AIDS 2014: An opportunity to highlight the deadly AIDS & TB link

In July 2014, Melbourne will play host to more than 14,000 researchers, medical experts, advocates and representatives of people living with HIV / AIDS at the AIDS 2014 Conference.  The theme for AIDS 2014 is “Stepping up the Pace” (of action to reduce infections and deaths).

With AIDS 2014 having such a large expected turnout, and a theme which indicates commitment to working towards eliminating HIV / AIDS, does RESULTS have scope during preparations for AIDS 2014 to play its customary role of focussing on issues which receive little attention or strong advocacy from other people?    

The answer is a very clear “yes,” for two reasons which the regional AIDS conference, the International Congress on AIDS in the Asia-Pacific (ICAAP) held in Bangkok in November, highlighted. 

·       The proposals by international working groups for post 2015 development goals (tentatively, the Sustainable Development Goals) place less emphasis on health goals than the Millennium Development Goals, and say very little about specific diseases such as AIDS and TB.  One of the panel sessions at ICAAP had the title “Disappearing Act?  AIDS and Development in the Post 2015 agenda.”

·       The deadly combination of TB and HIV still receives little recognition, even among people with a strong HIV focus.  The daily newsletter at ICAAP on 21 November contained an article “TB / HIV:  Why is ICAAP silent?”  See:  http://icaap11.org/index.php/media/newsletters.  This article noted that at least 170,000 people are co-infected with HIV and TB in South-East Asia and at least 50,000 people with HIV die from TB in South-East Asia each year.  However, few sessions at ICAAP and few of the activists and advocates in the region have made the TB and HIV combination a priority.

In our preparations for AIDS 2014 in Melbourne, RESULTS is aiming to break the silence on HIV and TB.  At ICAAP, Sarah Kirk (RESULTS Australia’s Global Health Consultant) and I promoted with potential partner organisations a TB/HIV Networking Zone at AIDS 2014, where the various people interested in both diseases (including researchers, activists and community representatives) can share information and ideas for action. 

In addition, with our international partners in ACTION, we are developing proposals for several papers and workshop topics for AIDS 2014 which will address issues such as: 

·       Obtaining additional resources for combating TB and HIV;

·       How to reach the 3 million people who are not diagnosed or treated for TB;

·       Reaching the most vulnerable populations for AIDS and TB.    

AIDS 2014 will provide a number of opportunities for RESULTS volunteers to raise the profile both of RESULTS and of our work on HIV and TB: 

·       The RESULTS Australia National Conference is taking place on the weekend preceding AIDS 2014 (19 and 20 July 2014).

·       The ACTION partnership is planning to have a booth at the Conference, at which we will be able to engage with Conference participants on HIV-related issues and also about RESULTS Australia’s work and role.

The AIDS 2014 Conference runs from 20 to 25 July 2014, and if you can spend some extra time in Melbourne following the RESULTS National Conference, you would definitely be welcome to be one of the volunteers helping to break the silence on TB and HIV and promoting RESULTS at the same time.

As a preview of the type of activity we can undertake, a short video of RESULTS’ CEO Maree Nutt, speaking at the AIDS 2012 Conference in Washington DC is also available on our web site:   http://www.results.org.au/our-actions/other-events/aids-2014/.       

Mark Rice

Global Health Advocacy Manager

Why I Support The Global Fund

By Gina Olivieri, RESULTS' Grassroots Engagement Manager

Over the past few weeks, RESULTS grassroots volunteers all over Australia have been writing to their MPs and asking that Australia give $US 375 million to The Global Fund to Fight AIDS, TB and Malaria for 2014-2016. Next week we will go to Canberra to meet with several MPs and Senators, sharing our vision of a world free of these deadly diseases, and our reasons for believing this should be a priority for Australia. In this blog post, I share my reasons for supporting The Global Fund.

1. The 15 year old students I met in Umlazi who planted a vegetable garden at their school, so they could provide free, nutritious food to all the orphans at school.
2. The boy of 15 I met on the south coast of KwaZulu-Natal who could not do his homework until 10pm, by candle light, because he had to take care of his younger brother, clean the house, and cook dinner first.
3. The homeless girl of about 14 I saw sitting in the front seat of a tow truck, being leered at by the driver.
4. The girl of about 13 with a piece of tape marked ‘134’ on her hand to indicate her place in the queue at a clinic in Umlazi.

