The APOPO-PASADA Collaboration Shining

The Second Durban Declaration Access Equity Rights - Now!

PASADA attended the just ended 21st International AIDS Conference which took place in Durban, South Africa from the 18th to 22nd of July 2016. The meeting Released the 2nd Durban Declaration as shown below;

The Second Durban Declaration Access Equity Rights - Now! There has been remarkable progress in our response to AIDS since the global HIV community last convened in Durban in 2000. Curbing the spread of HIV was the first step . Accelerating investment and action on robust human rights and social justice agenda is the next. Despite significant scientific advancements, we continue to encounter structural barriers that impede real world progress. Realizing the promise of scientific achievement requires a greater commitment to removing barriers between discovery and implementation. The 21st International AIDS Conference (AIDS 2016) must bring these pieces together – the key scientific advances needed to end the epidemic and the key structural barriers impeding progress – and secure greater political commitment including financial resources to get the job done.
Focusing on the five key scientific advances Ensure access to antiretroviral therapy for all people living with HIV The benefits of early and sustained antiretroviral therapy (ART) for the health of people living with HIV and treatment as prevention in the overall population are undeniable and broadly recognized. We must ensure that on diagnosis ART access for all people living with HIV becomes a reality despite resource constraints.   Scale up modern combination HIV prevention packages Pre-exposure prophylaxis (PrEP) and voluntary medical male circumcision are major breakthroughs in HIV prevention science. They should complement the benefits of universal ART and must remain a priority. Long-acting and more convenient prevention methods such as injectable PrEP should be further developed to become an integral part of today’s combination HIV prevention package.   Treat and manage co-infections and co-morbidities Morbidity and mortality in people living with HIV is increasingly driven by co-infections and co-morbidities. A range of new technologies and drug options have been developed which now need to be fully scaled up, notably, for hepatitis C and tuberculosis HIV co-infections. Non-communicable diseases like diabetes and hypertension are another important area of linkage requiring attention.   Amplify research efforts for a vaccine and a cure Preventive vaccine strategies and sustained HIV remission while off ART remain paramount to achieving definitive and economically-sustainable epidemic control. The recent progress in vaccine development and HIV cure research should be accelerated, driven by the necessary resources and motivation to consign AIDS to history. Optimize implementation research Implementation science should increasingly become the cornerstone for realising access, acceptability, uptake, and sustained adherence across the HIV cascade. This will include leveraging differentiated models of care and other innovative approaches to translate science into long-term, sustainable and equitable progress.		Addressing the five key structural barriers Focus on key populations within and across various HIV epidemic scenarios Key populations – men who have sex with men, transgender people, sex workers and people who inject drugs – are disproportionately affected by HIV and among these groups there has been a recent resurgence in HIV infections. National responses should create an enabling environment and increase their access to HIV services across the cascade – including for adolescent key populations.   Address gender inequality and empower young women and girls Socially-embedded inequalities render young women and girls – including transgender women - particularly vulnerable to HIV infection. We need a global plan for ending the epidemic among them that includes ensuring multi-sectoral policy and programmatic synergy and embraces sexual and reproductive health and rights.   Challenge laws, policies and practices that stigmatize and discriminate against people living with HIV and key populations It is long past time to amend and remove laws, policies and practices that inappropriately regulate (e.g. violation of sexual and reproductive rights), control (e.g. entry, stay and residence restrictions), punish (e.g. criminalization of HIV non-disclosure, exposure and transmission) and/or fail to protect (e.g. criminalization of homosexuality, sex work and drug use; lack of protection from violence) key populations and people living with HIV in many contexts.   Increase investment in civil society and community lead responses Civil society – as activists, advocates and service providers - has long been the backbone of the AIDS response, ensuring greater accountability and action from political leaders to address the epidemic. In many settings, these groups are under siege by restrictive laws and funding cuts. The global HIV community must stand in solidarity with civil society and reaffirm its place in the HIV response.   Enhance capacity of frontline healthcare workers Ensure that frontline healthcare workers have what they need to provide client-centred care through national roll out of quality pre- and in-service training. This should include addressing stigma and discrimination which is often considered one of the most significant barriers to accessing HIV services.
We, the undersigned, agree that the return of the conference to Durban this year will be a defining moment to establish a clear path toward guaranteeing that no one is left behind in the AIDS response. When we write the history of the epidemic, let it be that in Durban in 2016 we seized the opportunity to alter the course of this epidemic forever. Now, more than ever we must ensure Access Equity Rights – Now! For further information and signing the Declaration click here

