Lanka Plus commemorates World AIDS day

President of Lanka Plus T. W.Princey Mangalika pins the Red Ribbon to Dr. Ananda Samarakoon on World AIDS Day

Lanka Plus, is the only registered HIV/AIDS positive people's forum of Sri Lanka, has commemorated for the first time in its thirteen years of story the World AIDS day at the Jinaratna Technical College in Hunupitiya, Colombo 02 at dusk on World AIDS Day.. Stigma and discrimination are still very strong in the country where the lack of awareness and accurate information is one of the main risks for the spreading of the epidemic.

"We would have liked to have commemorated the AIDS day much earlier, but people living with HIV and AIDS (PLWHA) in Sri Lanka can't still speak up and share their experiences", affirmed T.W. Princey Mangalika, President of Lanka Plus, during the event.

More than 70 people joined Lanka Plus members during the event. UNAIDS, UNDP, ILO, National HIV/AIDS control programme and ActionAid, members of their Advisory Board, supported this first gathering

During the event, Lanka Plus presented an appeal to the Government of Sri Lanka, which aims "to share, not to challenge the on going HIV response in Sri Lanka, but to make it more effective and adequate for all citizens, particularly for the families who are infected and affected from the virus".

National Youth Services Council street drama group staged a drama on HIV/AIDS- Fight the Fear

Lanka Plus paid tribute to Late Dr. Kamalika Abeyratne, who is the founder President of Lanka Plus.

Candles are lit to remember the loved ones, who died of AIDS

There are 151 deaths reported so far due to AIDS related diseases in Sri Lanka according to STD (Sexually Transmitted Diseases) clinics

Walk for AIDS

People who care for HIV/AIDS affected persons in Sri Lanka, gathered in front of the STD (Sexually Transmitted Diseases) clinic on De Saram Road in Colombo 10 to show their solidarity on World AIDS Day

World AIDS Day was commemorated in Sri Lanka on December 1st 2006. Ministry of Health organized a "Walk for AIDS" along with the Sri Lanka Red Cross Society. People, who care and are concerned for the People Living With HIV/AIDS (PLWHAs) took part in the walk. And school students participated in the walk with solidarity -"Stop AIDS: Keep The Promise".

"We have to create more awareness about HIV/AIDS. We should make a behavioural change in our society to prevent HIV/AIDS. All should contribute to stop the spread of HIV/AIDS. It's our duty to act responsibly" says a student of Hindu College in Mutuwal, Subramaniam Sajikaran (15)

A large number of school students participated in the "Walk for AIDS" in Colombo

"AIDS is a deadly disease. We have to be very careful in our behaviours. We all should act together to fight the fear. A lot of people are not aware of the mode of infection. We should break the myths and misconceptions about the mode of getting infected with HIV" says a student of St.Peter's College, Negombo Ganguly Nadeesha (15)

Discrimination kills faster than AIDS itself

"AIDS is a social disease. People Living With HIV/AIDS should not be discriminated. We all should treat them as fellow humanbeings. They should be given equal chances in the society" says Dharmila Haridev (20) a nursing student from Negombo.

815 people are infected with HIV in Sri Lanka

"The youngsters have to be educated on HIV/AIDS. They should take the lead in guiding the rest in the society. It's our responsibility. We have to keep the promise" says a student of Hindu College in Muttuwal, Manisekaram Mahandas (16)

19th World AIDS Day was commemorated on December 1st 2006. This year's theme was "Accountability"

26 children are infected with HIV in Sri Lanka according to the Ministry of Health

Stop AIDS. Keep the Promise

“The smallest effort is not lost. Each wavelet on the ocean tost AIDS in the ebb-tide or the flow; each rain-drop makes some floweret blow; each struggle lessens human woe.” - Charles Mackay: 1814-1889, Scottish Poet, Song Writer

“In the 25 years since the first case was reported, AIDS has changed the world. It has killed 25 million people, infected 40 million more. It has become the world’s leading cause of death among both men and women aged 15- 59. It has inflicted the single greatest reversal in the history of human development. In other words, it has become the greatest challenge of our generation” says the Secretary –General of the United Nations, Kofi Annan in his World AIDS Day message.

