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Breakthrough in the Fight Against HIV
Study Shows ARVs Can Protect the Uninfected Against HIV
Khopotso Bodibe
AllAfrica
A multi-national study shows that if an HIV-positive person starts taking antiretroviral therapy early on, that is, when their CD 4 count is still high, their chances of infecting their HIV-negative partner can decrease by as much as 96%.
The results of the study are viewed as confirmation of untested wisdom among clinicians who have for a number of years thought that people on combination antiretroviral therapy have a lower chance of transmitting HIV to their uninfected partners. This was presumed on the basis that ARVs fight off HIV infection, which results in the reduction of the viral load in one’s system. The study involved almost 1 800 people in sero-discordant relationships, where one partner has HIV and the other doesn’t. They were from Africa, Asia and the Americas. In South Africa, the study was conducted at two sites in Johannesburg – Helen Joseph and Chris Hani Baragwanath Academic hospitals, and involved almost 100 participants. A key requirement was that they needed to have a considerably higher CD 4 count of 350 – 550.
“We were looking to confirm or to evaluate whether combination antiretroviral treatment can interrupt HIV transmission between HIV-discordant partners”, says Dr Guy de Bruyn, the principal investigator who conducted the clinical study at Chris Hani Bara.
The result showed a significant potential.
“We’ve shown that there’s a 96% reduction in transmission of HIV from the positive partner to the negative partner”, says Dr Sharlaal Badal-Faesen, the principal investigator at the Helen Joseph Hospital site.
This was a randomised study where participants were divided into two groups. Those on the intervention arm were given different ARV combinations and those on the control arm started receiving ARVs only when they reached a stage where, according to national AIDS treatment guidelines, they would qualify for treatment at a CD 4 count of 200 or when they started getting ill with AIDS defining symptoms.
“On the one arm, 50% of these patients received ARVs immediately. On the second arm, those patients did not receive ARVs when they started on the trial. They were monitored until their CD 4 counts reached 250 or below, and then initiated on ARVs. So, in that way we could compare subjects that got ARVs to subjects that do not get ARVs”, explains Dr Badal-Faesen.
Dr de Bruyn adds that “there had been 28 infections that were linked in other words, that were demonstrated by molecular methods to have come from the HIV-infected partner and passed to the initially uninfected partner. Of those 28, 27 were in the group that received treatment according to guidelines and only one was in the group that received immediate antiretroviral therapy. So, that is where we arrived at the 96% difference comparing those two rates”.
He says throughout the study, participants were advised to follow safe sexual practices, which some might have followed adequately and others not. That, then, would explain the differences in levels of infection in both study groups.
“What we are reporting is the actual number of infections that occurred. Essentially, we’re showing that the immediate treatment arm was protected at a far higher rate than people that were in the arm that was treated per guidelines. We assume that the behaviours, on average, would have been similar across both groups. That’s something that’s inherent in a randomised trial. For example, potentially by the act of randomization, the propensity to use condoms when advised to do so should be equally distributed between the two groups”, Dr de Bruyn says.
The second element of the study was to investigate whether early anti-retroviral therapy can protect HIV-positive people from HIV-associated illnesses, as “starting patients earlier on ARVs obviously improves their immunity. So, in so doing they have the added advantage of protection from opportunistic infection”, adds Dr Badal-Faesen.
“In this particular study we’ve shown that there was a 40% reduction in morbidity”, she says.
The recommendations arising out of the findings suggest that early intervention with ARVs could reduce morbidity in HIV-infected people as well as add to HIV prevention methods that exist.
“The implication is that we need to be providing treatment earlier than we do currently. The benefit to the individual receiving treatment is present whether you start late, when it’s life saving, or earlier, in which case you reduce clinical events as we saw in this study. Not only is it beneficial to the individual, but it’s also highly effective in reducing transmission to their partners. And that, hopefully, could be an important tool in reducing the epidemic”, concludes Dr de Bruyn.