A generation of orphans who have lost their parents to AIDS are vulnerable to exploitation, hunger and disadvantage. Child headed households abound, impacting on educational opportunities and putting girls especially at risk of HIV infection if they take an older boyfriend or ‘sugar daddy’ for financial security. Queues at HIV/AIDS clinics snake around the building and struggle to keep up with demand – despite the fact that many HIV+ people stay away for fear of stigmatisation.

What a lot of people don’t realise about The Global Fund is that it does much more than just pay for medicines. Grants from The Global Fund are used to strengthen, integrate and resource a variety of public health activities by government and non-government organisations to better educate the public about HIV risk, run support groups for HIV+ people, train community leaders, medical and support staff, and provide support for orphans and other vulnerable children, to name but a few.

These kids are my reason – what’s yours?

World Toilet Day 2013: #Igiveashit

By Samantha Chivers, RESULTS Australia's Campaign Manager (Maternal, Child and Neonatal Health)
 
Today, November 19th, the world comes together to think about toilets. World Toilet Day is an event that brings together advocates, the United Nations and organisations working in the field to give attention to the fact that billions of people around the world go every day without basic toilets. Important in itself, this lack of water and sanitation is also essential to consider when talking about undernutrition.

The burden of undernutrition around the world is high, and a major deterrent to development and health. As an indicator of long-term poverty and inequality, stunting – or having a low height for your age – serves a grim picture: around one quarter of children under five in the world are stunted. In the least developed countries, this rate rises to thirty-seven percent.

Undernutrition carries such a large burden that its impacts can be seen today, as well as tomorrow. Globally, around seven million children under five die every year from mostly preventable diseases such as pneumonia and diarrhoea. Astonishingly, undernutrition is the underlying contributing factor in nearly half of these deaths.

Undernutrition is a major barrier to families and nations escaping poverty. Stunting is a huge public health problem not only because it leaves children more susceptible to infectious diseases, but also because stunted growth in the first months of a child’s life means stunted development of the brain and thus, of cognitive capacity. Permanently. It limits the ability of children to learn and earn, and develop into adults who can lead healthy and productive lives. By keeping adults out of work and limiting their opportunities, undernutrition has a huge impact on the social and economic development of families, and of countries.

While undernutrition can come about from many causes, one that may not be so obvious is the link between undernutrition and hygiene. Clean water, access to toilets, and hygiene practices such as exclusive breastfeeding and handwashing are incredibly important for preventing disease, and thus, for preventing undernutrition. It turns out that half of undernutrition is associated with intestinal parasitic infections and repeated diarrhoeal episodes. Diseases transmitted from water contaminated by sewage, including worms, intestinal parasites, and bacterial infections like environmental enteropathy and typhoid, actually play a very large role in undernutrition. Some diseases, like diarrhoea, literally flush nutrients from the body, as well as depleting stores while mounting an immune response. Others, such as environmental enteropathy, cause an infection that damages the wall of the small intestine and limits the ability to absorb nutrients, slowly causing stunting. Contracting these infections from poor hygiene, defecating in the open, or not having access to clean water, is a strong contributing factor to being undernourished despite what you eat.

This year, RESULTS Australia is marking World Toilet Day. Our nutrition and child health campaigns focus on implementing interventions that are based on what works. The United Nations estimates that there are 2.5 billion people who still do not use an improved sanitation facility and a little over 1 billion practising open defecation. As a single gram of poo can contain 10 million viruses, one million bacteria and 1,000 parasite cysts, open defecation can cause serious infection and raise the prevalence of undernutrition. Working to integrate nutrition interventions with increased access to toilets and clean water and using basic hygiene practices such as handwashing, can have a major reduction in child undernutrition. It’s as simple, and as complicated, as that. So if you “give a shit” about child undernutrition, please appreciate the clean water that comes straight out of the tap the next time you wash your hands, and join us to learn how you can make a difference on this important issue.

@RESULTS_AU
@World Toilet Day
#WTD
#Igiveashit

Nutrition, Food Security and RESULTS

Samantha Chivers, Global Health Campaign Manager RESULTS Australia, on World Food Day

Hunger remains a persistent problem in the world. Around seven million children around the world die before their fifth birthday every year, mainly from preventable and treatable diseases such as diarrhoea, pneumonia and malaria. Shockingly, around half of these deaths are directly linked to undernutrition. While around one in four children are too short for their age worldwide, this rises to one in two in some countries in our region, such as East Timor, India and Cambodia.

