Sharing different forms of HIV/AIDS IEC materials within the region

Facilitators present a Cambodia’s T-shirt with picture and massage on HIV and AIDS as an IEC example to the participants at the workshop in Bangkok.

By Chhay Sophal

People Living with HIV (PLHIV), HIV/AIDS workers and media people have recently met in Bangkok, Thailand, to share experiences, lessons learned, and best practice methods when utilizing Information, Education, and Communication (IEC) materials, in the context of strengthening HIV and AIDS approaches, towards gaining Universal Access in the region. The meeting entitled “Working Together: IEC Workshop” was hosted by AIDS ACCESS Foundation on 21-23 May. Some 30 people from seven countries -- Cambodia, China, Laos, Myanmar, Nepal, Thailand, and Vietnam -- attended the workshop. Among the attendees there was one KHANA representative, and two representatives from KHANA’s implementing partners, SEADO and CPN+. Workshop facilitator Waranuch Chinvarasopak emphasized that the gathering in Bangkok would allow for an IEC network to be established and a framework provided to encourage each country to establish a national network. “During the three day workshop, we will be sharing our goals and visions on HIV and AIDS regarding to the prevention of new infections, promoting quality of life of PLHIV by reducing stigma and discrimination, and increasing access to quality care and treatment,” Chinvarasopak said. IEC is extremely important for initiating and supporting social and behavioral changes. IEC materials can increase HIV/AIDS awareness, knowledge and education, motivate change, and to sustain behavior changes, she added.
Before displaying the country specific HIV/AIDS IEC materials at the workshop, the participants brainstormed their ideas and reached an understanding of the commonalities shared between each country, when responding to HIV and AIDS, such as; acceptance, understanding, participation, support, living and working together, love, care, prevention, providing information, decreasing the infection and misinformation, empowerment, freedom, rights, accessing to treatment for all, and harmony.
The participants uncovered areas which require further attention, when designing, developing and delivering IEC materials. It was also discussed which areas should be up-scaled, due to the effectiveness of such materials and what materials/ methods should be discontinued. A strong focus was taken on the IEC development process, particularly; “Who is the target audience who do the IEC materials target?”, “What is the rational behind it why are such IEC materials needed?”, “What is the key message/s and what is the desirable outcome of the IEC materials (change/action)?”, and “ What approach or tone that will be used to deliver the IEC material?”. As well as this, the unexpected impacts or negative results of IEC materials on cultural norms of each country, was also discussed. The importance of media was highlighted, as media can potentially play a key role when outreaching to the public. The meeting urged media outlets and practitioners to report news stories on HIV and AIDS and other related issues without sensationalism to avoid negative consequences.
The workshop also discussed gender and HIV and AIDS and ended with some recommendations and suggestions on how to establish both a national and regional network for IEC network and how to effectively design and develop of IEC materials and BCC programmes.

Forum to discuss world food crisis

Mr. Werner vom Busch (left), Director of Media Programme Asia of Konrad Adenauer Foundation, gives his welcoming remark at the forum. Next, Mr. Pana JANVIROY, President of the Nation newspaper of Thailand, and Dr. Sebastian PAUST, Executive Director of Asian Development Bank.

By Chhay Sophal
While the world is facing a food crisis, many countries are making attempts to address these issues. Agricultural experts and a group of senior journalists from Asia and Europe have tried to uncover effective solutions for global consumers. The discussion was held in Bangkok, Thailand, in June and reported in the Asian-European Editors’ forum. The article is titled “The World Food Crisis: Effects on Asia and Solutions”....

Dr. Sebastian PAUST, Executive Director of Asian Development Bank, said both short-term and long-term factors can cause the food prices to increase in the world. The six short-term factors, he said, are the decline of US dollars, decline of food stocks, natural disasters, conflict and political unrest in several countries that disrupted local productions, disputable short-term policy responses in key importing and exporting countries, and heavy influence of market speculation. The long-term factors are stagnation of food grain yields and slow pace of development of high-yielding, distortion of incentive for agricultural production, neglecting of rural areas and insufficiency of agricultural sector in Asian nations, demographic pressure with growing of population while agricultural land is losing, energy price is rising causing the prices of agricultural tools such as fertilizers and fuels are high, Asian people eat more and better food (more consumption), diversion of cereal use from food to alternative fuel (biofuel), and the global trade issue, he added.