University of Ghana Thief ‘Fingering’ Update
JoyOnline
Four ‘Fingering’ University of Ghana Students on the Run
Four students of the University of Ghana suspected to have taken part in the ‘fingering’ of a young woman accused of laptop and mobile phone theft have absconded, the police have said.
The four were part of 13 others who allegedly sexually assaulted Amina Haruna and were last week invited for an interrogation and identification parade but refused to turn up.
The nine who did, have been granted bail by a court in Accra with a surety of GHS 9,000 each.
The bail follows a request by the defence to allow their clients the opportunity to prepare for their exams.
Police acting Public Relations Officer Cephas Arthur confirmed the four had absconded.
“For now we can say that they have absconded, that is a fact. The information we have is that they have run away,” he said.
He said the “police will ensure that these four people are also brought to face the law because they are suspected to have committed an offence.”
“The police are going to do everything possible; we are already collaborating with the university authority; we will continue to collaborate with them until we get them.
“We also have other means by which to get them. We can take a warrant for their arrest and publish the warrant.
“Even if they decide to travel abroad we also have the Interpol and other bodies [to assist],” he said.
Meanwhile, the nine are to reappear in court on May 30, 2011.
The Daily Guide
8 Legon Boys Charged For Amina Sex Assault
Eight students of the University of Ghana, Legon, have been charged for indecent assault of Amina Haruna, a lady who went to the campus of the university to trade.
Four more students are expected to join the eight, bringing the number of suspects to 12 in the Amina sexual assault saga.
The eight students who arrived at an Accra Circuit Court yesterday to face charges of indecently assaulting Amina Haruna, the lady who is also suspected to be a thief, were accompanied by tens of their colleagues in a show of solidarity.
The assault victim Amina was also there but it was unclear whether she would also be charged or would be a prosecution witness.
The students, who arrived in three buses, were seen walking to and fro the court while waiting for their colleagues to be tried.
The suspects who were identified by the victim, after a police identification parade, were initially taken to cells at the 28th February Road Court, popularly called Cocoa Affairs Court, and thirty minutes later whisked to Mrs. Georgina Mensah-Datsa’s court where it was revealed by a court clerk that the judge had retired for the day.
They were immediately sent back into the cells, waiting to be taken back to police custody as the case was adjourned to today.
The students are to be charged with indecent assault and causing unlawful harm.
DSP Kofi Blagodzi told journalists that he was still studying the docket and declined to give details such as the names of the suspects or what offence each was expected to be charged with.
Earlier, the Legon Police said they were screening the students suspected to have been involved in molesting Amina, who had earlier been arrested twice for stealing on the Legon Campus.
The university has also indicated in a press release issued on Wednesday April 20, 2011 that a fact-finding committee set up by the school had since Tuesday April 12, completed its work and submitted a report to the Vice-Chancellor who is the Head of the Disciplinary Committee.
“The fact-finding committee appointed by the Executive Committee of the University to look into the circumstances leading to the mentioned event has completed its work and submitted a report on its findings to the Dean of Students and the Vice-Chancellor on Tuesday, 12th April 2011. The Committee identified a number of students who were present during the molestation as seen in the video clips produced and also from credible eye-witness accounts.”
Following this development, a number of students who were identified were handed over to the police to assist in their investigations.
“Without any prejudice to the provisions of the University’s statutes, the list of persons duly identified in the report of the fact-finding committee has been handed over to the Ghana Police Service for its own investigations,” it stated.
The university said that “based on the recommendations of the fact-finding committee, the Vice-Chancellor, in his capacity as the Chief Disciplinary Officer of the University, has referred the case against the persons mentioned in the report to the Disciplinary Committee for students.”
Those persons were invited to meet with the Disciplinary Committee through a Writ of Summons issued on Wednesday, 13th April 2011.