On October 16th the United Nations hosted World Food Day, whose theme was Sustainable Food Systems for Food Security and Nutrition. Food security – or all people at all times having access to sufficient, safe and nutritious food – is an increasingly important issue for Australia, and for the Asia – Pacific region. Engaging with food systems to make them more equitable and diverse is especially important at this point in time. Worldwide, more than one billion people are undernourished, and the world will need to produce 50 percent more food by 2050 to feed a projected population of 9 billion people. 

In honour of World Food Day, I represented RESULTS Australia at the FAO World Food Day event hosted by the Sydney Food Fairness Alliance. Speaking at the event was Ronnie Kahn, founder of OzHarvest, nutritionist Rosemary Stanton OAM, and gardener Costa Georgiadis, in addition to a multitude of community organisations profiling their work in their own communities. Being relatively new to RESULTS it was inspiring to see members of the community come together to work on food security and nutrition in their local area, and especially to involve those who may be left out of traditional systems, such as new migrants and adolescents out of school. It also reminded me that connection with your community, be it local, regional, or global, be it based on geography, shared values or ideals, is the only way to make a sustainable difference. A small community of like-minded individuals can have a huge impact, through actions and through advocacy.

RESULTS Australia is working to build a network of the organisations working in the nutrition and food security fields. We are encouraging the Department of Foreign Affairs to pick up where the late AusAID left off, and continue to develop their first strategy dealing with child undernutrition in a holistic manner. To quote Senator Brett Mason, the new Parliamentary Secretary for Foreign Affairs "Australia is helping to fight hunger, improve nutrition and increase food production by working with communities to make farmland more productive, create better markets, and improve the health of mothers and babies". Nutrition is an issue that is a forgotten priority in our aid program. One in eight people around the world suffer from chronic hunger, and this will only increase unless we act.

Samantha Chivers, Global Health Campaign Manager, RESULTS Australia

With thanks to the Sydney Food Fairness Alliance and the Macarthur Future Food Forum for hosting RESULTS Australia.

Sources and Further Reading
http://progressreport.apromiserenewed.org/

http://www.savethechildren.org.uk/resources/online-library/life-free-hunger-tackling-child-malnutrition

http://www.irinnews.org/report/92039/timor-leste-chronic-malnutrition-among-world-s-highest

www.fao.org/getinvolved/WorldfoodDay/en/

http://blogs.worldbank.org/voices/world-food-day-challenge-feeding-more-people-fewer-resources

http://documents.worldbank.org/curated/en/2013/01/17747135/implementing-agriculture-development-world-bank-group-agriculture-action-plan-2013-2015

http://sydneyfoodfairness.org.au/blog/2013/09/25/fao-world-food-day-2013-october-16/

http://ministers.dfat.gov.au/mason/releases/2013/bm_mr_131016.html

http://www.ozharvest.org/ourimpact.asp?pageID=609

http://www.fao.org/docrep/018/i3458e/i3458e.pdf

http://sydneyfoodfairness.org.au/

http://www.sectorconnect.org.au/macarthurfuturefoodform

Eight hundred days to go….lessons learnt for saving children’s lives

Midwives training in Nicaragua. Credit: Steve Lewis

Steve Lewis, Global Health Advocacy Manager, RESULTS UK reports on child health progress at the UN General Assembly.

Last week at the UN General Assembly recommitted their efforts to meeting the Millennium Development Goals (MDGs) and began the formal process to decide the framework for the next 15 years. Some of the MDGs have been met, but the MDGs on Maternal Health and Child Health are among the most off-track.  RESULTS has recently committed to increasing our advocacy on Child Survival issues, so this week I have been meeting  with  various speakers who are convinced that progress can be sped up if the required resources can be made available.
At another event Tony Lake, director of UNICEF, outlined the good news, that since 1990 the number of under-five child deaths has fallen from 12 million a year to 6.6 million this year. But there is still a long way to go.  The majority of child deaths are preventable. Conditions such as pneumonia and diarrhoea kills over a quarter of children. There is “the fierce urgency of today’, to put in place the simple solutions that can prevent these deaths.

Princess Sarah Zeid of Jordan spoke movingly about her own experience of the critical role of trained health workers. “Three years ago I almost died in child-birth”, she explained, “only the presence of excellent health staff saved me and my beautiful child”. Fortunately all was well – but all women around the world should have the right to a trained health worker, and the commodities and services they need.

These commodities are not so complicated – the UN Commission on Life Saving Commodities for Women and Children has identified 13 under-utilised and over-looked life-saving commodities. Of these 13 commodities, 3 are specific to child health, which if scaled up could prevent death from conditions including pneumonia and diarrhoea. In fact the Lancet health journal in June 2013 showed that nearly all deaths from diarrhoea, and two thirds of deaths from pneumonia, can be ended through relatively simple solutions.