Speaking to the forum, Duncan Macintosh, spokesperson of the Manila-based International Rice Research Institute, the climate change followed by drought, flooding, and salinity is the worst problem of agriculture for present and the future. He, however, suggested that Asia can increase its agricultural products and food security until it improves technology by taking into account the climate change and taking full advantage of revolutions in biology, genetics, information technology and communications.

Since early this year, the world have been in food crisis and the international food aid agencies warned to cut off or end food supply to food seekers. The United Nations World Food Programme (WFP) feeding nearly 89 million people, including 58.8 million children, worldwide also met difficulties and it announced to cut some food supply this year. In Cambodia, the WFP has already cut food supplies to some 450,000 Cambodian primary-school students previously received breakfast. WFP, however, confirmed in April that monthly food rations to People Living with HIV/AIDS (PLHIV) and Orphans and Vulnerable Children (OVC) households, in addition to the food support to TB patients, pregnant and lactating women and their infants under the Mother Child Health programme will continue without interruption throughout 2008. By the end of 2008, WFP expects to distribute over 5,200 metric tons of food to 70,000 PLHIV and OVC beneficiaries alone and with the recent Cambodian government’s contribution of 3,000 metric tons of rice to WFP, together with other donations will be used to target the most in need. On April 23, German government announced to provide food support with $2.25 million dollars by an additional $15 million to Cambodia through WFP. According to a press release from the German embassy in Phnom Penh on 18 June, the Food Aid is not seen by the German government as a structural support to developing partners but its contributions to WFP are made available to safeguard the needs for survival of people in need.

Dr. Kwanchai A. GOMEZ, Executive Director of the Thai Rice Foundation, said the rice sources in Asia on a path of eradication and it is not Asia’s problem anymore, but the whole world. She urged the governments to push to produce more agricultural products to meet the consumers’ needs.

Vichai SRIPRASERT, Honorable President of the Thai Rice Exporters Association, and President of Riceland International Ltd in Bangkok, said high price means low sale and farmers always ask for high price but they are wrong. “If the price is too high, then only a small amount of rice is sold. If I were a farmer, I would not ask for high price of rice but I would ask for more water and more irrigation,” he said. Vichai also asserted that the current financial, fuel and commodity crisis influences the rising rice prices. .

Some 50 participants from Cambodia, Britain, Bangladesh, Bhutan, China, Czech, Denmark, France, Germany, India, Indonesia, Korea, Japan, Malaysia, Myanmar, Nepal, Pakistan, Philippines, Russia, Singapore, Sweden, Switzerland, Thailand, and Vietnam, attended the forum organised by German’s Konrad Adenauer Foundation on 12-15 June.

Cambodia’s Sex workers hail government’s intervention

By Chhay Sophal

On 15 February, 2008, Cambodia launched a new law on its human trafficking and sexual exploitation. The law aims at punishing all crimes against human trafficking and sexual exploitation in order to protect human rights and dignity; to improve the country’s proper customs and cultural value; and to implement the UN protocol on the issue. Article 23 of the law states that: “Prostitution” in this law shall mean having sexual intercourse with an unspecified person or other sexual conduct of all kinds in exchange for any value”.

