Category Archive for 'aids'

Yesterday, we gathered with a group of other students on Yale’s central quad to rally for the rights of drug users. We held signs reading, “Ban the Ban!” and “Clean Needles Save Lives!” One girl even dressed up as a needle. Passersby took photos or stopped to collect the small flyers we were handing out. Others just stared or hurried to the other side of the quad. A local newspaper sent reporters to take photos and write a story about our rally to end the federal ban on syringe exchange funding.

Syringe exchange programs (SEPs) allow injection drug users to trade used needles for sterile needles. Giving drug users access to clean needles protects them and those around them from HIV and other blood-borne diseases. Epidemiologic studies have shown that the presence of an SEP in a community does not increase drug use and reduces transmission of HIV. According to a study published in Social Science and Medicine in 2002, HIV prevalence steadily decreased by about 5.8% in cities with SEPs, and increased by about the same amount in cities that lacked the programs.

Congress initially lifted the 20-year ban on federal funding for syringe exchange in December 2009 due to enormous pressure from numerous policy advocates, including Physicians for Human Rights. Unfortunately, syringe exchanges were once again stripped of federal funding through the introduction of language in the Consolidated Appropriations Act, 2012—the federal budget for fiscal year 2012. House Republicans acted to reinstate the ban, and Democrats and the Obama administration failed to react. On December 23, 2011, while most of the country’s attention was elsewhere, the ban was signed into law.

The decision to ban federal funding for syringe exchange was not driven by economic concerns—syringe exchange is one of the most cost-effective ways to reduce HIV transmission. It was motivated by our society’s discrimination against drug users, a population that the government has deemed unworthy of health. We are all entitled to human rights, regardless of our race, ethnicity, gender, sexual orientation, or whether or not we use drugs.

The federal ban on syringe exchange funding violates the right to health, exposing drug users, their sexual partners, and, by extension, the entire community to increased HIV risk. Every nation in the world signed at least one treaty recognizing health-related rights—the US must not ignore this right. Yet the ban could also be considered a mechanism for cruel, unusual, or degrading treatment and for punishment given without due process. While drug use is illegal, it should be punished through established legal process and after a fair determination of guilt, not through denying drug users access to evidence-based health services and increasing their risk of disease.

As pre-medical students, future doctors, we feel that advocacy is an essential part of our work. We currently lack the medical skills to heal individuals, but we can raise our voices to help end systemic barriers to health. Once we earn medical degrees, we aim to continue being advocates, building on the strategies we have already learned and using insight into the challenges confronting patients to bring issues to the attention of policymakers. With advocacy around harm reduction and drug use, in particular, the voices of medical providers and public health professionals are crucial. The public health and medical communities must emphasize that programs like syringe exchange are evidence-based and use their positions of authority and understanding of drug use to reduce the debilitating stigma toward drug users.

It is time for everyone to take action. Repeal of the federal ban on syringe exchange funding will take the same fortitude and determination that it required in 2009. We must urge our members of Congress and President Obama to ensure that the ban is not included in the fiscal year 2013 budget. We can do this using many tools of activism: gathering signatures on a petition to Republicans in the House of Representatives, bringing media attention to the federal ban, holding lobby meetings, and raising awareness in our community.

Global health spending represents less than 1% of the US federal budget. Source: Kaiser Family Foundation.

What’s the Global Health Week of Action?

During National Actions, students and residents across the US coordinate their advocacy efforts to increase their impact. Every spring, the Global Health Week of Action focuses on an urgent health issue that transcends national boundaries. Join us this May 1-7, 2011 to protect federal funding for crucial health programs and research. Interested in creating your own campaign? At the bottom of this post, there are links to new resources to customize your Global Health Week of Action.

The threat to essential global health programs and research

The struggle over the federal budget this year is far from over. As we’ve seen over the past few months, international affairs has been targeted for spending cuts – despite being less than 1% of the overall budget, and despite huge returns on investment (pdf). For background, see previous posts on January 28February 15, and April 15.

Soon, your Senators and Representatives will decide on the federal budget for the coming year, FY2012. For this year’s annual PHR Global Health Week of Action (May 1-7, 2011), let’s make sure that Congress knows  that health professionals see that global health funding is critical – to protect the right to health, to advance international development and security, and to avoid needless suffering and death.

Recruit health leaders to join the campaign

PHR is launching an elite sign on letter that will be addressed to each member of the Senate and the House of Representatives, asking for their advocacy in Congress for a continued robust U.S. response to global health. This letter is a collaborative effort with IDSA’s Center for Global Health Policy, Partners in Health, the Foundation for AIDS Research (amfAR), Health GAP, and Physicians for Human Rights.

