their birth could be reduced to a mere 1%, while there are still parts of this world where up to one-third of children born to HIV-positive women are themselves infected with the virus.

As child-friendly HIV tests and medication are still missing, up to 50% of those children die before their second birthday.

The development of child-friendly medication is a Caritas concern. For this reason,  the “HAART for Children” campaign was launched in 2009.

An important event organised by CARITAS in the GLOBAL VILLAGE of the conference took place on Monday. So I decide to have a look around the GLOBAL VILLAGE Monday afternoon and to attend to some sessions there.

Many organizations show their activities in the field of HIV and AIDS.

Suddenly a puppet wants to kiss me. I would have loved to see my face at that moment.

 

The No Strings Campaign

 

The puppet belongs to NOSTRINGS – Life-Saving Lessons through the Magic of Puppetry, a programme supported by the Irish Caritas (Trócaire). I decide to watch one of their short films on stigmatisation of people living with HIV and AIDS. The protagonists of the film are puppets and those short films are showed around the world in order to spread information about HIV. Great idea, I can see children love it. Not just children by the way.

Then I attend to a session called: Left at the maternity hospital – Children and HIV in Eastern Europe’ which takes place in the GLOBAL VILLAGE. Caritas specialists from Ukraine and Russia share their experience in working with children affected by HIV/Aids and present challenges and good practices in supporting children having been left after birth or growing up in stigmatized families affected by HIV, dealing with drug addicted parents or living at high risk on the streets. The audience is primarily interested in getting as much information as possible on concrete programmes Caritas is running and good practice.

So, now it’s time to meet some journalists which are going to report on one of the main event of Caritas at the conference in their advocacy for child-friendly medicine.

Different experts such as Ronita Mahilal from South Africa and Rev. Msgr. Robert Vitillo talk about challenges in working with HIV positive children, about  possibilities and limitations in treatment.

Together with young people from Austria, Slovenia and Slovakia, Caritas President Franz Kueberl hands over 21.626 signatures collected by Austrian young people to Irene FreudenschussReichl (Director-General for Development Cooperation, Foreign Ministry, Austria).

Besides good and informative speeches, young people from Vorarlberg – which were strongly involved in getting signatures – dance and present a video, their message is: “HAVE A HAART FOR CHILDREN”

“Now governments and pharmaceutical companies have to show if they have a heart”, one of the participants tells me.

Discussions and events on Tuesday and Wednesday focus a lot on how to make programmes more efficient. Efficiency is one of the big words at the conference, also used by Bill Clinton in his speech.

Another important topic heavily discussed at the conference is flat-lining and reductions of financing of programs.

“For years they told us to upscale medication programs, now they suddenly tell us to downgrade. What they don’t tell us from Global Fund and PEPFA is how to do that. So every day I have to decide whom to give medicine and whom not,” said Fr. Richard Bauer, Director of Catholic AIDS Action of Namibia, which serves more than 14,000  AIDS orphans and many people living with the virus.

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HIV workshops day 2

Participants at a Catholic networking meeting in Vienna before the International Conference on AIDS. Credit Caritas Austria

Today’s group of participants is a little different than on Friday as some more participants have arrived in the meantime. The workshops I manage to attend to are “Ethical issues” and “Children and HIV and AIDS”.

Ethical issues

In this workshop, the presenters examined both the theological principles and values that should serve as the foundation of individual and social decision-making related to approaches to HIV prevention and other programming.

They also examined some of the issues and dilemmas that confront people who are living with or affected by HIV – such as issues of prevention of the sexual spread of HIV, assuring that resources and funding are made available on an equitable basis, regardless of where a person lives or what socio-economic background the person is from.

The special vulnerability of women and children was discussed. Participants debated the difficult challenges of integrating the values and teaching of the Catholic Church with the real-life, everyday situations, especially those over which some people do not have complete control.

Children and HIV and AIDS

In this workshop Caritas Ukraine and Caritas Moscow presenting their work. Many HIV-infections are due to drug abuse.

Some statistics. In 1991 93% of HIV infections in Russia were by drug abuse, nowadays 40% are by sexual transmission.