However, entertainment workers (EW)/sex workers (SW) and AIDS activists have expressed their concerns on the legislation. “I have never heard of the sexual exploitation law and if it is real I think it is really severe for us. I agree to say that selling sex is affecting the Khmer culture and really bad for the Khmer women’s reputation but we have no choice,” said a 36-year-old direct EW in a brothel in Sihanouk Ville, the international seaport and resort. Srey Rath, a widow of four children, who has been a sex worker for about 10 years said she and her friends do not want to make their living from selling sex but they are poor and illiterate. Rath was trafficked to Thailand to be a sex worker in late 1990’s. She used to use drugs as well. “We are women. We do not want to be sex workers but the poverty and the social situation has driven us to this. The leaders should understand about our situation”.
Poverty and the lack of skills seem to be significant factors hindering the social progression for the Cambodian women who contributed to the discussion. Most of them depend financially on their husbands, some of the women expressed that their husbands had died and that this placed a significant strain on their life particularly if they had children, “I really do not want to go out and sleep with men but since my husband died I have no support. I have no skill to find a job,” said a 27-year-old widow of three kids working as a waitress in a restaurant in Sihanouk Ville. “Going out with men at night I get about US$30 and sometimes up to $100,” she said. “If the sexual law becomes into affect and the enforcement is strict, I think it is really bad for us. We do not know how to survive.”
According to the National Center for HIV/AIDS, Dermatology and STDs (NCHADS), it is estimated that there are 3,430 direct EWs and 13,723 indirect EWs in Cambodia. KHANA, through its implementing partners nationwide, reached 1,568 direct EWs and 4,715 indirect EWs, providing them knowledge of HIV and STD preventions last year.

Anter Nita, Director of the Sihanouk-based Community United for Development (CUD), said if the law enforcement is so strong, EW, especially the brothel-based EW will go into hiding. CUD and other organizations working on HIV and AIDS and STDs will then need to reassess the current prevention methods to reach this population, to continue to provide them with health education. “My organization helps regularly educate about 345 sex workers how to prevent themselves from HIV and AIDS and STDs transmission, how to lobby their clients who use violence for sex without using condoms, and how to find good services for their health care,” Nita said. “Our programme for 100 condoms use and HIV prevention education programmes among sex workers will be affected if sex workers are in hiding.”

According to reports from local non-governmental organisations, the local police in a few provinces have instructed owners of karaoke parlors, night clubs, and bars that they will be finned if premises contain condoms. The reports showed that since the inception of the law some brothels have closed and people are now afraid of talking openly about or displaying condoms.
“I would like to appeal that the law should drop the version of punishment sex workers otherwise we have no way to make our living. We of course do not want to be sex workers, but we have no other job to do. On the other hand, the brothel-based sex workers will become freelance sex workers who have no specific place to stay and they can not receive any education on HIV and AIDS,” Srey Rath said.

Cambodia’s Sex workers hail government’s intervention

Khema sits on the floor in a room and applies her makeup. She is a 24-year-old widow, with two kids, and became a direct entertainment worker after fell into debt
By Chhay Sophal
A few months ago, Khema had no job and no income at all, as her brothel owner in Siem Reap closed his business. This impacted Khema significantly and caused her to spiral deeper into a state of destitute. She experienced a large amount of stress as she attempted to provide her two young children and elderly mother with basic necessities, such as food.

“I am so happy that I can earn money again. About three months ago, my brothel owner closed his business because he heard from police about fines and the detention centres” said the 24-year-old widow, whose husband had another wife. With no skills and little education, Khema left her home village in Kampong Thom to be a karaoke lady and then a brothel-based entertainment/sex worker in Siem Reap town (the main town in Cambodia which attracts the most tourists).

Sitting on the floor in a room with a wooden bed at around 5 pm, Khema applies make–up to her face before opening for business. With a big smile, she expressed the rush of happiness she had when she and her colleagues in the brothel discovered that they are free from threats from law enforcers. “Our shop owner told us that we act as massagers, not prostitutes. Doing is to avoid police’s arrest. I, of course still have a fear of being arrested by the police, but I have no choice. If I do not sell myself for sex, I cannot earn money to support my children and mother who live in the village, or me.”

On 15th February, the government launched a new legislation to punish all crimes against human trafficking and sexual exploitation. The law states that the country needs to implement the UN protocol on the issue while human rights and dignity must be protected and the country’s proper customs and cultural value must be improved. Article 23 of the law states: “Prostitution” in this law shall mean having sexual intercourse with an unspecified person or other sexual conduct of all kinds in exchange for anything value”.