DURBAN STATEMENT ON CHILDREN, ADOLESCENTS AND HIV

The The Coalition for Children Affected by AIDS and The Teresa Group hosted the just ended "Children and HIV" Symposium from the 15th to 16th of July, 2016 in Durban South Africa. This was an affiliated event of the 21st International AIDS Conference. The meeting released the following Statement  on Children and Adolescents regarding HIV;

DURBAN STATEMENT ON CHILDREN, ADOLESCENTS AND HIV

We, civil society organizations working on behalf of children and adolescents and their families, urge national governments to ensure the following five global targets1 are achieved as policies are set, resources allocated and programs designed to address HIV and AIDS in their respective countries:
3. HIV-sensitive Care, Support & Social Protection:
Commit to ensuring 75% of children, adolescents and their parents living with and affected by HIV
receive comprehensive care and support – including social and child protection.
Comprehensive care and support, including social and child protection, have been shown to
both improve adherence and retention for children and parents and to enable HIV-affected
children to achieve their developmental potential. New evidence also shows that comprehensive
social protection—providing some form of cash transfer in combination with care and support
interventions such as parental monitoring, teacher support, adolescent-friendly clinics and peer
group activities (sometimes known as “cash plus care”)—improves adolescent adherence and
reduces their risk behaviour.
4. Supporting Caregivers so Children and Adolescents can Thrive:
Commit to strengthening the capacity of families, the community-level child care workforce, and
the social welfare workforce, so that together they can meet the developmental needs of children
living with, and affected by HIV, from pregnancy, to early childhood, and into adolescence.
We recognize the critical roles that families and other caregivers play in caring for HIV-affected
children and adolescents – including fostering healthy growth and development. We must ensure
programming helps family caregivers to deal with stresses & support children at each stage of
development into adolescence. This requires scale-up of caregiver/parenting support programs,
integrated as part of health, education and social welfare systems.
5. Stigma Elimination:
Commit to ensuring that all children living with and affected by HIV are free from stigma and
discrimination due to their HIV status and/or that of their caregivers.
HIV-related stigma and discrimination cause severe psychological distress among children,
and can prevent access to education, treatment, and care. Children orphaned by HIV, and those
living with HIV positive caregivers, experience greater stigma and bullying than their peers. Other
groups of children being discriminated against include children of parents of key populations, key
population adolescents, and children and adolescents with disabilities. Governments must work
with all key stakeholders to ensure that safe and non-discriminatory environments are created in
health facilities, community organizations, educational settings and more broadly in society as a
whole.

30th Annual Joint Scientific Conference 2016

The National Institute for Medical Research announces that its 30^th Annual Joint Scientific Conference (AJSC) will be held at the Bank of Tanzania Conference Centre in Dar es Salaam, Tanzania from October 4-6, 2016. The goal of AJSC is to foster and facilitate communication and collaboration between scientists, trainers, policy makers, donors, students and the media. The conference will feature speakers discussing the latest research elucidating the need for innovative research to address the Sustainable Development Goals. For more details click here

WHO confirms antiretroviral therapy reduces the risk of life-threatening HIV-related infections

20 June 2016 - Adults and children with HIV who start antiretroviral therapy (ART) as early as possible reduce their risk of developing serious HIV-related infections, according to new findings published in the journal Clinical Infectious Diseases on 15 June 2016.