World AIDS Day was introduced by the World Health Organization on December 01 st in 1988. This was the first time that attention around the world was focused for one day in the year on AIDS. It provided a unique opportunity to highlight the seriousness of the epidemic. Since 1988 the World AIDS Day is being observed on December 01st annually. The theme for this year’s World AIDS Days is Accountability. The theme was developed by the World AIDS Campaign support team based on their work towards the World AIDS Day, and the outcomes of the London HIV and AIDS Campaigning and Advocacy meeting in February 2005.

By now more than 65 million people have been infected with HIV according to World AIDS Campaign of UNAIDS. At this rate World Health Organization predicts that in the next 25 years another 117 million people will die, making AIDS the third leading cause of death worldwide.

UNAIDS estimates that it will take US$ 20-23 million per year by 2010 to support rapidly scaled-up AIDS response in low, and middle income countries alone. In 200 the heads of state made a promise to halt and begin to reverse the spread of AIDS by 2015.

“Stop AIDS. Keep the Promise.’ is a tagline that will be maintained at least until the end of 2015. And for now World AIDS Day each year will have different variations of the theme whilst keeping the tagline ‘Stop AIDS. Keep the Promise.’ The World promised to stop AIDS by 2015. What will you do? The millennium Development Goal on AIDS is to halt and begin to reverse the spread of the epidemic by 2015. To achieve this, promises and commitments have been made by individuals, communities and nations.

The spread of HIV is quickening with more people infected in 2006 than in any previous year. Everyday 8,000 people die of AIDS-related diseases.15-24 year-olds accounted for 40% of the 4.3 million new infections this year, and two thirds of these are young women.

According to the latest figures published on November 21st 2006, by UNAIDS/WHO AIDS Epidemic Update, an estimated 39.5 million people are living with HIV. There were 4.3 million new infections in 2006 with 2.8 million (65%) of these occurring in sub-Saharan Africa and important increases in Eastern Europe, and Central Asia, where there are some indications that infection rates have risen by 50% since 2004. In 2006, 2.9 million people died of AIDS-related illnesses.

An estimated 8.6 million (6.0 million-13.0 million) people were living with HIV in Asia in 2006, including 960,000 (640,000- 2.5 million) who became newly infected in the past year. Approximately 630,000 (430,000- 900,000) died from AIDS-related illnesses in 2006. The number of people receiving antiretroviral therapy has increased more than threefold since 2003, and reached an estimated 235,000 (180,000- 290,000) by June 2006. This represents about 16% of the total number of people in need of antiretroviral treatment in Asia, according to the UNAIDS/WHO AIDS Epidemic Update December 2006.Only Thailand has succeeded in providing treatment to at least to 50% of people needing it according to UNAIDS/WHO 2006.

“Though the world has made progress in expanding HIV/Aids treatment to adults, children have been left behind. Only one in 10 children who needs treatment is getting it,” Bill Clinton former US President and the head of the Clinton Foundation said in his speech at the Delhi hospital. He was in India recently to launch the federal government’s national programme to treat children with HIV The Clinton Foundation was et up in 2002 to provide technical and financial help to poorer countries struggling to stop the spread of HIV/AIDS around the world. Since its inception, The Clinton Foundation HIV/AIDS Initiative (CHAI) has helped bring AIDS care and treatment to over 415,000 people living with HIV/AIDS in the world. The Clinton Foundation HIV/AIDS Initiative (CHAI) has negotiated with pharmaceutical companies to make HIV/AIDS treatment cheaper for children in developing countries.

UNAIDS Scaling up towards universal access: Progress in Asia and the Pacific, October 2006 states that UNAIDS is working with the government and civil society to revisit the targets already set and to make them ambitious and realistic. The process of target setting is ongoing and is expected to be completed by the end of 2006 in most countries . Bangladesh, Indonesia, China, Laos, Vietnam, Myanmar, and Sri Lanka are categorized as countries which are slow but moving.

Keeping the Promise? Sri Lanka

In Sri Lanka so far 815 HIV positives have been reported up to September 2006. 151 deaths have been reported up to now. 26 children have been reported to have infected with HIV. They all got infected through their mothers. HIV surveillance is conducted annually by the National STD/AIDS Control Programme (NSACP). However the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates the actual number of People Living With HIV/AIDS (PLWHA) to be 5,000 (3,000-8,300), and classifies Sri Lanka as a low-prevalence country with an adult prevalence rate of less than 0.1 percent.