According to reports from local non-governmental organisations, local police (in a few provinces) have instructed owners of karaoke parlors, night clubs, and bars that they will be finned if premises contain condoms. The reports showed that since the inception of the law some brothels have closed and people are now afraid of talking openly about, or displaying condoms. The reports also included that during some of the brothel crackdowns direct and indirect entertainment workers are becoming victims of sexual abuse and robbery, whilst in police custody. Choeun Sinoeun, Programme Manager of Men’s Health Cambodia, a local NGO based in Siem Reap, said since the announcement of the new law, several brothels have converted to massage and karaoke parlors but sex is still offered. However, he said, it is difficult for his organisation to reach entertainment workers; to provide them education on healthcare, especially on HIV/AIDS and STI prevention. “Direct entertainment workers do not want to show up due to their fear of being arrested by the police and being detained,” he said. With support from KHANA, he said, his organization reaches 20 direct entertainment workers and 1,100 indirect entertainment workers in Siem Reap; to provide them with HIV/AIDS and STI education and prevention via the promotion of the 100% condom use programme (Cambodia’s nationally commended strategy).

On 4th June, Deputy Prime Minister and Minister of Interior Sar Kheng explained the legal action that would be taken against officials accused of sexually abusing or robbing entertainment workers, who have been taken into custody during brothel crackdowns. His comment was made one day after hundreds of entertainment workers held a rally to protest the new law. Some protesters accused police and other law enforcers of poorly implementing the law. Furthermore some protesters spoke about the physical abuse, gang rape, and robbery that had been witnessed during some of these raids. Sar Kheng said the government, especially the Ministry of Interior, will take legal action against any official who is accused of such incidences. However, evidence must be provided by the victims before action can be taken.
A commitment to improving the protection of direct and indirect entertainment workers is good news for Kema and other entertainment workers nationwide. “I am really happy to hear this and I hope that police will not abuse and rob us,” she said. Khema, a single mother of two kids, decided to be a direct sex to deal with her debt with high interest in the village. “I have no money to pay back to my debtor. With no choice, I have to be a sex worker. I know such business is affecting to the Khmer culture and my reputation as well. But if I do not take this business, I do not know how my family and I can survive,” she added.

According to the National Center for HIV/AIDS, Dermatology and STDs (NCHADS), it is estimated that there are 3,430 direct entertainment workers and 13,723 indirect entertainment workers in Cambodia. KHANA, through its implementing partners nationwide, reached 1,568 direct entertainment workers and 4,715 indirect entertainment workers by providing them with education of HIV/AIDS and STD preventions, last year.

Many Cambodian women depend financially on their husbands. Some of them, expressed that if they became widows, they will be burdened, their families would suffer tremendously, poverty would increase and their literacy levels would plateau. “As I am a poor widow who has very little education, I do not know what to do to make money. When my kids were sick, I borrowed some money from my neighbours but I had no money to pay them back and the interest become higher and higher,” Khema said.

“I want to appeal to the government to help develop the rural areas, provide jobs and vocational training and skills to women, and to provide opportunities to girls to attend school to reach a higher education, so that they can have a good future and will be able to avoid the work I am doing.”

Cambodia’s sex workers and AIDS activists express concerns on the country’s new law

By Chhay Sophal

On 15 February, 2008, Cambodia launched a new law on its human trafficking and sexual exploitation. The law aims at punishing all crimes against human trafficking and sexual exploitation in order to protect human rights and dignity; to improve the country’s proper customs and cultural value; and to implement the UN protocol on the issue. Article 23 of the law states that: “Prostitution” in this law shall mean having sexual intercourse with an unspecified person or other sexual conduct of all kinds in exchange for any value”.