Frances Day-Stirk, president of the international confederation of midwives, spoke about the importance of women’s rights and education. “I wouldn’t be sitting here if it wasn’t for my mother, a strong woman who believed in educating girls as well as boys. That wasn’t so common where I grew up. From that start I became employed and an empowered woman. For a girl who doesn’t have those benefits, she can get left behind, in some countries if she dies she is hardly even counted”. Frances also called for a greater emphasis on Exclusive Breastfeeding until the age of six months – “the single biggest remedy for the undernutrition that contributes to 44% of all child deaths”.

Doctor Tedros from Ethiopia took up the themes of health workers and data collection. Currently Minister of Foreign Affairs in Ethiopia he was previously the Minister of Health when the country massively expanded the number of Community Health Workers. “We knew that Primary Health Care was essential, and we took it to all corners of the country….  Using women as health promoters was key, in my country women seek health services from other women.”

Ethiopia now has 38,000 village health workers who can give prevention advice and carry out basic care or treatment. Thanks largely to this ‘Health Army’ the country have achieved MDG 4 (to reduce child mortality by two thirds) ahead of schedule.  Ethiopia is now considered a role model in African health circles. One other aspect of their work is strong monitoring and data collection. “We strictly collect data in all our health facilities” said Dr Tedros, “and learn from our successes and failures. To make progress in health, accountability needs to be a mindset”.

To finish the evening, we returned to the theme of the MDGs, and how the next development framework should be different. Tony Lake identified a ‘fundamental flaw’ in the design of the current set of MDGs: “the MDGs have been very successful in pulling together global support for a short set of global goals. But there has been a basic mistake in the MDGS. They were based on national averages. So everyone looked for the low hanging fruit. The easy people to reach, the city dwellers, the better off. We now know that the poorest were left behind. In fact this has slowed us down. In the most remote areas there is more disease, so you get more results. So it’s more cost effective to work in the most disadvantaged areas. That will be the right thing to do.”

Over the next two years the global community will debate the exact make-up of the next development framework. It is unlikely that there will be such an emphasis on health issues in the next set of goals – but that does not mean efforts will tail off. With what the world knows now there is ample scope for a speed-up in progress. If enough funding is available it should be possible to put in place the components of much-improved health systems in almost all countries. Trained health workers, educated girls, access to medicines and health supplies, immunisation for all, and proper nutrition are the building blocks that will allow us to reach ‘health for all’ by 2030.

Australian Election Outcome – Challenges and Opportunities

 

by Mark Rice, RESULTS Global Health Advocacy Manager

 

Election Results generally

The Federal Election has resulted in the Liberal–National Coalition winning a decisive majority in the House of Representatives (with the Coalition likely to hold 90 seats, Labor 55 seats and independent and minor party candidates 5 seats). In the Senate, no party has achieved an outright majority, and Labor and the Greens Senators will make up less than half of the Senate once newly-elected and re-elected Senators start their term next July.  From mid 2014, a range of independent and minor party Senators will have the balance of power, and are unlikely to support consistently either of the major parties in Senate votes.

New Decision-makers

The members of the Ministry that poverty campaigners are most likely to aim to influence are (left to right in the photos):

- Prime Minister – Tony Abbott MP (NSW);

- Minister for Foreign Affairs – Julie Bishop MP (WA);
- Treasurer – Joe Hockey MP (NSW);
- Parliamentary Secretary for Foreign Affairs – Senator Brett Mason (QLD);
- Assistant Treasurer – Senator Arthur Sinodinos (NSW) 

 

The importance of influencing the Treasurer and Assistant Treasurer are:

• RESULTS and other campaigners make an annual Budget submission to the Treasury, proposing priorities for the aid program for the coming years.
• The Treasurer represents Australia on the governing board of the World Bank and Asian Development Bank, and the Treasurer or Assistant Treasurer attend regular meetings of these organisations. 

Aid Policy – Known amount and unknown impacts

Just before the election, the Coalition released its Foreign Affairs Policy and final set of spending and savings measures.  The Foreign Affairs Policy provides the following limited details on the Coalition’s aid policy:

• Continued support for Australia’s aid eventually reaching 0.5% of gross national income (GNI).
• In the period to 2016-17, a freeze in aid in real terms (with aid being adjusted only to offset price increases).
• A stronger focus on the Asia-Pacific and Indian Ocean regions, and increased quality of aid delivery.
• Examining the possible expansion of a guest worker program for people from the Pacific Islands.