95% of HIV transmission is through unprotected sex. 3% of HIV is transmitted through mother to child, 1% through blood transfusion, and 1% through by drug users injecting drugs, the rest of the drug users inhales drugs. Although no formal studies have been carried out, Sri Lanka has an estimated 30,000 drug users according to Panos Global AIDS Programme in July 2006.

Anti Retro Viral Treatment (ARV) began in latter part of 2004. World Bank strengthened the national response. From December 1 st 2004, 82 beneficiaries started to receive free Anti Retro Viral Treatment (ARV). 213 people have developed AIDS.

According to Panos Global AIDS Programme in July 2006, the World Bank is the major donor to the National HIV/AIDS Prevention Programme (NHAPP) in Sri Lanka and a grant of US$ 12.5 million (Sri Lankan Rupees 1,250 million) was made available for HIV/AIDS activities for the period 2003-2008. Of this sum, US$ 11.5 million (Sri Lankan Rupees 1,150 million) was allocated for prevention activities, and US$ 1 million (Sri Lankan Rupees 100 million) for treatment. Although the World Bank project was approved in 2003, funds were released only in 2005. According to the National Strategic Plan for Prevention and Control of HIV/AIDS (the Strategic Plan), a budget of US$ 11,588,000 was needed for HIV/AIDS by the Ministry Of Health (MOH) for the 2002-2006 period. Of this the government was to contribute US$ 3.6 million (Sri Lankan Rupees 360 million), the private sector US $ 620,000 (Sri Lankan Rupees 62 million), and Non- Governmental Organizations US$ 145,000 (Sri Lankan Rupees 14.5 million). The Ministry Of Health is currently preparing the next Strategic Plan for the period 2007-2011. The Strategic Plan consists of three technical units for prevention, care and surveillance.

There are currently 26 STD clinics (Sexually Transmitted Diseases) in the Island. There is no consultant venerologists at the Jaffna Teaching Hospital, and the STD clinic lack adequate testing facilities, and no privacy for the persons. The accumulated number of People Living With HIV/AIDS (PLWHA’s) is 38, while people living with HIV is 16 to date. There are more women than men living with HIV/AIDS. Out of these, two are children. The first case of HIV positive was detected in 1993 in Jaffna.

“HIV/AIDS is like landmines. We have to be very careful. Sri Lanka is a low-prevalence country compare to African countries, where the prevalence rate is 30%-40%. When the prevalence rate is low, people do not make a note of it until it becomes a threat. There is no compulsory testing for HIV/AIDS in Sri Lanka. It’s voluntary testing, except for the people who go abroad for employments are tested for HIV/AIDS. The treatment is free of charge in Sri Lanka. It’s an incentive. More work to be done to create awareness on HIV/AIDS” said the Minister for Health at a press conference in Colombo recently.

World leaders still failing to deliver on funding for HIV/AIDS says ActionAid

“Rich countries are in a danger of making mockery for their own commitment to fight this” said Aditi Sharma Head of the HIV/AIDS team at ActionAid in a press release to mark the World AIDS Day.

She further states that , “We cannot allow leaders to abandon the fight against AIDS as if it were some passing fashion. More than a year after world leaders committed to access there is still no funding plan to finance this goal.

We must not allow prejudice and ignorance to diminish HIV/AIDS prevention efforts. Governments must allocate significant funds to back rhetoric on promoting women’s rights and the cost of treatment must be cut. And preventative healthcare needs to be accessible to halt the needless death of millions of people. While there is now some recognition that the fight against AIDS will not be won unless gender inequity and violence against women and girls are targeted., there is no government or donor around the world committing adequate funds or implementing programmes needed to advance the sexual and reproductive rights of women, and reduce their vulnerability.”

The funding gap is still US$ 10 million a year and only billion a year and only 20% of people living with the virus are receiving treatment. Across Asia, one in six people are receiving treatment while in India treatment remains at below 10% of need. But worldwide, only 20% of all young women understand how to prevent transmission.

Africa continues to bear the brunt of the epidemic with 72% of global deaths caused by the virus, according to UNAIDS Report on the global AIDS epidemic 2006.

Red Ribbon

According to the UNAIDS website, the Red Ribbon symbolizes the AIDS awareness. In 1988 a group called Visual AIDS was founded by arts professionals as a response to the effects of AIDS on the arts community and as a way of organizing artists, arts institution, and arts audiences towards direct action on AIDS.