Amina Haruna, a resident of Maamobi in Accra, was on Thursday March 31, 2011 stripped naked when she was caught by students of the Mensah Sarbah Hall, Annex B, popularly called Okponglo, on the Legon campus for allegedly stealing a number of mobile phones and a laptop computer.
Though some of the students were seen trying to free her from the claws of her captors, others were seen eagerly stretching her thighs widely open for their colleagues to insert their fingers and even mobile phones into her vagina, revealing her clitoral region.
Amina’s brassiere and her underpants where shredded and even snatched away, leaving her stark naked for the boys to do their own thing, despite her pleas for leniency.
Police Grab 29 Legon Molesters for Questioning
Twenty nine students of the University of Ghana, Legon have been handed over to assist in the investigations into the molestation of Amina Haruna, 25, who is suspected to have stolen a laptop and mobile phones from the Mensah Sarbah Hall of the university.
The students, who are all residents of the Annex B (Okponglo) of the Mensah Sarbah Hall of the university, were identified by the university authorities on a video tape. The names of the students are being with-held by the police for security reasons.
The students were first handed over to the Legon Police, who in turn conveyed them to the headquarters of the Criminal Investigations Department (CID) of the Police Service for the identification parade which was underway at the time of filing this report.
The victim will have to identify his alleged attackers to enable the police to proceed with their investigations into the incident.
The handover of the students was in fulfillment of an agreement which was reached between the police and the university authorities. Soon after the alleged molestation, the university authorities set up a fact-finding committee to investigate the incident. It recently presented its findings to the Dean of Students and the Vice Chancellor of the university.
The committee, according to a statement issued by the Registrar of the university Mr. J. S Budu, identified a number of students, who were present during the molestation, as seen on the video clips produced, as well as credible eyewitnesses account.
It said based on the recommendations of the committee, students identified were given hearings by the disciplinary committee, as per a writ of summons. A number of students were said to have caught the suspect with mobile phones and a laptop at the hall of the University at about 1 am on that fateful day, Thursday, March 30, stripped her naked and inserted their fingers into her private parts.
She was however rescued by security officers of the university who took her to the Legon Police station at about 3 a.m
Unknown to the students, the act had been filmed by an unidentified person who later released the footage onto the internet. The occurrence, which the authorities said had dented the image of the university, was widely condemned by human right groups, with women’s right activists calling on the security agencies to expedite action on the matter
Legon Authorities to Screen Fingering Boys
Joy Online
The Legon Police say they are currently screening a number of students of the University of Ghana, suspected to have been involved in molesting Amina Haruna, an alleged thief who the police said had earlier been arrested twice for the same offence on the Legon campus.
The university has also indicated in a press release issued on Wednesday, April 20, 2011, that a Fact Finding Committee set up by the school had since Tuesday, April 12, completed its work and submitted a report to the Vice-Chancellor, who is the Head of the Disciplinary Committee.
“The Fact-Finding Committee appointed by the executive committee of the University to look into the circumstances leading to the mentioned event has completed its work and submitted a report on its findings to the Dean of Students and the Vice-Chancellor on Tuesday, 12th April 20II. The committee identified a number of students who were present during the molestation as seen in the video clips produced and also from credible eye-witness accounts,” the press release stated.
Following this development, a number of students who were identified were handed over to the police to assist in its investigations.
“Without any prejudice to the provisions statutes of the University, the list of persons duly identified in the report of the Fact-Finding Committee has been handed over to the Ghana Police Service for its own investigations,” it stated.
The university said that “based on the recommendations of the Fact-Finding Committee, the Vice-Chancellor, in his capacity as the chief disciplinary officer of the University, has referred the case against the persons mentioned in the report to the Disciplinary Committee for students.”
Those persons were invited to meet with the Disciplinary Committee as per a Writ of Summons issued on Wednesday, 13th April, 2011.
The school authorities assured the university and the general public that it would not relent in the discovery and sanctioning of the culprits.
