The US State Dept conducted last November 29th LiveAtState, an interactive virtual press briefing platform anchored by Ambassador Deborah Birx, Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy.
A physician and a former Army colonel, she took questions online on the PEPFAR 2018 program and the recent Faith Communities and HIV Technical Summit held at the State Dept.
Among questions selected from a world-wide response was from Marino World on the risk of the disease on migrant workers.
The briefing was timed with the 30th anniversary of the first World AIDS Day and the 15th anniversary of the development of the U.S. President Emergency Plan for AIDS Relief (PEPFAR).
HIV was on the verge of wiping out an entire generation in many countries around the world. Then, in 2003, Pres. Bush launched PEPFAR catalyzing a tidal shift against the disease.
Bipartisan support on PEPFAR came from all U.S. presidents – Bush, Obama, Trump – and eight U.S. Congresses. The U.S. Government has invested more than $80 billion in the global HIV response, the largest commitment ever by any country to address a disease.
This PEPFAR investment has saved 17 million lives, prevented millions of new HIV infections, and transformed the global HIV response.
Questions came from journalists and watch groups from around the world, with particular interest on those from Africa. Yet, Marino World was an early pick from online questions.
Marino World, Manila, Philippines: Trends in new and emerging economies are overseas workers and merchant marines who, while away and alone, may turn to paid or casual sex or have multiple partners, which then promotes the transmission of HIV. How would you suggest these trends be addressed?
Birx: Today in Lesotho, at the border where a lot of males and minors move back and forth, they have developed a system where before you cross the border to go to work, if you are HIV positive, you get to have a full six months’ dose of that drug that you need for your own health, to carry with you without having to come back to Lesotho to get additional drugs.
With men at significant risk, they could take pre-exposure prophylaxis (PrEP) every day to keep them from getting the virus.
If you are circumcised, risk is 65% less for life.
1. Violine Thelusma from Pasroadeh Social Media: What are the latest medical advancements in AIDS treatment?
Birx: We have innovators in pharma, and they have been transferring those innovative drugs and allowing them to make them while still on patent. All of our HIV drugs that are effective, come in a cocktail — we have a new cocktail called TLD.
This new drug combination has much less side effects and ability for people to develop resistance to the virus.
2. Elvis Chang, New Tang Dynasty, Asia Pacific TV in Taiwan: What is your comment on China’s scientists’ gene editing experiment on babies against AIDS?
Birx: We would really like if all the geneticists would work with us to create a virus or a virus to find a way to cure HIV. With 37 million people infected, we cannot eradicate HIV until actually cured. If we had a vaccine and a cure today, we could be talking about elimination rather than just controlling the virus.
3. Watch group from the US Embassy in Zambia: Trump has emphasized African countries should fund their own developmental programs, including healthcare. Does the President’s position and America First policy threaten funding to Zambia and others?
Birx: PEPFAR has bipartisan support that transcends any one party. Though, Trump expects that we create a program that becomes more efficient and effective each year to really demonstrate that foreign assistance can have an impact and outcomes without ever-increasing resources.
Right now, Namibia, Botswana, South Africa, Eswatini, Ukraine, Vietnam –critical partners for us in this fight – are actually funding 70 to 80% of their responses. For Zambia, they are funding many of the health care workers, many of the facilities, and more needs to be done both in investments to actually get control of this epidemic.
4. Kevin Kelley, Nation Media Group.Kenya: Is PEPFAR aligned with WHO’s “know your status” theme on this World AIDS Day? Specifically, is PEPFAR stepping up promotion of HIV testing in its core target countries? I’m especially interested in efforts in East Africa – Kenya, Uganda, Tanzania.
Birx: Last year we tested nearly 95 millions, 85millions the year before, most from Sub-Saharan Africa. The year before, we tested 85 million people.
We know that we’re missing right today 50 % of men between 15 and 35. That means 50% who have HIV and need to be on life-saving drugs don’t know their status, and often present very late in disease with tuberculosis.