Three years later, in 1991, some of the Visual AIDS artists came together to design a visual symbol to demonstrate compassion for people living with HIV and their care givers. Inspired by the yellow ribbons honoring American soldiers serving in the Gulf war, the artists chose to create a red ribbon to symbolize support and solidarity for people living with HIV and to remember those who have died from AIDS-related illnesses. The colour red was chosen for its, “connection to blood and the idea of passion — not only anger, but love, like a valentine,” the Project founders say. The project was to become known as the Red Ribbon Project.

The symbol came to Europe on a mass scale on Easter Monday in 1992, when more than 100,000 red ribbons were distributed during the Freddie Mercury AIDS Awareness Tribute Concert at Wembley stadium. More than one billion people in more than 70 countries worldwide watched the show on television. Throughout the nineties many celebrities wore red ribbons, encouraged by Princess Diana’s high profile support for AIDS.

By mobilizing the visual arts communities , Visual AIDS raises money to provide direct services to artists living with HIV/AIDS.

Today the Red Ribbon has become an international symbol of solidarity and support for people living with HIV. Wearing a red ribbon is a simple and powerful way to challenge the stigma and prejudice surrounding AIDS .Wear yours with pride this World AIDS Day. Wear a Red Ribbon and show that, you care for them.

Dr. Kamalika Abeyratne: Tireless campaigner for HIV/AIDS awareness

Dr. Kamalika Abeyratne campaigned tirelessly to create awareness about HIV/AIDS, and stood for the rights of People Living With HIV/AIDS (PLWHA’s) in Sri Lanka. She campaigned vigorously against stigma and discrimination faced by People Living With HIV/AIDS (PLWHA’s). Further she advocated to make the drugs free of charge for the People Living With HIV/AIDS (PLWHA’s) in Sri Lanka. Under the circumstances the pediatrician Dr. Kamalika Abeyratne was subjected to HIV infection

We have gone to the top of information technological revolution. But the fear of the deadly disease is staggering. Though the rate of AIDS, which is due to the HIV infection, is much less in Sri Lanka, yet many are unable to get rid of the fear of the disease. Those who are infected with HIV do not like to reveal it. If revealed many fear there would be no treatment for it and would be ostracized from the society.

A National award was conferred on Late Dr. Kamalika Abeyartne by the former President Mrs. Chandrika Bandaranaike Kumaratunga in 2005.Dr.Kamalika Abeyratne was honoured by the then President Mrs. Chandrika Bandaranaike Kumaratunga for the medical service, she rendered to the society on the International Women’s Day in 2000.She was hounoured with an award by AIDS Coalition for Care, Education, and Support Services (ACCESS) in 1999, for her dedicated service to create awareness about HIV/AIDS in Sri Lanka. And Zonta Club recognized her with an award in 2000.

Late Dr. Kamalika Abeyratne’s father was a well known Professor George Wickramasuriya. She was a role model for the People Living With HIV/AIDS. She was a cheerful soul with a charming smile always.

Dr. Kamalika Abeyratne passed away on December 10th 2004.

The following intervie was published in Sunday Thinakkual of June 03 rd 2001. It’s been reproduced here to pay tribute to Late Dr.Kamalika Abeyratne on World AIDS Day, which falls on December 01st 2006:

Q: How are you helping those who are infected with HIV/AIDS?

A: Due to the social structure, one who is infected with HIV is relevant to get the blood test done, or fear to tell, or hesitate to tell outside that he or she is infected to HIV. Under these circumstances it is difficult to tell exactly how many are infected with this virus. Yet you have to say that HIV is fast spreading. During the last several years, one who is infected with HIV infection there is no sign of AIDS liable to spread it to others. So it is a very dangerous disease.

Further more, one who is infected with HIV has to reveal that he or she is infected with HIV. If he or she accepts and says that he or she is infected with HIV, then we can help him or her.

In the meantime, some of those who were in Sahara House, the non governmental organization in New Delhi, the capital of India, called us on telephone and asked us to collect all information about those who were affected by HIV/AIDS. We told them to contact the Mind and Heart centre and get all the information. About 10 -15 of them contacted us. We asked them to come on a particular date to a particular place. We expected them and made all arrangements to meet them. But out of those who contacted us on phone not a single person turned up. This is very unfortunate. It is very regrettable and disappointing. Under these circumstance how can we help them?