“Management would like to assure the University community and the general public that it is doing all that is possible to bring to book and sanction all those involved in the despicable act seen in the video.”
Amina Haruna, a resident of Maamobi in Accra, was on Thursday, March 31, 2011, stripped naked when she was arrested by students of the Mensah Sarbah Hall on the Legon campus for allegedly stealing a number of mobile phones and a laptop computer.
Though some of the students were seen trying to free her from the claws of her captors, others were seen eagerly stretching her thighs wide open for their colleagues to insert their fingers and even mobile phones into her vagina, revealing her clitoral region.
Amina’s brassiere and her underpants where shredded and even snatched away, leaving her stark naked for the boys to do their own thing despite her pleas for leniency.
The Legon Police told media persons that Amina had twice been arrested for a similar offence and was arraigned.
She jumped bail after an Accra Circuit Court granted her bail.
The police had since sought a bench warrant to arrest her, but were unsuccessful until the unfortunate incident.
However the Legon Police Commander, Chief Superintendent Frank Anning, told DAILY GUIDE in an earlier interview that the Police would arraign Amina and her assailants as well, since the law had no place for offenders and those who took the law into their own hands.
Amina said, but for the intervention and care by her grandmother, would have committed suicide.
She feels dejected as her fiancé has also deserted her and revoked plans to marry her.
UN Cites Urgent Need to Boost Humanitarian Aid in Aftermath of Ivorian Crisis
27 April 2011 –The post-electoral crisis in Côte d’Ivoire may have ended but thousands of civilians are still suffering from the consequences of the four months of turmoil that engulfed the West African nation and require increased humanitarian assistance, the United Nations said today.
UN aid officials have estimated that up to 1 million Ivorians have been displaced by the violence, with some internally displaced and others forced to flee into neighbouring countries – particularly Liberia, which is hosting 135,000 Ivorians.
The crisis ended earlier this month when Laurent Gbagbo finally surrendered, ending months of violence that erupted in the wake of his refusal to step down after he lost the UN-certified presidential run-off election last November to Alassane Ouattara.
While the fighting has ended, UN relief officials say ongoing insecurity in some places, as well as difficulties in accessing essential health, education and sanitation services, is increasing the vulnerability of the population.
“A greater proportion of the population has been directly or indirectly affected by the crisis which started late last year. These populations should be assisted without further delay to enable them to live in acceptable conditions and regain their dignity,” said the UN Humanitarian Coordinator in Côte d’Ivoire, Ndolamb Ngokwey.
The UN has already deployed an evaluation team, known as UNDAC, to Abidjan and the country’s west, both of which bore the brunt of the recent violence. In the west, the team confirmed persistent needs in the areas of shelter, food security, health care, water and sanitation, access to education and protection.
The priority needs in the area include the distribution of tarpaulins, kitchen utensils, mats and other non-food items, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). In addition, the presence of arms and the risk of sexual abuse require urgent attention.
In the area of health, OCHA noted that despite the looting of health centres, pharmacies and maternities, medical personnel have started to resume work. It also cited the need to accelerate vaccination programmes for children, as well as rehabilitate water pumps and promote basic hygiene practices.
In the commercial capital of Abidjan, assessment teams have highlighted the need to assist the Government in the areas of civilian protection, health, education and public hygiene, including lightening the burden put on overstretched referral hospitals due to an absence of operational dispensaries and community health facilities.
“With the impending rainy season, clearing of drainage and cleaning of conduits, markets and other public places would be necessary to prevents epidemics of diseases such as cholera,” stated Laurent Dufour, UNDAC’s Team Leader in Côte d’Ivoire.
Earlier this month, UN agencies and their partners launched an appeal for $160 million to provide food security, nutrition, education, protection, water, health care and sanitation to as many as 2 million people throughout Côte d’Ivoire. To date, the appeal is 20 per cent funded, according to OCHA.