  Letter to Congress: Support global health funding

Please ask the leadership and health professionals at your schools and hospitals to agree to add their name to the letter above. Senators and representatives are interested in the opinions of thought-leaders, like your school’s deans and professors, the head of your hospital’s department, and doctors, nurses, and other health professionals. Recruiting these leaders to participate is an effective way to influence Congressional representatives.

Share this letter with leading health professionals on your campus or in your community. The more deans, professors, nurses, public health researchers and practitioners, and doctors who participate, the better. To sign onto the letter, please click here and enter your name, title, affiliation, and city. The deadline for signing on is Sunday, May 8th at 9 pm EST.

You might use this script when asking people to join the campaign:

Global health spending is in jeopardy for the FY 2012 federal budget. Cuts in global health support would have dramatic and long-term consequences, and would do almost nothing to balance the budget. I would like to invite you to join us in sending a letter to Congress.

Please consider adding your name to this letter, which is a collaborative effort with IDSA’s Center for Global Health Policy, Partners in Health, the Foundation for AIDS Research (amfAR) and Physicians for Human Rights (PHR).  PHR will present these letters to our state’s members of congress to demonstrate that leaders in health support lifesaving and cost-effective global health programs. Please help show our senators and representatives that health professionals who live and work in the state they represent value U.S. leadership in global health.

You might ask for a face-to-face meeting to request that they sign on to the letter. If they agree to meet, be well-informed and prepared to make your case. Here’s a series of posts on this issue in this blog. Laurie Garret’s now-classic “The Challenge of Global Health” (pdf) and this analysis of the sources and uses of global health funding offer useful context. Your target may also be persuaded by an email or a phone call. Either way, respect their time: being able to succinctly state your case is an important skill in advocacy.

When they agree to sign on, please add their information to this form.

If they’re enthusiastic, ask them to share the letter and the link to the form with other leaders.

PHR will compile the names of the leaders who you recruit to sign on to the letter.  We will deliver the letters to your members of Congress. If you’d like to join us, please let us know! You can track the status of US funding for key global health accounts to be sure your information is up-to-date.

Ready to do more? Other options for your Global Health Week of Action.

To educate your campus or community, refer to the PHR Student Chapter Toolkit for detailed information about how to plan and lead an advocacy campaign, host educational events, and more.

You may choose from these issues and use the PHR Toolkits to lead education and advocacy, or select another issue that you’re passionate about:

A widow and her children in Afghanistan.

The federal budget battle is not yet over, and global health funding is in jeopardy.

In previous posts on January 28 and February 15, I urged you to make your Senators aware that global health funding is a priority to you. Budget cuts for critical health programs – even short term – will have disastrous long term consequences. Cutting too deeply would hamper our ability to prevent or cure illness and to support the health and wellbeing of the millions who depend on sustained funding. Thanks in part to the advocacy of people like you, the cuts to international development for the rest of this fiscal year were less drastic than many feared.

The fight is not over, and the discussion over the past months demonstrates that many politicians consider global health programs to be expendable. Although global health funding may not be drastically reduced in the short term, these essential programs are under serious threat in the coming year (FY2012).

For this year’s annual Global Health Week of Action (May 1-7, 2011), let’s make sure that DC knows that health professionals see that global health funding is critical – to protect the right to health, to advance international development and security, and to avoid needless suffering and death.

Next week, I’ll share the materials for the Global Health Week of Action. I’ll also launch an exciting new resource so that you can plan your own educational or advocacy inititative.

US leadership is crucial to improving health

For over 100 years, America has been a leader in the efforts  to improve global health. The US supports the Millennium Development Goals, which means reducing deaths in children less than five years of age by two-thirds, lowering the maternal mortality rate by 7%, and halting the HIV/AIDS, tuberculosis and malaria epidemics. This has been a nonpartisan issue for years. Under both Republican and Democratic administrations, the U.S. government has joined other nations to innovate, lead, and fund health programs worldwide.

There is much to be proud of. As a result of U.S. leadership on global health, the world’s most vulnerable communities are reaping extraordinary health dividends. With America at the forefront of the global AIDS response, the number of AIDS deaths has declined by almost a quarter over the last decade, while the number of new HIV infections has fallen by a comparable amount. In part due to America’s considerable investments in malaria control, global production of insecticide-treated bed nets has risen five-fold since 2004, and the number of households regularly using bed nets for malaria prevention has increased more than 40-fold in some African countries. U.S. support has also proved vital to achieving recent improvements in TB case detection and treatment rates and reductions in overall global TB burden, accomplishments that have effectively halted what was only recently an out-of-control growth in new TB cases.