Q:How do you compare the HIV/AIDS status in Sri Lanka with our neighbouring countries in the region?

A:When we look at our neighboring countries, our country is the one that is the least affected by HIV/AIDS spreading rate in the region. But in countries like India and Philippines, those who are affected by infectious disease get together and form organization to improve their conditions. But in our country there is no cooperation to our efforts. In the school syllabus, the health education regarding reproduction be included forth withy. We do not like to have a healthy discussion about sex, or sexuality in our society.

During the international conference held in Chennai, in India, some mantras shouted saying “Where are the protective sheaths?”, “We have not been supplied with productive sheaths”, “We do not have sufficient productive sheaths”. This matter is being talked about freely to this extent in India. They are also taking measure to prevent HIV/AIDS.

An Irish woman who owns a small industry, has given worth opportunities to those who are infected with HIV –Aids. These girls attend school and study. They are also given opportunity to earn. It has to be mentioned that the bags made by these girls are being sold in a big shop, that sells attractive things like “Body shop” you can also see “sex is fun, but stay with one” printed in those bags.

Q:How are you treated by the society?

A:It is very unfortunate that I got an infectious disease like HIV.This is very unfortunate and vexatious. Because of my love for children I started practicing as a pediatrician from the time I passed out in 1959, from the medical college. I started practicing in the historic city of Anuradhapura, and Gampaha. From 1968 I worked for two decades at the Lady Ridgeway Hospital in Colombo. Further from 1980 my husband Michael who is also a pediatrician, and I were attending to the medical needs of the needy people in the remote villages in Sri Lanka. After some years we went to Saudi Arabia and served for five years at King Fahd Specialist Hospital in Al Gassim, Saudi Arabia from 1990-1994 and worked as a Senior Consultant Pediatrician, and returned to serve in the country.

In 1995 when we were going to Tangalle to serve the medical needs for “Nawajeevana”, the home based rehabilitation programme for the handicapped, we met with a fatal car accident. Due to the serious injuries, which left Dr. Kamalika Abeyratne with HIV positive after a blood transfusion at Karapitiya Hospital. The blood belonged to one who was infected with HIV due to this I was also infected with HIV. It was the beginning of the end of my life.

The President of Sri Lanka Mrs. Chandrika Bandaranaike Kumaramatunga has taken action to supply me with the necessary medicine for five years. I am very much obliged to her. She ordered a helicopter to bring us back from Tangalle to Colombo. But due to the bad weather the helicopter could not land in Tangalle. We came to Koggala airstrip, and from there we were flown to Colombo.

The news started to spread like wild fire immediately, when I was found HIV positive. Thus started our trauma. The nursing homes refused to admit me, except Asiri Nursing Home, and Oasis Nuring Home later. Then I went to London for further treatment.

I had my family’s fullest support and care with love along with my friends, and colleagues. But other People Living With HIV/AIDS (PLWHA’s) have to undergo more trauma than I have gone through. Because our social set up is such. They have to face stigma and discrimination, which lead to several problems. The society is not in anyway uniting them or comforting them. We should take care of People Living With HIV/AIDS (PLWHA’s) without any discrimination. We should treat them as equal citizens of the country.

Appeal to the Government of Sri Lanka from Lanka Plus

Lanka Plus, the only registered HIV/AIDS positive people’s forum of Sri Lanka wants to address the Government of Sri Lanka and all other key stake holders including UN, on World AIDS Day 2006.

We want them to listen with care and patience what some of the people living with HIV and AIDS (PLWHA) in Sri Lanka have experienced in the last 10 years time. We, the members of Lanka Plus believe that PLWHA should speak out and share their experiences and learning and make some recommendations on existing HIV and AIDS response programmes. Our intention it to share, not to challenge the on going HIV response in Sri Lanka, but to make it more effective and adequate for all citizens, particularly for the families who are infected and affected from the virus, to lead a normal life with dignity in an environment secured our human rights by all civilians.

Situation of positive people in Sri Lanka

Since inception of Lanka Plus we have come across lots of challenges like denial of our fundamental human rights due to stigma and discrimination attached to the causes of transmission of the virus. We faced this situation because of lots of misunderstanding due to lack of information and misconceptions about the disease, disseminated at the initial stage which still exist today.