WHO/A. Kari

Two studies in adults and children, supported by the World Health Organization (WHO) and conducted in collaboration with Columbia University, the London School of Hygiene & Tropical Medicine and McGill University, are the first global systematic and comprehensive analyses of data on HIV-related opportunistic infections over a 20-year period in 3 global regions: Africa, Asia and Latin America. The 2 reviews compared the risk of serious HIV-related infections before and after starting ART, then estimated the global number of cases of infection that would have been prevented (using data from 2013), and the costs saved, if ART had been started earlier.
“Opportunistic and other infections are the major cause of death in adults and children with HIV,” said Dr Philippa Easterbrook from WHO’s Department of HIV. “There have been previous estimates on the impact of ART in reducing deaths and new HIV infections, but not on its impact on each of the serious infections to which people with HIV are vulnerable, especially in low-income settings. Knowing how common these infections are is really important for planning HIV health services in these countries, including procuring drugs and diagnostic tests.”
In 126 different studies based on almost half a million adult HIV patients, the most common infections were oral thrush, tuberculosis, shingles and bacterial pneumonia – each of which occurred in more than 5% of adults before ART. There was a major reduction in the risk of development of all infections for those on ART, by 57% to 91%, and this was greatest in the first year of treatment. It was estimated that earlier ART would have prevented at least 900 000 cases of life-threatening infections and saved around US$ 50 million in 2013.
In the second review – 88 studies based on 55 679 HIV-infected children – bacterial pneumonia and tuberculosis were the most common infections, each occurring in around 25% of children before ART. As with the adult studies, there was a reduction in risk for all infections for those on ART, but this was greatest (by more than 80%) for HIV-related diarrhoea, cerebral toxoplasmosis and tuberculosis, with a smaller impact on bacterial septicemia and pneumonia. It was estimated that earlier access to ART could have prevented at least 161 000 cases of serious infections in children, with a saving of around US$ 17 million in 2013.
“Compared to adults, there is always a relative lack of data on HIV-infected children to inform guidelines and practice, and the scale-up of ART in children has been much less successful,” said coauthor Dr Marie-Renée B-Lajoie from McGill University. “But our study shows that the effect of ART in reducing HIV-related infections in children is as dramatic as that seen in adults.”
Dr Andrea Low, coauthor from ICAP, Columbia University, commented that “the level of effect of ART on serious infections in adults in these low-income settings was even more striking than that observed in high-income countries”. However, she also noted that interpretation of regional variation in incidence and the effect of ART is limited, as there were significant gaps in data from some regions, such as Latin America.
Dr Gottfried Hirnschall, Director of WHO’s HIV Department, concluded: “We know that ART has a dramatic effect in reducing death rates as well as new HIV infections. These findings demonstrate that ART has the same effect in reducing the risk of serious HIV-relatedI nfections in adults and children – thus, further explaining the reduction in death rates. This reinforces the need to continually prioritize the expansion of access to ART. The new WHO guidelines recommend starting ART in all HIV-infected persons as soon as possible, regardless of the stage of infection.”

From the WHO Website

Habari (Hello) from the Motherland!

June 20, 2016 Jennifer LeBlanc Leave a Comment

A few months ago we introduced two Queen Elizabeth Scholars who are now in Tanzania for the summer. Matt Jalink (Intern) and Keisha Jefferies (Scholar) have sent us updates to share.

Habari (Hello) from the Motherland!

Keisha Jefferies is a Master’s of Nursing student at Dalhousie University

What an experience this has been thus far. Not only is this my first time in Tanzania, but it is also my first trip to the Motherland. I was unsure of what to expect in terms of the lifestyle, social norms and attitudes, but I am definitely adjusting, settling in nicely and loving every moment!
Since arriving in Dar, I have been learning Swahili (one of the National languages in Tanzania) and it is paying off in the sense that I am able to connect with many people and build relationships. I still have a long way to go before I can hold a decent conversation in Swahili, but people are certainly amused and supportive of my attempts!

