Welcome to the February 2010 edition of The Governance Response to HIV and AIDS- News Diaries from Southern Africa. Click through to get further information, and more story ideas if you are a community journalist.

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Your media@idasa GAP e-newsflash team

OLDER MEN’S BEHAVIOUR

HIV prevention is based on getting people to change their sexual habits - but this is a very difficult process as South Africa’s President Zuma has shown, writes Health-e. President Zuma's aversion to using condoms during his extramarital relationships, despite having numerous children born out of wedlock, is a good example of just how difficult it is for older people to adapt to less risky sexual behaviour. He is also a clear example of a man involved in "multiple and concurrent partnerships", a trend believed to be peculiar to southern Africa that contributes to our high HIV/AIDS rate. Another behavioural danger is "intergenerational sex". Young women under the age of 25 are up to six times more likely to be HIV positive than young men of the same age. This is because many young women are involved with older men.

In President Zuma’s message to the nation for World AIDS Day he called for a “massive mobilisation campaign” to spur South Africans to safeguard their health, educate them about the risks and convert “knowledge into a change of behaviour.”
http://www.health-e.org.za/news/article.php?uid=20032638
http://www.nytimes.com/2009/11/01/world/africa/01zuma.html?_r=1

Story ideas:

You could do a feature article interviewing young people about how they view the behaviour of older men. Are young girls aware of the risks of “intergenerational sex” and how factors like wealth and status influence power in sexual relationships?
The gap between the South African president’s words in his public message and his personal actions is a good launching point for discussions on leadership among young people. See how you can use your media to facilitate this discussion among citizens – what qualities do they look for in a leader, are they able to value the message yet separate it from the person giving it?

The Health-e article is posted for discussion on our hivmedia.ning.com forum. Have your say at http://hivmedia.ning.com/forum/topics/president-zuma-and-hiv?xg_source=activity

FILM ON MULTIPLE CONCURRENT RELATIONSHIPS

A Zimbabwean film on multiple concurrent sexual partnerships (MCPs) runs for just 24 minutes, but the producers are hoping that its message will last much longer, PlusNews reports. The film, Big House, Small House, is the latest offering from the One Love Campaign, which works to reduce HIV prevalence and MCPs in 10 southern African countries. The title refers to the colloquial expression "small house", used to denote long-term, illicit sexual relationships. Television stations around southern Africa will air the movie as part of a series of 10 films – one from each of the campaign’s focus countries – highlighting the dangers of MCPs.
http://www.irinnews.org/report.aspx?ReportID=88169

Story ideas:

If the films are shown on television in your country you could do a follow-up with reactions of citizens who saw it.
Ask citizens about multiple concurrent sexual partnerships in their communities – the level of awareness of the dangers for HIV transmission, the cultural significance, the challenges in changing behaviour. Do citizens think films such as this one are useful in encouraging people to change behaviour? What other ideas do they have for raising awareness of the dangers of MCPs?

BUSY AFTER RETIREMENT

PlusNews reported on a trend in Tanzania where retired doctors and other health workers come back to work in a “Retired but not tired” project where they work exclusively in HIV care and treatment clinics, freeing up regular medical staff to handle other illnesses. "Tanzania has a relatively young retirement age and this means many of those retired still have the energy and the skills to serve in various sectors, including the medical sector - this is the opportunity we have utilised within the retired officers' programme," said Dr Eric van Praag, Family Health International Tanzania country director. Tanzanian health workers now retire at the age of 60; until 1999, they retired at 55. The retired workers are trained in different aspects of HIV care, management and treatment so that they are up to speed with current requirements in managing HIV and the opportunistic infections that come with it.
http://www.irinnews.org/report.aspx?ReportID=88194

Story ideas:

Many people in their sixties are working, formally or informally, in HIV care. Find people in your community who have come back to work after retiring, as well as those who have had to take on the role of primary care-giver to children in their old age, and ask them how they manage and what motivates them.

Are they part of a formal programme, like the one described above, if not would they like to be? Would knowing people in a similar position to their own be a help?