However, after almost 10 years of our struggle to survive as an independent organization, working for the benefit of the PLWHA, we have gathered lots of experiential learning which is exclusively by people living with HIV/AIDS. And we would like to share our key concerns and make some recommendations to all key stake holders of National HIV/AIDS response programme, which we believe it will help us all to initiate a consulted effort to develop a long term sustainable HIV/AIDS response.

Lessons learnt from the past

One of the very first challenges we faced from the very beginning was access to treatment and ARV was not available at that time. We are very thankful to our Government that they are now providing ARV free of cost.

However the service is not adequate in terms of number of hospitals and clinics established. At present, only one hospital (IDH) in Colombo city has treatment facilities. But CD4 and other testing facilities are not available there. Not all staffs working in the Hospital are sensitized to serve the PLWHA.

Therefore our first appeal is to extend the services at least in other three major hospitals around Colombo and provincial hospitals as well. So that, more people can get access to free treatment.

HIV is not only transmitted through sex. Non-sex activities (blood transfusion, use of contaminated injecting syringe, use of non sterile surgical instruments in the hospitals, mother to child transmission, etc.) also play important role as mode of transmission. Therefore to remove stigma attached to HIV and AIDS and to make the service accessible to all section of people, we strongly recommend separation of HIV treatment from STI clinics. We firmly believe that an independent service unit in a hospital setup (like any other unit) would help to de-stigmatize HIV and AIDS make the service accessible to all.

The treatment literacy and access to information for the PLWHA is still not at very satisfactory level. Therefore we would like to draw the attention of the National HIV/AIDS campaign on increasing the awareness level on the treatment literacy and have a better follow up and monitoring system to see the progress of the treatments.

Though the medicine is free, but treatment related other costs are not covered that eventually increases family expenditure that happen because large number of positive people leave outside Colombo city. To get free medicine they travel to Colombo city from different provinces. Some times they had to stay in Colombo two to tree days. In those cases they pay for their travel, accommodation and food. There are tests that also cost money.

Therefore we would like to propose the Government conduct a need assessment towards developing a comprehensive treatment package which should make provisions of covering costs related all kind of tests, treatment for opportunistic infections, travels and accommodation, nutrition, alternative food for the positive babies.

Otherwise the present free ARV programme would become a burden for positive people and their families. At the same time we would request to increase existing facilities in other district/ teaching hospitals (at least one in one district) to get access to the ARV and other treatment related services.

In addition to the above mentioned medical related facilities hospices could be established further for the terminally ill patients who need care and support. We believe the Government/Ministry of Health should extend their support on realising this dream as an extension of the Government commitment for the HIV/AIDS.

The treatment guideline

To avoid treatment hazards a proper treatment guide line needs to develop for Sri Lanka. Proper implementation and monitoring can only avoid the risks of toxicity, growing drug resistance and side effects and maintain treatment ethics. We therefore propose to appoint a committee for developing a treatment guideline which is very necessary to protect lives of PLWHAs.

There are evidences that in different countries human trials of AIDS medicine are taking place. In most of the cases people are not informed about the trial, no protection of volunteers are in this kind of trials, if goes wrong. Therefore we would like to make an appeal Government of Sri Lanka that any such trials ever happen in Sri Lanka should properly informed and rights of the people should be properly protected.

To develop a cadre of trained professionals in HIV/AIDS response programme, we would suggests HIV/AIDS should be a part of the medical curriculum for the final year medical students and they should be given a complete practical training in treating positive patients for universal access.

Although the Sri Lankan Health service adopting WHO guidelines on medical ethics we humbly request the Sri Lankan Government and the Ministry of Health to appoint a special committee to draft a special guidelines for the medical professionals in dealing with the Positive patients and promotion of the implementation of the guidelines at all medical and health institutions.

Pre and Post adequate counseling for newly identified Positive people and the family members

There is no mandatory pre and post counseling for HIV testing. Therefore people are scared about testing. This is another concern we are having. We need proper counseling for the PLWHA through Government health system through well trained counselors.

Prevention and care support

Stigma is still attached to HIV and AIDS related message in the media, such as, “you don’t get HIV/AIDS if you don’t engage in elicit relationship” and “life will be flowery and rosy until you get HIV/AIDS”. Those posters and stickers should be removed from public places. The National HIV/AIDS program should focus on the messages to give the written/correct information on how to get prevented from the disease and how to treat the PLWHA as a social responsibility. Therefore the social security network for the PLWHA under the presidential secretariat could be established to prevent all the discriminations and ill treatments faced by PLWHA.