Swahili Dar Language (SDL) School where I am learning Swahili.

I have also had the opportunity to volunteer with my host (who is a dietician, nutritionist and lifestyle coach) on a project currently underway with the World Food Program (WFP). The project is focused around increasing awareness about healthy living for staff by proving education on healthy food choices, baseline measurements such as blood pressure (BP), fast blood glucose (FBG), height, weight and body mass index (BMI) as well as sharing options for exercise/ physical activity. We had a few busy days of preparing, presenting, taking baseline measurements and interacting with the WFP staff. Currently, my host is completing the analysis and will soon roll out the intervention phase of the project.

WFP Staff/ project coordinators, Nurses from Muhimbili National Hospital (MNH), my host and volunteers.

In addition to learning Swahili and volunteering with the WFP project, I am also working on my own project and program requirements for my Masters! Needless to say, it has been a busy 6 weeks but I am finding time to make friends and enjoy the beautiful city of Dar es Salaam. I have met some wonderfully nice people throughout the city and at the university. I have been fortunate enough to have been invited to attend 3 Masters level lectures on Research Methods for the Midwifery and Critical Care students. This was an amazing experience. Not only I was also able to share ideas and learn from the students and faculty, I was able to sit in and provide feedback on thesis topic presentations.

Students from the Masters of Midwifery and Women’s Health program at Muhimbili University of Health and Allied Sciences (MUHAS) and myself enjoying the warm waters of the Indian Ocean.

Masters students and myself at Kipepeo Beach in Kigamboni.

I am looking forward to the many adventures, experiences and opportunities over the next 7 weeks!

Karibu Tanzania! (Welcome to Tanzania)

Matt Jalink is a Community Health and Epidemiology student at Dalhousie University

Karibu Tanzania! (Welcome to Tanzania). I’ve heard this phrase countless times since arriving in Dar es Salaam. Reminiscent of my last visit to the northern city Moshi, the friendliness Tanzanians have shown me is amazing. This hot, bustling metropolis is quickly becoming one of my favorite cities, and stretches out into dozens of districts each with its own subsection of wards. I reside in the city centre district in a quaint little hotel 10 minutes walk from the Indian Ocean. I catch the dala dala (minivan buses) to work every morning in a nearby district called Temeke. Commuting is an experience in itself with obscene driving, constant usage of the horn and doubling the van’s capacity limit giving the suspension a workout. Traffic jams are frequent, so at times hoping on a boda boda (motor cycle taxi) is needed to maneuver around the traffic.
Working as an epidemiology student at PASADA has been a fantastic learning experience. In a very self-directed role, I have been acting primarily as a consultant on a tuberculosis diagnostic test project. Applying the skills I have gained from my coursework to the workplace has been both rewarding and challenging. Participating in data collection in some of the slums of Dar es Salaam was an eye-opening experience despite thinking that I was mentally prepared. However most of my time has been spent assembling the data set and coding the dataset for analysis.

Pastoral Activities and Services for people with AIDS Dar es Salaam Archdiocese (PASADA).

The majority of my free time has been spent exploring the city and surrounding area. Bongoyo Island was a beautiful escape from the city. Watching the Africa Cup of Nations qualifying match between Tanzania and Egypt at the national stadium as an avid football (soccer) player and fan was an incredible atmosphere to be apart of.
Kwaheri! (Bye for now)

The Canadian Queen Elizabeth II Diamond Jubilee Scholarship Program (QES) aims to build a dynamic community of young global leaders in Canada and across the Commonwealth. Queen Elizabeth Scholars engage in projects both at home and abroad, encompassing international education, discovery and inquiry, and professional experiences. Queen Elizabeth Scholars undertake projects that provide meaningful learning experiences, with the potential to create lasting impact. Dalhousie University has teamed up with its partners in the Caribbean, Uganda and Tanzania to develop an international student mobility project, funded by QES, for current Dalhousie students and students in other Commonwealth countries looking to study at Dal. The Global Health Office manages the relationship between our partner associations and Dalhousie, collaborating with many units across campus, and within the QES network, to make these projects possible

 Copied from Dalhousie University Blog

Double burden of malnutrition

From WHO Website, May 2016

The double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases, within individuals, households and populations, and across the lifecourse.