The accompanying set of spending and savings measures revealed that the planned freeze to aid in real terms uses 2012-13 rather than 2013-14 as the base year, meaning that reductions in planned aid start in the current financial year, and total aid over four years is $4.5 billion lower than previous estimates.  The “before and after” figures below show the financial impact of this policy announcement.

 Financial impact of aid reductions

	2013-14	2014-15	2015-16	2016-17
Previous estimates ($m): [1]	5,666	6343	6849	7398
After reduction ($m):	5,010	5470	5619	5657
Difference ($m):	656	873	1,230	1,741

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[1] http://devpolicy.org/in-brief/aid-in-2016-17-to-be-back-at-2012-13-levels-under-coalition-plan-20130905-1/

On average, aid in 2013-14 to 2016-17 is expected to be 0.33% of GNI, compared with the average of 0.39% of GNI over the same four years included in the previous Government’s August Economic Statement. 

The policy would result in a $250 million reduction in aid in 2013-14 in real terms from 2012-13, although aid would be just maintained in real terms in the four years to 2016-17.  (The 2013-14 Budget provided for an increase in aid in real terms of about $400 million this financial year.)  Obviously, our greatest concern is the reduction in 2013-14, as nearly all aid for this year is already committed and any reductions would require deferring or cancelling some committed payments. 

RESULTS seeking to find answers to several questions about how the Government would achieve these reductions, including:

• Whether the amount included in aid since 2012-13 for on-shore asylum seeker costs ($375 million) would be part of the reductions (which could soften the blow a little). 
• Whether existing multi-year contributions due to finish in 2013-14 (such as the current pledges to the Global Fund to Fight AIDS, TB and Malaria, the GAVI Alliance and the Global Partnership for Education) will proceed in full.

Opportunities 

The current situation presents several opportunities as well as threats for campaigners on poverty:

• As we have advance notice of planned reductions in aid (unlike previous times when governments have deferred or reduced planned aid), we have time to seek changes to the announced policy. 
• In the House of Representatives, up to 42 of the 150 members will be new, and the best time to influence the priorities and position of a Member of Parliament is when they are newly-elected.

In coming months, we will be seeking MPs’ support for an increased contribution by Australia to the Global Fund for 2014 to 2016, and to extend contribution to GAVI by two years to 2015.  One objective for these actions, as well as securing much-needed funding for these organisations, is to help build the case for increased overall aid by highlighting effective measures to improve health.

RESULTS is also planning to have our staff and volunteers visit Members of Parliament in Canberra  in one of the early sitting weeks of the Parliamentary term, so we can make our case to a number of the influential MPs and potential allies in person.  

 

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High expectations for the world's poor

The Hoopla asked some of Australia’s most eloquent, outspoken and passionate women to tell them what they thought of Australia's election result. Our CEO Maree Nutt was one of them. Here are her observations .

The Coalition election-eve promise to slash $4.5 billion dollars from foreign aid looks set to become a reality. Instead, those billions of dollars are to be invested in infrastructure projects providing Australians with better roads and motorways.

The winners  will be Melbourne’s East West link ($1.5 billion), Sydney’s WestConnex ($1.5 billion) and the Brisbane Gateway Motorway upgrade ($1 billion). 

I am devastated to think that millions of people around the world could miss out on life saving vaccines, bed nets to prevent malaria or basic schooling so that we can get from A to B faster and smoother.

Only last year, both major parties were committed to increasing Australia’s aid to 0.5% of gross national income by 2015. The Labor Government pushed that timetable out by two years and also diverted aid funds to pay for asylum seeker costs. With the Coalition announcement last week, it has emphatically won the ‘race to the bottom’ on the aid issue and their decision will soon become a reality.

As individuals, we Australians are a generous lot.

In Tony Abbott’s electorate alone, 54,000 individuals, 1500 corporates and 72 church and community groups support overseas aid either through donations, activism and volunteering.

Many of them have ben very vocal leading up to the election, including 3,000 on Manly Beach just over 2 weeks ago spelling out the message “Halve Global Poverty” on the sand.

We cannot allow the new Abbott government do this to the aid budget. Now, more than ever, we need to press for change and not accept this mean-spirited representation of Australian values.

We are still the lucky country. We can still afford to be generous to the world’s poor … and have our new roads too.

Click here to read the observations from all of The Hoopla's Women With High Expectations.