UN News Center
UN report Reveals Increasing Spending on Education in sub-Saharan Africa
27 April 2011 –Countries in sub-Saharan Africa have been increasing expenditure on education by six per cent every year over the past decade, but many are still lagging in efforts to provide children with quality primary education, the United Nations agency tasked with promoting universal education says in a report unveiled today.
“This report shows very clearly how committed African nations and their partners are to achieving Education for All,” said Irina Bokova, the Director-General of the UN Educational Scientific and Cultural Organization (UNESCO).
“It also shows that their efforts are paying dividends, with more children going to school than ever before. This is very encouraging and should spur all of Africa’s partners to provide the support that will help fill the remaining gaps,” she said of the findings of the report, entitled Financing Education in sub-Saharan Africa – Meeting the Challenges of Expansion, Equity and Quality.
The document, published by UNESCO’s Montreal-based Institute for Statistics (UIS), presents comprehensive data on the financing of education in 45 African countries and includes historical statistics to track financing trends since the World Education Forum was held in 2000.
The increase in investment on education has been accompanied by some spectacular results in Africa, according to the report, which points out that between 2000 and 2008, the number of children in primary school rose by 48 per cent – from 87 million to 129 million. Enrolment in pre-primary, secondary and tertiary education has also grown by more than 60 per cent during the same period.
Despite the increased spending on education, however, many countries in the region are still a long way from providing every child with a good quality primary education. The most recent data show that in one third of the countries, half of all children do not complete primary education.
Some 32 million children of primary school age are still out of school in sub-Saharan Africa, according to the UNESCO survey, which forecasts that the number will rise as the population of children between the ages of five and 14 years is expected to grow by more than 34 per cent over the next two decades.
On average, education accounts for more than 18 per cent of all public spending in sub-Saharan Africa compared to 15 per cent in other regions. Overall, the region devotes five per cent of its gross domestic product (GDP) to education, which is just behind the levels spent by North America and Europe.
The report discounts the assumption that the increased investments were used to absorb the costs associated with the abolition of primary school fees, which dramatically increased enrolment, but also led to over-crowded classrooms in many African countries.
According to the report, public spending on primary education grew at a faster rate than primary enrolment, and points out that many governments not only expanded access to schooling but also sought to improve the quality of education provision.
“The Education for All message has not fallen on deaf ears,” said Hendrik van der Pol, the UIS Director. “Now we need to protect these investments from the current economic storms. Strategic decisions will have to be made based on the facts – not assumptions,” he added.
The report also notes that across the region, families are the largest private financers of education, providing 30 per cent of all primary education resources, with the proportion rising to 49 per cent and 44 per cent respectively for upper and lower secondary education.
At tertiary level, however, family contributions fall to 22 per cent, meaning that that almost $8 out of every $10 spent on tertiary education is subsidised by the government, a situation that raises serious questions of equity.
Africa: 2011 Closes UN’s Roll Back Malaria Decade
Angolan Press
Luanda — The commemoration of the World Malaria Day this year marks the end of the UN’s roll back malaria decade and offers an opportunity for renewed commitment on the pandemic.
This was said Sunday by the World Health Organisation (WHO) regional director for Africa, Luis Gomes Sambo.
According to him, this affords us an opportunity to renew our common vision and commitment as we look forward and aim at attaining the Millennium Development Goals (MDGs) by 2015.
Malaria, by its complexity involving health as well as environmental and socioeconomic determinants and consequences, relates virtually to all the MDGs, the official also stated, adding that “as it is well known, our part of the world is home to an estimated 795 million people exposed to malaria. Close to 90% of deaths due to malaria worldwide occur in Africa.