Greater Involvement of People living with AIDS

We can not see this in practice at a greater level. Now after we re-organized our Lanka Plus forum we are getting more opportunities to raise our concerns at various forums, with the support and the direction of the Advisory Board Representatives of Lanka Plus. The sensitivity of the employers on the HIV/AIDS is not at all satisfactory and the newly identified positive people are being discriminated from their rights to employment. Nor agencies interested in employing positive persons. Participation at all levels should be ensured by proper implementation of ” greater involvement of people living with HIV/AIDS (GIPA)” principles.

Through our observation and review of present HIV/AIDS policy in Sri Lanka, we would like to make following recommendations for developing a better-coordinated, comprehensive and sustainable HIV and AIDS National policy for 2007- 2010:

National AIDS Council should be activated to provide policy guidance and regularly review the progress of national response;

HIV should be considered as a development and human rights issue in which health (treatment) is an important component along with other components like prevention (awareness), care and support. Therefore, to have proper reflection of 2006 Political Declaration to set an ambitious but achievable National targets on three programmatic areas i.e., prevention, treatment, care and support.

A National HIV/AIDS Commission should be set up for policy implementation, programme monitoring and inter agency coordination. Commission should be set up at President’s office and directly report to the Honorable President who is also the Chief Patron of the National HIV/AIDS Council.

To comply with “three ones” policy, following arrangements should be made in the strategy. All funds should be placed in one basket from all sources for allocation against national intervention plan.

In solidarity,

T.W. Princey Mangalika
President of Lanka Plus

[Full Text of Press Release - Lanka Plus]

"Responding to the Challenge of STIs and AIDS"

"It is bad enough that people are dying of AIDS, but no one should die of ignorance"- Elizabeth Taylor –American Actress

According to the latest figures published on November 21st 2006, by UNAIDS/WHO AIDS Epidemic Update, an estimated 39.5 million people are living with HIV. There were 4.3 million new infections in 2006 with 2.8 million (65%) of these occurring in sub-Saharan Africa and important increases in Eastern Europe, and Central Asia, where there are some indications that infection rates have risen by 50% since 2004. In 2006, 2.9 million people died of AIDS-related illnesses.

An estimated 8.6 million (6.0 million-13.0 million) people were living with HIV in Asia in 2006, including 960,000 (640,000- 2.5 million) who became newly infected in the past year. Approximately 630,000 (430,000- 900,000) died from AIDS-related illnesses in 2006. The number of people receiving antiretroviral therapy has increased more than threefold since 2003, and reached an estimated 235,000 (180,000- 290,000) by June 2006. This represents about 16% of the total number of people in need of antiretroviral treatment in Asia, according to the UNAIDS/WHO AIDS Epidemic Update December 2006.Only Thailand has succeeded in providing treatment to at least to 50% of people needing it according to UNAIDS/WHO 2006.

"Poverty and war are the biggest factors for HIV/AIDS in the developing countries. If a country is poorer or facing a war situation, it is inevitable that HIV/AIDS spread faster in this country than other countries. Poverty and war lead the developing countries to be more vulnerable" says Dr. Veerakathy Harindra FRCP, FRCP (Glasg) Clinical Director, Department of Genito Urinary Medicine, St. Mary's Hospital, Portsmouth, United Kingdom.

He delivered speeches on "Responding to the Challenge of STIs and AIDS", and "Advances in HIV prevention" at the annual scientific session of the College of Venerologists of Sri Lanka in October 2006.

The following are the excerpts of an interview with Dr. Veerakathy Harindra FRCP, FRCP (Glasg) Clinical Director, Department of Genito Urinary Medicine, St. Mary's Hospital, Portsmouth, United Kingdom:

Q: How do you compare the HIV/AIDS situation now with twenty five years ago?

A: Twenty five years into the global HIV/AIDS epidemic HIV infection rates are alarmingly high. The rate of new HIV infections continues to climb every year, with an estimated 4.9 million people having been infected during 2004. There is no "magic bullet" for HIV prevention. None of the new prevention methods currently being tested is likely to be 100% effective and all will need to be used in combination with existing approaches. Greater access to existing HIV prevention tools could avert half of the new infections projected to occur over the next decade.