U.S. leadership has been especially critical in promoting the health and wellbeing of women and children. Since 1990, the childhood mortality rate has fallen by nearly 30%. Due in part to U.S. support for health systems strengthening in low-income countries, the number of maternal deaths decreased by 34 percent from 1990 to 2008, even as the population of reproductive-aged women increased.

Don’t jeopardize fragile gains: maintain or expand global health funding

In short, the world is within reach of achieving one of the most important of all global goals—sharply reducing health inequities. Yet recent gains are exceedingly fragile, and the drastic cuts in global health funding that have been proposed place the advances of the last two decades in grave peril.

As Michael Gerson, a former advisor to President George Bush  in the creation of the President’s Malaria Initiative, says in a recent Washington Post article,

Global health programs are not analogous to many other categories of federal spending, such as job training programs or support for public television. A child either receives malaria treatment or does not. The resulting risk of death is quantifiable. The outcome of returning to 2008 spending levels, as Republicans propose, is predictable. Fiscal conservatives tend to justify these reductions as shared sacrifice. But not all sacrifices are shared equally. Some get a pay freeze. Some get a benefit adjustment. Others get a fever and a small coffin. This is not fiscal prudence. It is the prioritization of the most problematic spending cuts — a disproportionate emphasis on the least justifiable reductions. One can be a budget cutter and still take exception to cuts at the expense of the most vulnerable people on earth. In Britain, Prime Minister David Cameron is pursuing even greater austerity while increasing funding for development.

Although the need for fiscal restraint has placed policymakers in a difficult position, proposed cuts in global health programs would contribute very little to deficit reduction.

International affairs constitutes only about 1% of the federal budget, with health assistance representing only a fraction of the larger account for foreign assistance. These eminently affordable investments are humanitarian, diplomatic, and economically sound, as they enable people to continue working and reduce the likelihood of disease transmission, thereby averting substantial future health care costs.

Join PHR in May for the Global Health Week of Action. Ensure that the lives of the most vulnerable are not placed in even greater jeopardy.

(Part 3 of a 3-part series.)

PHR’s 2011 National Conference, Our Role, Our Responsibility: Defending Health and Human Rights, will be held in Boston on February 12.  The conference focuses on both the duties of and opportunity available to health professionals, and the work they can do in three areas; as clinicians, as advocates, and as researchers. PHR Student Chapters have participated in effective advocacy work for years; a notable victory was the recent congressional overturn of federal funding for syringe exchange programs, which occurred in December 2009 after a lengthy campaign.

Congress overturned the 22-year-old ban three years after PHR joined the battle to end the ban. PHR worked to make Congress, the administration and the public understand the impact of the ban beyond US borders. The ban had long hampered foreign assistance efforts; for example, the important intervention tool of syringe exchange was excluded from US global AIDS funding efforts. With legislation to overturn the ban passed, the Office of the Global AIDS Coordinator was able to revise funding guidelines and allow funding for needle exchange services. This victory for HIV and viral hepatitis prevention was an example of rational, evidence-based advocacy working to overturn an illogical and detrimental law.

PHR Student Chapters were at the forefront of this effort, writing to their representatives and mobilizing members. The April 2009 AIDS Week of Action saw Student Chapters educating their fellow students, as well as the public and their elected officials, on the importance of overturning the needle ban. The UCLA PHR Chapter organized an April 2009 rally in support of the bill, in addition to meeting with their Senators and House Representatives. Further student efforts are cataloged on the student blog.

When the House passed legislation ending the ban, NY Rep. José Serrano praised PHR, along with other advocacy organizations, for helping to end the ban in the House:

“I also wish to recognize the incredible efforts of the various national and local groups that have been working for years to make this possible, especially AIDS Action, Physicians for Human Rights, and the Harm Reduction Coalition. Without the work of these valiant groups all across the nation, the step we took today never would have been possible.”

At the Syringe Exchange Victory Celebration in the US Capitol, PHR Senior Global Health Policy Advocate Paola Barahona presented Former House Speaker Nancy Pelosi with her Champion of Public Health Award, for her work on ending the ban. Barahona discusses her experience moderating the Celebration here. Without the tireless advocacy work of PHR members – and PHR Student Chapters in particular – this crucial victory for harm reduction and human rights may never have been achieved.

Federal funding for health is in jeopardy.

In the recent State of the Union address, President Obama announced a five-year freeze on domestic spending (aka non-security discretionary spending). On Jan. 25th, the House of Representatives approved a resolution to reduce non-security spending to 2008 levels.

We cannot balance the budget on the backs of the most vulnerable.

