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Archive for July 30th, 2012

EU-funded projects pressure

Posted by African Press International on July 30, 2012

Solar panels installed in Area C

JERUSALEM,  - As demolition orders continue to threaten the work of humanitarian organizations in Israeli-controlled Area C in the West Bank, the European Union (EU) and humanitarian agencies are pressing to change the rules of the aid game.

“We all know that when we turn one stone in Area C, what we get is confrontation with the occupying power,” Ulrich Nitschke, project director at the German Agency for International Cooperation (GIZ) in the West Bank city of Ramallah, told IRIN. “But now, there is a major policy shift among the member states of the EU.”

Land in the West Bank is categorized as A, B and C. Area A is under the control of the Palestinian Authority (PA), and Area B the joint control of Israel and the PA. About 95 percent of Palestinians live in these two areas, though they make up only 40 percent of the land area. In Area C, Israel retains military authority and full control over building permission.

Instead of making the implementation of EU-funded projects in Area C dependent on the Israeli Civil Administration and its requirement to obtain a permit, a new process is now guiding the EU’s approach.

“They are pressuring Israel to reach an actual game change in Area C. There has to be a game change,” says Tsafrir Cohen, Middle East coordinator of the German organization Medico International.

The first step of the new process is the development of legal and technical guidelines (master plans) for each local community in need under the leadership of the local Palestinian governments. The master plans are then presented to the Israeli Civil Administration, which opens a case for each locality submitted, and is asked to check whether all legal and technical requirements are met.

“As soon as we get a green light on the technical stuff, the EU donors are counting six months. If there is still no permit issued after that, the project is implemented without,” Nitschke said.
So far, a total of 24 master plans have been submitted; four were technically approved by the Israeli government in January 2011, but no permits have yet been issued. “Obviously six months have passed since then. But some member states got cold feet and wanted to double-check with Brussels before,” Nitschke said.
Meanwhile, some EU member states have formed an interest group to advocate change, including Germany, the UK, Belgium, Denmark, France, Sweden and the EU Commission, he added.

“Demolition can happen any time”

Each year, hundreds of Palestinians in Area C have their homes demolished by the Israeli authorities because they are unable to obtain permits for their buildings. In 2011 alone, about 1,100 Palestinians were displaced due to home demolitions by Israeli forces, over 80 percent more than in 2010, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said in a report.

“The Israeli authorities claim that structures are demolished because they lack building permits. However, the reality is that it is next to impossible for Palestinians to obtain such permits, leaving them no option but to build without them to meet their basic needs for shelter,” Ramesh Rajasingham, head of OCHA in the occupied Palestinian territory (oPt), told IRIN.

OCHA says that a total of 620 structures were torn down in the West Bank in 2011, of which 62 were European-funded projects.

Medico International faced demolition orders on (mostly standalone) wind and solar energy facilities it built in collaboration with the Israeli organization Community, Energy, and Technology in the Middle East (COMET-ME) in the south Hebron hills, which has become a hotspot of demolitions and forced displacement over the last years.

Tsafrir Cohen said his organization had hitherto been able to prevent the demolition of its energy installations through an effective diplomatic and public outreach campaign, in particular in Germany. “But the orders are there and demolition could happen any time.”

Some 1,500 Palestinians in the south Hebron hills are dependent on a similar alternative energy supply, because the Israeli authorities are preventing them from being connected to the electricity grid, he said, adding: “Thousands of people still don’t have electricity in the Hebron hills. We have thousands more in Jordan valley. But we simply can’t assist properly because of the permit problem.”

Aid agencies operating in Area C are currently facing a dangerous situation, said Cohen. “If we only build humanitarian infrastructure where Israel allows us to, we are in danger of being pushed out of Area C together with the Palestinians,” he said.

Medico International calls this process a “policy of targeted de-development”, aimed at forcing the Palestinian population out of Area C into the densely populated urban enclaves. “In the end we will work in a Bantustan,” Cohen added.

Sidestepping the permits?

Some donors hoped that permits might be made available for solar and wind energy harvesting systems in Area C, but their hopes were dashed: “We don’t get any permits, so we simply build without,” Elad Orian, co-founder of COMET-ME, told IRIN. At least eight of the standalone energy systems the organization installed in recent years are under threat of demolition, he added.

The EU effort to change the rules of the game is encouraging for agencies implementing projects in Area C, but Orian said it remains close to impossible to get international funding for COMET-ME projects without a permit from the Israeli authorities.