In the context of a changing global nutrition landscape, influenced by economic and income growth, urbanization, demographic change and globalization, diet-related epidemiology has seen a significant shift in recent decades.

Burden

In 2014, more than 1.9 billion adults worldwide, 18 years and older, were overweight while 462 million were underweight. More than 600 million were obese. In the same year, 41 million children under the age of five were overweight or obese but 159 million were affected by stunting (low height-for-age). While 50 million children were affected by wasting (low weight-for-height). In low- and middle-income countries, almost five million children continue to die of undernutrition-related causes every year yet simultaneously these same populations now witness a rise in childhood overweight and obesity – increasing at a rate 30% faster than in richer nations.
This double burden of malnutrition can exist at the individual level – for example obesity with deficiency of one or various vitamins and minerals, or overweight in an adult who was stunted during childhood – at the household level – when a mother may be overweight or anaemic and a child or grandparent is underweight – and at the population level – where there is a prevalence of both undernutrition and overweight in the same community, nation or region.
Moreover, the relationship between undernutrition and overweight and obesity is more than a coexistence. Reflected in the epidemiology and supported by evidence, undernutrition early in life – and even in utero – may predispose to overweight and noncommunicable diseases such as diabetes and heart disease later in life. Overweight in mothers is also associated with overweight and obesity in their offspring. Rapid weight gain early in life may predispose to long-term weight excess. These are just some of the examples of biological mechanisms, which along with environmental and social influences, are increasingly understood as important drivers in the global burden of malnutrition across the lifecourse.

Opportunity

This double burden of malnutrition offers a unique and important opportunity for integrated action on malnutrition in all its forms. Addressing the double burden of malnutrition will be key to achieving the Sustainable Development Goals (in particular Goal 2 and Target 3.4) and the Commitments of the Rome Declaration on Nutrition, within the UN Decade of Action on Nutrition.

For further reading click here

Life expectancy increased by 5 years since 2000, but health inequalities persist

From the WHO website

Life expectancy increased by 5 years since 2000, but health inequalities persist

News Release

19 May 2016 | GENEVA - Dramatic gains in life expectancy have been made globally since 2000, but major inequalities persist within and among countries, according to this year’s “World Health Statistics: Monitoring Health for the SDGs”.
Life expectancy increased by 5 years between 2000 and 2015, the fastest increase since the 1960s. Those gains reverse declines during the 1990s, when life expectancy fell in Africa because of the AIDS epidemic and in Eastern Europe following the collapse of the Soviet Union. The increase was greatest in the African Region of WHO where life expectancy increased by 9.4 years to 60 years, driven mainly by improvements in child survival, progress in malaria control and expanded access to antiretrovirals for treatment of HIV.

“The world has made great strides in reducing the needless suffering and premature deaths that arise from preventable and treatable diseases,” said Dr Margaret Chan, Director-General of WHO. “But the gains have been uneven. Supporting countries to move towards universal health coverage based on strong primary care is the best thing we can do to make sure no-one is left behind.”
Global life expectancy for children born in 2015 was 71.4 years (73.8 years for females and 69.1 years for males), but an individual child’s outlook depends on where he or she is born. The report shows that newborns in 29 countries – all of them high-income -- have an average life expectancy of 80 years or more, while newborns in 22 others – all of them in sub-Saharan Africa -- have life expectancy of less than 60 years.
With an average lifespan of 86.8 years, women in Japan can expect to live the longest. Switzerland enjoys the longest average survival for men, at 81.3 years. People in Sierra Leone have the world’s lowest life-expectancy for both sexes: 50.8 years for women and 49.3 years for men.
Healthy life expectancy, a measure of the number of years of good health that a newborn in 2015 can expect, stands at 63.1 years globally (64.6 years for females and 61.5 years for males).