To avoid losing the progress that targeted spending has made in saving lives and improving health outcomes, the Senate should pass an omnibus bill that provides slight increases to FY10 levels for the majority of global health accounts. Last year’s efforts to pass an omnibus bill died in December when it became clear that 60 votes were not available to overcome a threatened Republican filibuster, the Washington Post reported. The federal budget is currently running on a Continuing Resolution that expires March 4, 2011. If the Senate fails to sustain or increase funding, this will have a direct impact on health outcomes in 2011 and the years to come.

An arbitrary freeze on spending is short-sighted and ineffective. The money saved will not adequately address the federal deficit. For example, foreign aid is a small fraction of the US budget. The International Affairs budget makes up about 1% of the overall federal budget, yet was able to fund the treatment of AIDS, TB, and malaria for millions of people. This investment is humanitarian, diplomatic, and economically sound, as it allows people to continue working and reduces the likelihood of transmission, and hence avoids increased health care costs.

A return to 2008 levels would dramatically reduce funding for the Global Health and Child Survival USAID Account (USAID-GHCS). January marked some milestones that offer a glimpse of the urgency of the need for continued investment in global health.  This month was the one year anniversary of the earthquake in Haiti and the six month anniversary of the floods in Pakistan. Yesterday, the WHO Director General, Margaret Chan, commented that increased funding is necessary and asked,

“Will progress stall? Will powerful innovations, like the meningitis vaccine, like the vaccines for preventing diarrheal disease and pneumonia, like the new diagnostic test for tuberculosis, fall short of reaching their potential? Public health has been on a winning streak. But will we still have the resources to maintain, if not accelerate, these gains?

Domestic health is also at risk. Most insiders anticipate a healthcare reform repeal vote in the Senate before long.

Please call your Senator to share your opinion. You can use this script:

I am a voter in your state. I urge you to sustain or expand funding for global and domestic health because it’s a smart investment. When it comes to health, short-term funding cuts will have long-term repercussions. We need to continue the work to make health care affordable and accessible, make prevention a priority, and ensure that women have access to the reproductive and other health care services they need. As a member of Physicians for Human Rights, I will be keeping an eye on how you vote on this issue.

You can find your senator here.

Please report your call here.

“I spend half my time comforting the afflicted and the other half afflicting the comfortable.”
— Wess Stafford, President, Compassion International

As the newest member of the PHR National Student Program team, I’m looking forward to working closely with you all over the next few months as we prepare for the National Conference in February. It is encouraging to see the incredible work the student members have accomplished so far. As health professionals, you are dedicating your careers to caring for the sick. As PHR members, you have committed to advocating for the adoption of a human rights framework for health care provision. Talk about comforting the afflicted and afflicting the comfortable! It is inspiring, to say the least.

Wednesday marked the beginning of our 10-day National Action dedicated to raising awareness of a pressing concern at the intersection of health and human rights: Access to Essential Medicines — decidedly a human rights issue. I find the complacency of the pharmaceutical industry to so many of the health needs of the international populace to be frankly appalling. Encouraging pharmaceutical companies to license certain ARV patents to the Medicine Patent Pool is simple human rights advocacy you can do today — just use the letters in the National Action Toolkit. I find it only fitting that our National Action wraps up on December 10, International Human Rights Day.

Over the course of this week-long National Action, PHR calls on you to organize engaging on-campus or city-wide events to raise awareness of this critical problem. Please see the National Action Toolkit for a comprehensive guide to getting started. It offers a variety of resources that outline the political, social and economic factors that impede access to essential medicines and lead to medical supply shortages and disparities in treatment worldwide.

Even if you are unable to organize or attend an event yourself, keep up-to-date on the issue! I am a firm believer in the maxim “knowledge is power.” Review the literature, read current news articles, and check out engaging websites and presentations — all of which can be found in the Toolkit Resource Guide.

A demonstration in Uganda.

This week, students across the US will use the new National Action Toolkit to educate their communities about why patients are denied access to life-sustaining medicines and lead their communities to take action. Join PHR and Chapters across the US in advocating for better access to essential medicines in resource-poor settings through UNITAID’s new Medicine Patent Pool. Our new National Action Toolkit offers analysis, resources to educate your community, and easy advocacy projects. This week of action spans from World AIDS Day (December 1) to International Human Rights Day (December 10). This National Action is dedicated to our friend and colleague, Sujal Parikh, in recognition of his leadership in this area. Let us know about your Chapter’s National Action! Send the National Student Program Coordinator, Hope O’Brien, an update with photos and flyers, and we’ll feature your Chapter on the blog.