TRADITIONAL HEALERS WORKING WITH WESTERN MEDICS

In rural KwaZulu-Natal, the province with the highest HIV prevalence in South Africa, traditional healers and Western medicine are starting to integrate, Health-e reports. Internship for traditional healers in Edendale Hospital is being run by iTeach, a non-governmental organisation headed by Dr Krista Dong. iTeach’s staff of 20 work throughout the hospital and in the 17 clinics within the catchment, implementing simple, cost-effective solutions to repair weaknesses in the chain of care for patients with HIV. The organisation has been working with traditional healers for several years to help with the early diagnosis of HIV and successful treatment. “The idea that patients must choose between ARVs and traditional medicines or long-standing cultural practices, causes some to avoid coming forward for ARVs until they are very sick and desperate,” says Dong. “By working with traditional healers to ensure healers are knowledgeable about the health risks associated with AIDS, we are developing strategies to optimise patient safety and that patients are willing and able to follow. We are not encouraging patients to see healers, but addressing the fact that patients do access both systems of care, and we want to ensure that it is done safely.”
http://www.health-e.org.za/news/article.php?uid=20032590

Story ideas:

There are increasing efforts to integrate traditional healing and Western medical practices with regards to HIV – try to find a similar project in your area and interview people involved. What challenges did the project face? What have the parties involved learned from each other in the process? How have HIV-positive patients benefitted from the integration efforts and what prospects are there for the future?

If there is no such project nearby, what is hindering such an initiative? Interview people at hospitals / clinics to find out whether they would be support for a programme like this.

TESTING FOR HIV AT HOME

An HIV home test kit, which will enable people to find out their HIV status in private, is being piloted to people living in Umgungundlovu district (Pietermaritzburg), which has the highest HIV rate in South Africa. The home-test kit will detect whether the person has produced antibodies for the virus. The presence of antibodies means that the person has been exposed to HIV and needs to get medical help. The development of the self-test is the third phase of Project Masiluleke, an innovative partnership between a variety of organisations. The first phase of “Project M”, as it is known, was launched in October 2008 with up to a million HIV/AIDS messages a day being sent out as part of “please call me” SMSes donated by MTN. These messages directed people to the national AIDS Helpline, and resulted in a 300% increase in calls to the line from the month that it launched. Phase two, which will start soon, involves sending patients on antiretroviral treatment automated SMS reminders of their scheduled clinic visits.
http://allafrica.com/stories/200912010746.html

Story ideas:

The privacy these tests will bring needs to be weighed against the absence of post-test counselling. What do citizens in your readership / listener area think of home tests? Are they concerned about reliability of results? Is stigma in the community so strong that many more people will test if they can do so in private?

CUTS IN FUNDING

Health-e examined South Africa’s dilemma as it faces potentially huge cuts in donor support for its HIV/AIDS programme over the next five years. “There is not a friendly feeling in the US towards more funding for HIV/AIDS,” Dr Roxana Rogers, USAID South Africa Health Team leader, told a meeting in Cape Town on the future of US assistance for HIV/AIDS, hosted by the US-based Council on Foreign Relations. Almost a million South Africans will soon be on lifelong antiretroviral treatment and this number will triple in the next decade if government keeps to its implementation plan. Scenario planning by Treasury indicates that the demand for treatment and care will peak in 2021, when the country would need close to R30-billion. At present, 40% of the HIV/AIDS budget goes to antiretroviral treatment. “We are facing a double whammy of having to rapidly scale-up spending on HIV/AIDS at the same time that we have to replace donor funds,” said Dr Keith Cloete of the Western Cape Treasury. Professor Alan Whiteside from Health Economics and HIV/AIDS Research Division at the University of KwaZulu-Natal, said that donor funding typically had a three- to five-year time scale, and South Africa needed to move to more sustainable health development funding. “We need to get more for our money and be more imaginative. We are an AIDS-afflicted country so we should develop an AIDS economy.”
http://www.health-e.org.za/news/article.php?uid=20032631

Story ideas:

How do potential cuts in funding affect HIV/AIDS programmes – government and NGO-run – in your community? How reliant are they on funding and what steps are they taking to keep their projects going?
Are they in touch with other programmes in a similar position / keeping up to date with financial developments / probing the people they serve for potential ideas for sustainability?

Possible sources for comment and more information:

• Democracy institute IDASA: www.idasa.org
• Engender Health: www.engenderhealth.org
• Family Health International: www.fhi.org
• Foreign correspondents association of southern Africa: www.fcasa.co.za
• Health-e: www.health-e.org.za
• Kettering Foundation Readers’ Forum http://forum.kettering.org/reading_room/readers_forum
• Medecins Sans Frontiers: www.msf.org
• Media Institute of Southern Africa: www.misa.org
• Red Cross Society: www.redcross.org
• SADC Secretariat: www.sadc.int
• SARPN: www.sarpn.org.za
• Your national AIDS council
• Southern African AIDS Trust (SAT) www.satregional.org
• Southern African Humanitarian Information Management Network SAHIMS), www.sahims.net
• Southern Africa Malaria Control: www.malaria.org.zw/samc.html
• Treatment Action Campaign (TAC): www.tac.org.za
• UK Department of International Development: www.dfid.org.uk
• UNAIDS: www.unAIDS.org
• University of Washington: http://www.washington.edu
• World Bank: www.worldbank.org
• World Health Organisation (WHO): www.who.org