Targets of Sustainable Development Goals

This year’s “World Health Statistics” brings together the most recent data on the health-related targets within the Sustainable Development Goals (SDGs) adopted by the United Nations General Assembly in September 2015. The report highlights significant data gaps that will need to be filled in order to reliably track progress towards the health-related SDGs. For example, an estimated 53% of deaths globally aren’t registered, although several countries – including Brazil, China, the Islamic Republic of Iran, South Africa and Turkey – have made considerable progress in that area.

• World Health Statistics 2016: Monitoring health for the SDGs

While the Millennium Development Goals focused on a narrow set of disease-specific health targets for 2015, the SDGs look to 2030 and are far broader in scope. For example, the SDGs include a broad health goal, “Ensure healthy lives and promote well-being for all at all ages”, and call for achieving universal health coverage. This year’s “World Health Statistics” shows that many countries are still far from universal health coverage as measured by an index of access to 16 essential services, especially in the African and eastern Mediterranean regions. Furthermore, a significant number of people who use services face catastrophic health expenses, defined as out-of-pocket health costs that exceed 25% of total household spending.
The report includes data that illustrate inequalities in access to health services within countries –between a given country’s poorest residents and the national average for a set of reproductive, maternal and child health services. Among a limited number of countries with recent data, Swaziland, Costa Rica, Maldives, Thailand, Uzbekistan, Jordan and Mongolia lead their respective regions in having the most equal access to services for reproductive, maternal, newborn and child health.
The “World Health Statistics 2016” provides a comprehensive overview of the latest annual data in relation to the health-related targets in the SDGs, illustrating the scale of the challenge. Every year:

• 303 000 women die due to complications of pregnancy and childbirth;
• 5.9 million children die before their fifth birthday;
• 2 million people are newly infected with HIV, and there are 9.6 million new TB cases and 214 million malaria cases;
• 1.7 billion people need treatment for neglected tropical diseases;
• more than 10 million people die before the age of 70 due to cardiovascular diseases and cancer;
• 800 000 people commit suicide;
• 1.25 million people die from road traffic injuries;
• 4.3 million people die due to air pollution caused by cooking fuels;
• 3 million people die due to outdoor pollution; and
• 475 000 people are murdered, 80% of them men.

Addressing those challenges will not be achieved without tackling the risk factors that contribute to disease. Around the world today:

• 1.1 billion people smoke tobacco;
• 156 million children under 5 are stunted, and 42 million children under 5 are overweight;
• 1.8 billion people drink contaminated water, and 946 million people defecate in the open; and
• 3.1 billion people rely primarily on polluting fuels for cooking.

Note to editors

Published every year since 2005, WHO’s “World Health Statistics” is the definitive source of information on the health of the world’s people. It contains data from 194 countries on a range of mortality, disease and health system indicators, including life expectancy, illness and death from key diseases, health services and treatments, financial investment in health, and risk factors and behaviours that affect health.
WHO’s Global Health Observatory updates health statistics year round of more than 1000 health indicators. Members of the public can use it to find the latest health statistics on global, regional and country levels.

For more information, please contact:

Simeon Bennett
WHO Department of Communications
Mobile: +41 79 472 7429
Office: +41 22 791 4621
Email: simeonb@who.int

HRH The Crown Princess of Norway visiting Tanzania

HRH The Crown Princess of Norway visiting Tanzania

Research Methods Course in Sexual Reproductive Health, HIV and Gender-Based Violence