PHR members are invited to attend the Boston Initiative to Advance Human Rights’ sex trafficking film forum event at the Brattle Theater in Cambridge, MA, from December 2 through December 5. The festival, which is the first of its kind, will screen 12 films, which will be followed by panel discussions with filmmakers, academics, and activists.

The film forum will explore the power of film in bringing about a movement to combat commercial sexual exploitation and modern-day slavery. PHR recently blogged about this issue.

Additional events include an opening night live performance by Tony award-winning actress and humanitarian Sarah Jones, followed by a cocktail hour with hors d’oeuvres by legendary chef Lydia Shire of Scampo, music performance, and a silent auction. On Saturday there will be a book signing with Siddharth Kara, author of Sex Trafficking: Inside the Business of Modern Slavery.

Tickets are available for purchase now. Discounted tickets are available for students, seniors, and non-profits.

Learn more, including film titles and times, at BITAHR’s the official website, and at their Facebook page.

Access to basic medicines can mean the difference between life and death, and is a critical link in realizing the Right to Health. The UN Working Group on Access to Essential Medicines opened its report on Essential Medicines with the assertion that “The lack of access to life-saving and health-supporting medicines for an estimate 2 billion poor people stands as a direct contradiction to the fundamental principle of health as a human right.”

Join PHR in advocating for better access to essential medicines in resource-poor settings through UNITAID’s new Medicine Patent Pool. Our new National Action Toolkit offers analysis, resources to educate your community, and easy advocacy projects. This week of action spans from today – World AIDS Day (December 1) – to International Human Rights Day (December 10).

As Stephen Marks points out in Access to Essential Medicines as a Component of the Right to Health in Health: A Human Rights Perspective, there are many obstacles to making essential medicines available in poor countries: affordable prices; government commitment and policy; adequate, sustainable, and equitable public sector financing; generic substitution; consumer information; efficient distribution; control of taxes; and careful selection and monitoring.  These structural gaps are addressed by the WHO Medicines Strategy, but have proven to be nearly intractable in many low-income countries, with some notable and inspiring exceptions.

Some countries have attempted to overcome the first gap, affordable prices, by negotiating lower prices or substituting patented drugs with ones obtained through their own production or parallel importation. The pharmaceutical industry challenges the idea that patents cause a lack of access (in part, because not all of the 319 products on the WHO Model List of Essential Medicines are patentable). Nevertheless, patents to protect investment in research and development are linked to the high price of certain drugs, notably antiretrovirals (ARVs) to manage HIV/AIDS.

As Lisa Foman asserts in ‘Rights’ and Wrongs: What Utility for the Right to Health in Reforming Trade Rules on Medicines, public pressure, legislative advocacy, and legal accountability are more likely to provoke corporate innovation for diseases affecting poor countries than commercial reasons. In other words: the profit motive does not adequately produce public goods like medicines.

So, this year, we suggest you put these human rights strategies to work. This December, the PHR NSP National Action asks you to educate your community about this human rights issue, and ask drug companies to participate in the UNITAID Medicine Patent Pool.

The prohibitive cost of providing needed drugs impedes access. Join the PHR National Student Program in demanding universal access to essential medicines.

A couple weeks ago, I was lucky enough to have a poster at the International AIDS Conference in Vienna, Austria. This conference is amazing – everyone is there from all parts of the AIDS movement: investigators, advocates, NGOs, everyone. And, coming out of it, there are two things I want to highlight for the PHR student community:

First, the lifting of the AIDS travel ban was a huge step forward for the US, and because of it, in 2012 we’re finally going to be able to hold the International AIDS Conference on US soil, in our nation’s capital.

But even though people with HIV can come into the US, a lot of at-risk populations still can’t. People with a history of sex work or drug use offenses are still going to run into major visa and entry issues, so we in the human rights community have our work cut out for us. We only have a scant 2 years to get the US government to lift its substance use and “moral turpitude” travel restrictions (yes, that’s the actual legal language). Having an AIDS conference in our country but not allowing the most at-risk populations to attend would be a disgrace to our country’s AIDS record, and a violation of the human rights of hundreds if not thousands of people.

Second, the first successful proof-of-concept trial for a vaginal microbicide brought us this much closer to the long-sought female-controlled AIDS prevention mechanism. This field is exploding, and holds real hope for new prevention strategies until a highly effective vaccine is available. (And, as I heard at one session, the ladies liked using the gel – they didn’t want to give it back at the end of the trial. Even better.)

So, the bottom line is, there’s reason for hope, but we’ve got serious problems to solve before then. So let’s get on it.

(Cross-posted from the Northeast Regional Hub.)