However, entertainment workers (EW)/sex workers (SW) and AIDS activists have expressed their concerns on the legislation. “I have never heard of the sexual exploitation law and if it is real I think it is really severe for us. I agree to say that selling sex is affecting the Khmer culture and really bad for the Khmer women’s reputation but we have no choice,” said a 36-year-old direct EW in a brothel in Sihanouk Ville, the international seaport and resort. Srey Rath, a widow of four children, who has been a sex worker for about 10 years said she and her friends do not want to make their living from selling sex but they are poor and illiterate. Rath was trafficked to Thailand to be a sex worker in late 1990’s. She used to use drugs as well. “We are women. We do not want to be sex workers but the poverty and the social situation has driven us to this. The leaders should understand about our situation”.
Poverty and the lack of skills seem to be significant factors hindering the social progression for the Cambodian women who contributed to the discussion. Most of them depend financially on their husbands, some of the women expressed that their husbands had died and that this placed a significant strain on their life particularly if they had children, “I really do not want to go out and sleep with men but since my husband died I have no support. I have no skill to find a job,” said a 27-year-old widow of three kids working as a waitress in a restaurant in Sihanouk Ville. “Going out with men at night I get about US$30 and sometimes up to $100,” she said. “If the sexual law becomes into affect and the enforcement is strict, I think it is really bad for us. We do not know how to survive.”
According to the National Center for HIV/AIDS, Dermatology and STDs (NCHADS), it is estimated that there are 3,430 direct EWs and 13,723 indirect EWs in Cambodia. KHANA, through its implementing partners nationwide, reached 1,568 direct EWs and 4,715 indirect EWs, providing them knowledge of HIV and STD preventions last year.

Anter Nita, Director of the Sihanouk-based Community United for Development (CUD), said if the law enforcement is so strong, EW, especially the brothel-based EW will go into hiding. CUD and other organizations working on HIV and AIDS and STDs will then need to reassess the current prevention methods to reach this population, to continue to provide them with health education. “My organization helps regularly educate about 345 sex workers how to prevent themselves from HIV and AIDS and STDs transmission, how to lobby their clients who use violence for sex without using condoms, and how to find good services for their health care,” Nita said. “Our programme for 100 condoms use and HIV prevention education programmes among sex workers will be affected if sex workers are in hiding.”

According to reports from local non-governmental organisations, the local police in a few provinces have instructed owners of karaoke parlors, night clubs, and bars that they will be finned if premises contain condoms. The reports showed that since the inception of the law some brothels have closed and people are now afraid of talking openly about or displaying condoms.
“I would like to appeal that the law should drop the version of punishment sex workers otherwise we have no way to make our living. We of course do not want to be sex workers, but we have no other job to do. On the other hand, the brothel-based sex workers will become freelance sex workers who have no specific place to stay and they can not receive any education on HIV and AIDS,” Srey Rath said.

Stigma takes centre stage at AIDS Conference in Mexico

By Chhay Sophal

Standing up for the rights of People Living with HIV (PLHIV) and other vulnerable people remains at the forefront for HIV/AIDS activists around the world. Stigma and discrimination were critical issues discussed at the 17th International AIDS Conference in Mexico City on 3-8 August, 2008. Although HIV/AIDS activists and policymakers have worked hard to sensitize the public and debunk inaccuracies about the virus, many PLHIV still face hardships even beyond their disease.

“In most countries, stigma against people living with HIV remains a grave challenge. One third of countries still do not have laws to protect people living with HIV…This must change,” said United Nations Secretary-General Ban Ki-moon in his address at the opening session of the Conference on 3 August.

In his remarks, the Secretary-General focused largely on issues of stigma and discrimination, as he called on politicians around the world to “speak out against discrimination and protect the rights of people living with and affected by HIV, for schools to teach respect, for religious leaders to preach tolerance, and for the media to condemn prejudice in all its forms”. Mr. Ban who has met with his colleagues in the fight against HIV/AIDS as well as people living with HIV since taking his post as the UN Secretary General, also urged all nations to “live up to their commitments to enact or enforce legislation outlawing discrimination against people living with HIV and members of vulnerable groups.”