We need a partnership to figure out: how do we get men who believe themselves to be healthy? For the first 10 years of HIV infection, or eight to 10 years, you don’t know that you’re infected because you feel fine.
We need the people who perceive themselves to not be at risk for HIV to be tested for HIV today so that we can get them treated before they develop the devastating ravages of a failed immune system.
5. Antonia Laborde from El Pais: When is it estimated that insurers will grant the pills at no cost to the patients?
Birx: In all areas of PEPFAR, PrEP is free. The cost is going to the clinic to be tested.
6. Mohamed Ataya, Masrawy.com, Egypt: Is there anything being done to prevent or treat those with HIV from spreading the disease in conflict zones (like Syria and Yemen)?
Birx: Every place there is a refugee program, there is the ability to test and treat like in South Sudan and Northern Uganda and medication, they can travel with.
Traditionally, conflict zones have had a much lower rate of HIV in general but we should not be stigmatizing refugees and others fleeing violence. They are not at a particular higher risk of spreading the virus.
7. Kevin Kelley, Nation Media Group, Kenya: Wouldn’t U.S. efforts be even more effective if merged with the work of UNAIDS? Why should the U.S. run a separate program?
Birx: We are in deep partnership with UNAIDS which uses the 90-90-90 strategy PEPFAR utilizes. We’re bringing resources to country-led strategies to ensure that they’re implemented with fidelity.
PEPFAR uses UNAIDS document to be in sync; even UNAIDS staff (like Michel Sidibe) proving UNAIDS and PEPFAR are completely aligned.
Dr. Birx explains further that PEPFAR:
1. May give technical or financial support to nonconventional researchers like in Zambia claiming to have developed treatment for HIV/AIDS from herbs. But the project must be submitted to the US Natl Institute of Health (NIH) for rigorous validation.
2. Our biggest problem with treatment is that many men don’t come into a clinic until they begin to feel sick. In a survey in 13 countries in sub-Saharan Africa, about 50% are missing of men with very low CD4 cell counts and destroyed immune systems.
3. Two public-private partnerships were organized to address the above:
a. MenStar– to actually talk to men to go to the clinic to be tested. They are not indifferent but “scared to come to the clinic and find out if they’re HIV-positive or not. “
b. Dreams – (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe Young Women) to prevent infections in young women between 15 to 24 in 15 countries (with 10 countries, 63 districts, showing an 85% decrease in the infection). Before, three out of every four new HIV infections in sub-Saharan Africa is in women 15 to 19.
4. American dollars are well-spent at PEPFAR, a revolutionary program in foreign assistance begun 15 years ago. Visit gov showing precisely what the results are there, holding governments, communities, and partners accountable for the resources they receive.
Ambassador Birx is a world-renowned medical expert, military-trained clinician in immunology, focusing in HIV/AIDS vaccine research.
Birx was awarded two prestigious U.S. Meritorious Service Medals and the Legion of Merit Award for her groundbreaking research, leadership and management skills.
She has published over 220 manuscripts in peer-reviewed journals, authored nearly a dozen chapters in scientific publications, as well as developed and patented vaccines.
Birx received her medical degree from the Hershey School of Medicine, Pennsylvania State University; in 1980, trained in internal medicine and basic clinical immunology at the Walter Reed Army Medical Center and the NIH.
Fails on UN Goal
HIV INCREASES IN THE PHIL
In an Al Jazeera analysis based on consolidated reports from the World Health Organization (WHO) and UN AIDS Programme, there is a downward trend in the world of the disease.
In 2015, 2.1million cases were listed; reduced to 1.8 million in 2016.
But figures are opposite and alarming in the Philippines from reports of its own Dept of Health (DOH).
In 2016, 9,264 cases were listed; 11,103 in 2017 up 19.9%.
Worst and alarming, AIDS increased 3,147% over a ten-year period: 342 in 2007, 11,103 in 2017!
Recent listing reflects 95% are male transmissions, with 38 cases involving minors with some under 15 years old.
With a population of over 100 millions, the current total of HIV cases is relatively low although high in percentage.