A big issue in Russia as well as in the Ukraine is stigmatisation and discrimination. Many HIV-infected children are abandoned by their mothers and there is an increasing number of orphans. Orphans, children of drug-abusers and people living with HIV and AIDS are strongly rejected by society.

A lot of the work of Caritas is therefore focused on changing behaviour and enable social integration of orphans. Caritas Moscow works with the staff of state institutions where HIV-infected children are still separated from others.

Caritas Vorarlberg presented their “HAART for children” campaign. This international campaign promotes the development of ‘child friendly’ dosages and formulations of anti-retroviral medication for use with children living with this virus.

There was little time left for discussion but everybody seemed happy to get to know other realities and share experiences.

Summary: A good preparation for the congress that is going to start tonight and a  lot of input for just two days of sessions.

“One of the difficulties of such workshops is that – as always – we get so much input and there is so little time to discuss it”, a participant says.

And, in fact, one often ends up getting the feeling that there is never enough time to share everything and discuss everything. But there is also a feeling that through these networking sessions people get motivated as they see others experiences.

And this gives strength to move on in “fighting” against HIV and AIDS together.

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HIV workshops day 1

Participants at a Catholic networking meeting on HIV prior to the International Summit on AIDS in Vienna. Credit: Caritas Austria

by  Stefan Lechner, Caritas Austria

First of all, as promised in the earlier blog, outcomes of Friday’s sessions are summarised. (Catholic HIV and AIDS specialists met before then in Vienna before the International HIV Conference this week).

Moving from end-of-life-care to promotion of positive living with HIV

Participants in the workshop said that a major challenge is the needs of families affected by HIV or AIDS.

Another topic discussed was that of “positive prevention” – how to prevent further transmission of HIV within couples already experiencing the infection in one or both of partners.

And another problem is that clients might get dependent on the programmes they’re involved with and experience difficulties leaving it, as in many programmes everything is provided for.

Also a challenge is that programmes need to adapt as the situation changes.  With the introduction of antiretroviral therapy people have better prospects of life and programming should focus on that.

HIV and Addiction

In the workshop focusing on “HIV and Addiction”, medical and non-medical treatments were discussed. A key theme was that, in the absence of a conscious choice by a person to abandon the use of drugs, other measures are unlikely to work.

“Especially young people are very likely to get addicted,” said Dr. Dimitrov Ivaylo from Bulgaria. “As they consider themselves different from others. And often end up in the vicious circle of addiction.”

Very different approaches and experiences were discussed by the group (for example in relation to the issue to substitution therapy).

Spirituality and Pastoral Care

In this workshop possible approaches to capacity-building for clergy (including bishops), religious, and other pastoral agents were discussed, as well as participative approaches to such training.

Participants stressed the importance of listening, as every beneficiary has individual needs. It is important to be sensitive to the death experience, but it also is important to focus on survivors.

Work is challenging for people affected by HIV but also for those who work with them and care-givers often are at risk of burnout. It is important for all – persons living with or affected by HIV as well as care-givers to pay attention to their own needs. And not simply to wait for God to provide a solution for each and every human challenge.

An interesting general point was made by a participant from Mozambique. In some projects, “people celebrate every time some kind of support is not needed anymore”.

I take advantage of a break to also get some information on Rwanda. As there are many people everywhere we decide to have a walk in the garden of Kardinal Koenig Haus. We find a nice and calm place and sit down.

Dr. Kanani Prince Bosco starts telling me about Rwanda’s specific situation: “In Rwanda there are not only a lot of orphans because of HIV and AIDS, there are also a lot of orphans from the Genocide in 1994 (find the full interview in another blog).

Suddenly, we notice that a small animal is sitting close to us it seems as it is listening.

Quite surprised I ask Dr. Kanani Prince Bosco if he knows that animal. He replies that he had never seen something similar. I tell him: “That is a fox. Apparently a tame one.” A very unusual sight in the middle of Vienna.

As the fox is gone I ask him about his expectations for the congress he tells me: “My expectation is to get information and exchange best practices. See good programs that have shown success. We all have something to learn.

We all have something to share. It’s a good opportunity to learn and share.”

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