Expounding on this appeal, Dr Margaret Chan, Director-General of the World Health Organization, said the world must work harder to reduce such common challenge. “We must work much harder to fight stigma and discrimination, including institutionalized discrimination. In many countries, legal as well as social and cultural barriers prevent groups at risk from receiving the interventions and knowledge needed to reduce harmful behaviour, Dr Margaret said.

Dr. Pedro Cahn, the AIDS 2008 Conference Co-Chair, added that “along with many of you here, we have raised our voice against stigma and discrimination, denouncing social inequity as a major driving force of this human tragedy and speaking on behalf of thousands of HIV professionals from around the world”.

As the conference co-chair and International AIDS Society Governing Council Regional Representative for Latin America and the Caribbean, Dr. Luis-Soto Ramirez, said in his opening session that stigma and discrimination “continue to hamper our progress against this disease.”

The world leaders also applauded the decision by United States Congress to re-authorize PEPFAR with 39 billion dollars for AIDS, an initiative signed into law by President G W Bush on 30 July. They also welcomed the news the United States has lifted its 20-year law banning PLHIV from entry into the United States.
At the end of the conference, on 8 August, delegates also called for the removal of laws that criminalize and stigmatize groups at risk for HIV. The New York Times quoted Edwin Cameron, a justice of the Supreme Court of Appeals in South Africa, as saying that “criminalization is a poor tool for regulating H.I.V. infection and transmission.” According to the Times, Justice Cameron, who is living with HIV, said “let one of the conference outcomes be a major international push-back against misguided criminal laws and prosecutions.”

In an op-ed article in the Washington Times on 6 August, the UN Secretary General also said “Stigma remains the single most important barrier to public action. It is the main reason too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment.” Stigma, he said, is a chief reason the AIDS epidemic, the silent killer, continues to devastate societies around the world.

G8 leaders get pressure on responding to AIDS

By Chhay Sophal

At the end of the 17th International AIDS Conference on 3-8 August in Mexico City, G8 industrialised nations are urged to more actively commit to responding to AIDS, the world silent killer.

Michel Kazatchkine, the Executive Director of the Global Fund to fight AIDS, tuberculosis and malaria, said at the close of the six-day conference that the world “should be deeply concerned that with less than two years to go before our deadline for universal access, the G8 has committed little more than a third of the resources that it has promised to deliver by 2010."

In his closing session remarks, Dr. Julio Montaner, Director of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, Canada, and the new President of the International AIDS Society, said though there is “tremendous commitment” on the part of the United States, which has contributed $48 billions towards responding to HIV/AIDS, tuberculosis and malaria, such responsibility cannot lie solely on the Americans’ shoulders. “The world must follow their example. Ultimately, if George W Bush got it, the rest of the G8 leaders should get it!” he said. Dr. Montaner also called upon the Canadian Prime Minister Hon. Stephen Harper to join the rest of the G8 leaders “to match President Bush’s contribution, now! …We must keep the pressure on the G8 leaders to follow up on their commitment to achieve universal access to prevention, care and treatment by 2010.”

Addressing the opening session of the conference on 3 August, United Nations Secretary-General Ban Ki-moon said that more funding is needed in the next decades to fight against AIDS. “As the fight against AIDS nears the end of its third decade, we are still facing a huge shortfall in resources. The responses to HIV and AIDS require long-term and sustained financing,” he said. “As more people go on treatment and live longer, budgets will have to increase considerably over the next few decades. In the most affected countries, donors will have to provide the majority of the funding.” Mr. Ban also promised that he would work to “mobilize funding and to ensure that AIDS will remains a system-wide priority for the United Nations. You can count on me.”

In 2005, the G8 nations set a goal of providing HIV treatment to all who needed it by 2010. The G8 nations comprise Germany, Canada, the United States, France, Italy, Japan, the United Kingdom and Russia.

World need “Combination” in responding to AIDS

By Chhay Sophal

At the mass gathering of the 17th International AIDS Conference in Mexico in early August, world leaders were urged to create a global “combination” to combat a common crisis, AIDS.