Gomes Sambo went on to say that the poor, children, pregnant women, people living with HIV/AIDS, victims of unrest and disasters and non-immune travellers are particularly vulnerable. Therefore, progress in the fight against malaria in Africa is critical to reaching the ambitious targets set in the UN Secretary General’s call for Universal Access to essential interventions, the AU Abuja Declaration and Plan of Action, Resolutions of WHO Governing Bodies and the Roll Back Malaria (RBM) Global Malaria Action Plan (GMAP).
In this regard, he added, it is encouraging to note that malaria control alliances are being strengthened throughout Africa. For example, the African Leaders Malaria Alliance (ALMA) has committed to support elimination of preventable malaria deaths by 2015. The African Union and Regional Economic Communities have also kept malaria high on their health and development agenda.
Countries and partners are making commendable efforts to accelerate and sustain progress in malaria prevention and control in our Region. For example, endemic countries have reflected malaria control in their poverty reduction strategies, the official stated.
Programme reviews are ongoing and strategic plans are being updated to take into account funding and capacity gaps to reach universal access. The success rate for malaria proposals for the Global Fund (GFATM) reached 80% in Round 10. Consequently, effective interventions including protection from the mosquito vector through the use of Insecticide Treated Nets (ITNs) and Indoor Residual Spaying (IRS), prompt treatment of malaria cases using Artemisinin-based combination therapy (ACT), intermittent preventive treatment of malaria in pregnant women (IPTp) and infants (IPTi) are being adapted and scaled up, the WHO regional director also stated.
According to him, cross-border initiatives are catalyzing efforts to accelerate and sustain control and, where possible, to prepare for the transition to pre-elimination. The Affordable Medicines Facility for Malaria (AMFm) has been launched in Ghana, Kenya, Madagascar, Niger, Nigeria, United Republic of Tanzania and Uganda to ensure access to quality ACTs in private sector facilities. Malaria vaccine trials are ongoing in Burkina Faso, Ghana, Gabon, Malawi, Mozambique, Tanzania and Kenya.
As he went on to say, by the end of 2010, a total of 11 countries (Algeria, Botswana, Cape Verde, Eritrea, Madagascar, Namibia, Rwanda, Sao Tome and Principe, South Africa, Swaziland, Zambia and Zanzibar, United Republic of Tanzania) had registered more than 50% reduction in malaria cases and deaths; the proportion of households owning at least one insecticide treated net (ITN) was 42% and 35% of children under five years of age slept under an ITN; 27 countries had reported implementation of Indoor Residual Spraying (IRS) so that 73 million people accounting for about 10% of the population at risk of malaria in the Region were protected by IRS; 33 countries had adopted a policy of parasitological testing of all suspected malaria cases and 35% of malaria cases in the Region were confirmed by a diagnostic test.
In his opinion, in order to consolidate the gains achieved so far, “we need to ensure: rigorous governance to strengthen performance and accountability; mobilization of additional resources; linking disease programme development and health systems strengthening; better coordination of stakeholders and partners under national stewardship; and effective involvement of every exposed individual and community.”
Among the critical challenges that countries need to address are: weak surveillance, monitoring and evaluation capacity; inadequate operational research platforms; lack of implementation of regulatory measures such as the ban on oral Artemisinin-based monotherapies and inadequate monitoring of parasite resistance to antimalarial medications and mosquito resistance to insecticides, he stated.
Gomes Sambo pledged that WHO will continue to work with Member States and partners to mainstream malaria control in health and development policies and plans; mobilize domestic and external funding; foster public private partnerships, support alignment of stakeholders around country priorities and provide guidance and assistance to ensure efficient use of resources for performance and impact. We shall also continue to support initiatives for the removal of taxes and tariffs on malaria commodities, and a ban on the marketing of oral artemisinin monotherapies.
On the other hand, he called upon Governments, parliamentarians, Nongovernmental Organizations, the private sector, civil society groups, faith-based organizations and all exposed communities to take stock of our common achievements and mobilize financial and human resources in a decisive push to further accelerate malaria prevention and control for the socioeconomic progress of countries of the African Region.