A wide range of HIV prevention approaches are available. Behaviour therapy, condom use, voluntary HIV testing and treatment of sexually transmitted infections are proven methods of HIV prevention. A number of promising HIV prevention approaches are in late stage clinical trials.

Male circumcision:
Countries with higher rates of male circumcision have lower rates of HIV infection. The first randomised trial in South Africa showed that circumcised men were 60% less likely to become infected with HIV compared to uncircumcised men. Removal of HIV target cells from the foreskin, keratinisation of skin surface and reduction of STIs are the key factors associated with this reduction. Further 3 trials are on going in Kenya and Uganda.

Microbicides:
Microbicide is a chemical product applied in the vagina to prevent HIV. Anal application is also been studied. Currently five first generation vaginal microbicide candidates are in late stage clinical trials. They act as a physical barrier, maintain vagina flora, and prevent STIs (Sexually Transmitted Infection). In addition a number of second generation microbicide candidates including Tenofovir containing microbicide are in earlier stages of research.

Cervical barrier:
cervical barriers such as diaphragms may help protect women from HIV and others STIs Sexually Transmitted Infection). An efficacy trail of the diaphragm for HIV prevention is nearing completion in south Africa and Zimbabwe.

Herpes suppression:
Genital herpes simplex infection increases the risk of HIV acquisition as well as risk of transmission to others significantly. Trials are being conducted in Africa and the US to test the efficacy of suppression of herpes with acyclovir to lower HIV risk.

Pre-exposure prophylaxis with antiretrovirals: Efficacy trials in the use of Tenofovir and Truvada are being conducted in Botswana, Thailand and Peru. This approach has being successfully used in the prevention of mother to child transmission of HIV. A significant disadvantage to this approach could be the development of drug resistance.

HIV Vaccine:
The aim of the vaccine is to induce either neutralising antibody or T cell response or both. But for more than 25 years scientists have struggled to develop an HIV vaccine. Genetic diversity of HIV, infecting cells of the immune system, spreading from cell to cell and integration of the viral genome have been the key stumbling block in the development of a effective HIV vaccine. Currently 30 HIV vaccine candidates are in clinical trials.

These promising new HIV prevention approaches have the potential to dramatically reduce the burden of HIV/AIDS around the world. Women account for more than half the HIV population globally. They often do not have the social or economic power to refuse sex. Many of these new development provide women with HIV prevention methods that they could initiate.

Q: Why women are more vulnerable than men?

A: Women are biologically vulnerable to HIV than men. Women are increasingly at risk of HIV globally. 10%-20% of the virus is transmitted from person to person. Women are powerless in the developing countries due to socio economic status of their families.

About 40 million people in the world are infected with the Human Immunodeficiency Virus (HIV).More than 16,000 new infections occur,

Approximately 24 million people have died from Acquired ImmunoDeficiency Syndrome (AIDS). About 90% are due to sexual contact, highlighting the need for prevention of HIV transmission.

A recent study conducted by the London school of Hygiene & tropical Medicine estimated that a microbicide that reduced the risk of infection by 40% & that was used by 30% of women at risk in low-income countries – would avert more than 2 million HIV infections a year & save $ 1-billion annually in health care cost.

"Empowering women to protect themselves seems so elemental, and yet when I hear people pontificating against AIDS and acting as if we can do everything through abstinence, I think they don't know what most women are up against in too many parts of the world today." - Bill Clinton, Former President of United States of America, and the head of Clinton Foundation, which provide technical and financial assistance to developing countries to stop the spread of HIV/AIDS around the world.

Q: What more should be done in the developing countries to prevent HIV/AIDS?

A: The developing countries need to have a better infrastructure for heath care. HIV/AIDS is the biggest problem in Africa and India. HIV/AIDS is a growing problem in China .

The majority of the doctors in Thailand, and in India are being trained in HIV/AIDS. They have better knowledge about HIV/AIDS compared to twenty five years ago. People Living With HIV/AIDS (PLWHAs) are treated with love and care in Thailand.

The doctors in Sri Lanka are also undergoing training on HIV/AIDS. Awareness on HIV/AIDS is being created among the various sections of the society in Sri Lanka. It's a positive start to make towards the prevention of HIV/AIDS in Sri Lanka.