Speaking in his closing session remarks, Dr. Julio Montaner, the President of the International AIDS Society, said the key word emerging from the conference was “combination”. Dr Montaner said that five combinations are very important to tackle the crisis: combination of prevention strategies tailored to decrease HIV transmission; of antiretroviral therapy to dramatically reduce morbidity and mortality among those infected; of antiretroviral therapy to reduce community viral load as an aid to HIV prevention; of strategies to enhance HIV testing; and of strategies to reduce poverty and discrimination.

Dr Montaner added that although the number of people dying of AIDS is down to two million people in 2007, from 2.2 million in 2005, it is “still 2 million too many!”

UNAIDS Executive Director Peter Piot said that the world must never forget that the epidemic could return with new surprises. “Combination prevention is very important. Combination prevention means finding the right mix of activities for each local epidemic. Combination prevention also involves mobilizing for social change – no more stigma around HIV,” he said. “We’ve got a mind of our own! Broadening the coalition must not come at the expense of the non-negotiables of working across sectors, involving civil society and of people living with HIV, grounding our action in science, rooting all we do in human rights, and focusing on results for people.”

Sharing his thoughts during closing session remarks, Dr. Pedro Cahn, the Conference Co-Chair, said it is now time for world leaders, scientists and community members to keep their commitments on track. “On your way back home be reminded that you can make a difference. People living with HIV and AIDS and millions more at risk need you to do your part of universal action now,” he said.

Dr Margaret Chan, Director-General of the World Health Organization, said that a “commitment to universal access” is an expression of respect for the value of each and every life affected by the disease and that it is a “monumental achievement”. He added, however, said the epidemic is not over. “We are in this for the long haul…. The pursuit of equity, social justice, and universal access is its driving force. This is an inclusive approach that encourages community participation and ownership, including ownership by people living with HIV,” he said.

What is the International AIDS Conference?

35-year-old HIV-positive widow, Makara, prepares snooker ball for her young clients at her home. Makara says she never knows about the17th international AIDS conference in Mexico.

By Chhay Sophal

While thousands of world leaders, policymakers, AIDS activists, and People Living with HIV (PLHIV) have met during the 17th International AIDS Conference in Mexico on 3-8 August, Cambodian PLHIV know little about it. “I am really unaware of the conference so I do not know what they talk about. Did they find an HIV vaccine?” asked Makara, 35-year-old widow who is living with HIV.

Living in Sihanouk Ville, an international seaport and resort town in the southwest of the country, Makara often sees on reports on HIV and AIDS on television and in the newspaper, but she has not seen any reports on the AIDS conference in Mexico. “I very often watch TV but I never saw a report on the conference,” she said.

Several PLHIV and AIDS peer educators interviewed also said that they did not know about the global event. “I listen to radio but I never heard the news on the conference,” said another HIV-positive widow, 38.

Speaking in his closing session remarks at the 6-day AIDS Conference, Dr. Julio Montaner, the President of the International AIDS Society, said the conference organisers sponsored over 2500 delegates from 95 countries. He said the organisers are in a “debt to the members of the media who joined us in Mexico. They have worked tirelessly to cover all aspects of the conference. Their work represents a fundamental piece of the puzzle, as it provides effective and timely knowledge translation of our proceedings.”

However, no Cambodian journalists were invited to cover news at the conference, although several governmental and non-governmental organisations representatives attended. Mr. Pen Samtthy, the Editor-in-Chief of the country’s leading newspaper, Rasmei Kampuchea or Light of Cambodia, said he was also surprised that no journalists from Cambodia were invited. Mr. Samitthy who is also President of the Club of Cambodian Journalists, whose members number nearly two hundred journalists, said that he wished his colleagues had attended the Conference to cover the developments and the stories behind it.
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Chinda (right), a 38-year-old widow living with HIV, sells banana at her home to her neighbouring kid while being interviewed by Chhay Sophal. Chinda says she is unaware of the17th international AIDS conference in Mexico.