But the UN observes the Philippines “has the fastest growing HIV epidemic in the Asia-Pacific” in recent years.
Fact is, the Philippines is one of eight countries that account for 90% of the disease in the region.
Collaterally, the country is at the pit of UN’s Millennium Development Goal (MDG) of reducing the disease for which millions of dollars were released.
Artificial birth control methods had been frowned upon in the majority Catholic country. The church holds on to its interpretation the Holy Bible tells people to “go out and multiply,” referring to reproducing bodies rather than spreading the Gospels.
Hence, the large population reminiscent of the Agricultural Age when a big family is popular as a direct source of labor and force.
In 2012, the government passed the reproductive health reform law which promoted the use of condoms and artificial means aside from abstinence and natural methods.
President Rodrigo Duterte said Filipinos are “too carefree” in family planning and should use the free pills to avoid pregnancy, get injected to be free for six months to fully exploit the libido.
But the president counseled (or joked) not to use condoms being “not satisfying” like eating candy with its plastic wrapper.
Actually, it is not an original joke but a jaded pedestrian tease.
Yet, this presidential remark invited a hornet of criticism.
Ana Santos, journalist and reproductive health advocate, says HIV epidemic has been festering because of the low use of condoms due to shame and stigma and the misconception that condoms are not pleasurable.
Carlos Conde, Human Rights representative, raged that instead of criticizing condoms, the president should expand accessibility and use nationwide.
Ronnievinn Pagtakhan, HIV-AIDS prevention advocate, claims of the 100-120 tested in their Manila clinic, some 8-10% test positive.
She believes, “in view of the explosive growth in the number of HIV infections in the Philippines, we need more conversations rather than quick judgment and hate.”
Of late, DOH had placed a series of mass media advertisements on HIV-AIDS awareness. But rather than explaining the socio-civic aspects, the placement warns that “even you” can be afflicted.
This is almost strengthening the alienation like those sick of tuberculosis.
More so, the conservative society is yet to fully accept diversions from the usual male-female roles defied by the lesbian-gay-bisexual-transvestite (LGBT) community.
But Filipino ambivalence is clear at the by-ways: all major television stations feature LGBT talents, from drama to hosting to “beauty” pageants earning sizeable blocks of viewers and following.
But just may be for entertainment, not as a way of life.
Marino World (MW) has always supported appeals of those positive and discriminated at work or for employment. Yet, MW understands the wariness of owners and principals on the negatives of those positive in the workplace.
A dent in the stalemate seems achieved by Positibong Marino Phil (PMPI) headed by Jebsen Rederri Go Gamido, founded by Filipino seafarers with HIV (PLHIV), himself included.
At the PMPI first anniversary last July 22nd, the “Red Ribbon Award” were given to Magsaysay Maritime, Carribean Cruises, OSM Maritime Services and Sea Power Shipping PMP for outstanding HIV policy programs in the workplace, including non-discrimination, work accommodation and confidentiality of seafarers with the affliction.
- PMPI had earned endorsements from officials, among whom:
- Hans Leo Cacdac, Administrator-Overseas Workers Welfare Administration (OWWA);
- Conrado Oca, President-Associated Marine Officers’ and Seamen’s Union of the Phil (AMOSUP);
- Steve Trowsdale, Inspectorate Coordinator-Intl Transport Workers Federation (ITF);
- Marlon Rono, Director-Joint Manning Group (JMG);
- Lui Delos Santos, Chief-Policy Development and Review (MARINA);
- Gerard Belimac, Program Manager-Dept of Health (DOH); and
- Tyrone Sy, Phil Rep-World Health Organization (WHO).
Not to be out-done by the activism of foreign artists, Ms. Jehza Huelar agreed to be ambassadress for PMPI. The 2018 Binibining Pilipinas Supranational titlist placed on the Top Ten at the global tilt December 8th in Poland.
Ms. Huelar is a seaman’s daughter, honored last April 27th by AMOSUP at the new AMOSUP-JSU Seafarer House at Intramuros, Manila.