No ARV no life for PLHIV

By Chhay Sophal

Holding an Anti Retro-Viral (ARV) pill in her hand, 8-year-old Cambodian Heang Sok Heng, whose mother and younger sister died of disease related to AIDS in several years ago says “my grandmother gives me to take it everyday”. Living with her grandmother, Heang Sok Heng was diagnosed as HIV-positive when she was one year old. “She cannot live without ARV. If she does not have it, she will die and leave me alone,” says Chhoeu Voeun, Heang Sok Heng’s 58-year-old grandmother.

The young girl takes ARV twice a day -- in the morning before going to school and before going to bed – while Opportunistic Infection preventatives are taken at lunchtime. “Without these medicines, my granddaughter cannot survive,” said Chhoeu Voeun bursting into tears. “ARV has given my granddaughter a second chance at life, she cannot live without it.”

Heang Sok Heng is one of tens of thousands of Cambodian People Living with HIV (PLHIV). Although the country’s HIV infection rate has dropped from 1.2% in 2003 to 0.9% in 2006, the prevalence amongst married women infected by their husbands is still high, while one third of new infections result from transmission from mothers to children.

An official from the National AIDS Authority (NAA) said ARV will remain in high demand for at least the next two years. “Some 18,300 women and 17,000 men will need ARV between 2008 and 2010,” said Dr. Hor Bun Leng, NAA Deputy Secretary General. He estimated that an HIV-positive person could spend about US$1,000 each per year for ARV. Dr. Bun Leng also warned that the epidemic can return if the country is reluctant to take steps for additional prevention. Vulnerable groups such as people aged 15-49 years mobile populations, sex workers, men who have sex with men, drug users and married women are at high risk and the high mortality rate from AIDS has resulted in many orphans and widows, he added.

This situation is replicated across the world. The efforts of researchers and medical workers, who work together to produce and deliver ARV, are saving the lives of those with HIV/AIDS. “Three million people on antiretroviral therapy worldwide is not just the greatest public health achievement of the new century, it is a tribute to all of you who have fought so hard to understand HIV and to make available the drugs that are saving these lives,” Festus G. Mogae, former president of the republic of Botswana, said in his opening remarks on August 3 at 17th International AIDS Conference in Mexico City. Mogae also said he salutes and acknowledges “the leading role of pharmaceutical companies of the world who are often maligned.”

Speaking in his opening speech at the conference, UNAIDS Executive Director Peter Piot, also urged scientists and funders to continue their efforts to develop an HIV vaccine allow more people to access ARV. “In the long run the best way to stop people dying from AIDS is to reduce new infections in the first place. But in the meantime, the treatment imperative remains as strong as ever, because let’s never forget that this is about people. Because this is about entitlement to life,” he said. “One of the main lessons of providing antiretroviral therapy to millions of people is that we should not wait until systems are fixed before acting, because I know what would have happened to the 3 million people on ART today if we had waited: most would be dead by now.”

In his opening session speech at the conference, Dr. Luis-Soto Ramirez, the Conference Co-Chair and International AIDS Society Governing Council Regional Representative for Latin America and the Caribbean, said several countries in the region have challenged the idea that treatment could only be accessible to “the lucky few who had the money to pay for antiretroviral drugs,” and are fighting hard to lower drug prices to bridge the gap between north and south. “It is time to bring drugs to everyone in need, regardless of who they are, where they live, or how much they earn. It is time for Universal Action NOW,” he said.

In his closing session remarks, Dr. Julio Montaner, Director of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, Canada, and the new President of the International AIDS Society, said though the number of children infected with HIV/AIDS fell from 410,000 in 2005 to 370,000 in 2007, this was hardly a victory,…”

If the appeals of the leaders and delegates at the conference are realised, there will be good news for Heang Sok Heng and PLHIV across the world. “I am really happy if all PLHIV can get regularly enough ARV with free of charge. We do not fear any more,” said Heang Sok Heng’s grandmother. “I would like to call on the world doctors to produce more ARV for PLHIV and find HIV vaccine so that my granddaughter and other people living with AIDS can live longer.”