The policy shift led by the EU reflects a greater focus on international humanitarian law (IHL) instead of Israeli administrative rules, said Cohen, adding: “Israel uses administrative law above IHL. No one does enough to stop them.”

ah/kb/cb
source http://www.irinnews.org

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A “sin tax” on tobacco and alcohol could help countries fund their HIV treatment programme

Posted by African Press International on July 30, 2012

A “sin tax” on tobacco and alcohol could help countries fund their HIV treatment programmes (file photo)

WASHINGTON DC,  - While global HIV funding has stayed flat in recent years, poorer countries have quietly been putting more of their own money into financing the HIV response. “Something very interesting has been happening” in Africa, Bernhard Schwartländer, director of strategy at UNAIDS told a plenary session at the 19th International AIDS Conference in Washington DC.

Treatment numbers are rising despite stagnant funding. “A lot of very clever and dedicated people are working very hard in making sure that services are delivered more efficiently, and… more people receive HIV services with the same amount of money.”

Domestic spending on HIV/AIDS in several African countries, including Kenya, Namibia, Sierra Leone and Uganda, rose by more than 100 percent between 2006 and 2011. For the first time ever, domestic resources exceed international AIDS spending as national governments take on the challenge of redistributing resources, UNAIDS noted.

But the reality is that national AIDS programmes have expanded beyond the capacity of governments to fully support them. If Malawi, for instance, took on the financing of its antiretroviral (ARV) programme – currently funded entirely by the Global Fund to fight AIDS, Tuberculosis (TB) and Malaria – this would consume two-thirds of its overall health budget, said Sharonann Lynch, policy advisor at international health charity Médecins Sans Frontières (MSF).

Poorer governments are still largely dependent on global resources. “The lives of 80 percent of the people who receive AIDS treatment in Africa depend every day, every morning, on whether or not the donor writes another cheque. That is unacceptable – such dependency simply must end,” said Schwartländer.

New sources of income

As an alternative to donor support, innovative financing mechanisms to bridge the funding gap are gaining increasing support from governments. Zimbabwe’s AIDS levy – a 3 percent income tax – generated more than US$26 million in 2011, UNAIDS reported recently. However, Albert Manenji, finance director of Zimbabwe’s National AIDS Council, told IRIN/PlusNews that only 30 percent of Zimbabweans were in the formal sector and contributed to the levy, so they are looking at broadening the revenue base to include small businesses and the informal sector.

Rwanda and Uganda have begun to impose a levy on the use of mobile phones to fund health programmes, and Botswana, Gabon and Malawi, among others, are investigating such a levy specifically for AIDS financing.

''The lives of 80 percent of the people who receive AIDS treatment in Africa depend every day, every morning, on whether or not the donor writes another cheque. That is unacceptable – such dependency must end''

Imposing a “sin tax” on alcohol and tobacco to pay for universal access to ARVs could be one of the most ambitious taxes to be implemented.

Modelling by Liverpool University researchers based on the 20 countries with the highest HIV burden suggests that 10 of these countries, including South Africa, Botswana and Malawi, could fully fund universal access over the coming years if governments put a small “global health charge” on alcohol and cigarettes.

Andrew Hill, a research fellow at Liverpool University, said the proposed tax would also generate “substantial additional funds to treat malaria, tuberculosis and other diseases”. Raising taxes could also deter the use of cigarettes and alcohol, lowering the burden of non-communicable diseases linked to smoking and drinking.

The idea of a “sin tax” has long been popular in developed countries, and now the “fat tax”, a levy on sugary drinks and other foodstuffs associated with obesity, is also growing in momentum. But Hill admitted that enforcing these taxes in poorer countries would be difficult.

Schwartländer also suggested that the recent fines imposed on large pharmaceutical firms could be set aside for health assistance, “rather than disappear in the general coffers of those countries”.

In July 2012, British drugmaker GlaxoSmithKline pleaded guilty to criminal charges and agreed to pay $3 billion in fines for promoting its best-selling antidepressants for unapproved uses, and failing to report safety data about a top diabetes drug.

Schwartländer pointed out that “three billion dollars could easily pay for a year of drugs for all those on treatment today”.

kn/he
source http://www.irinnews.org

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Better paediatric HIV formulations – Fewer babies are being born HIV-positive

Posted by African Press International on July 30, 2012

Researchers are developing improved HIV pills, kid-friendly treatment “sprinkles”, micro-tabs and even medicine-dispensing pacifiers (filephoto)

WASHINGTON DC,  - Fewer babies are being born HIV-positive, but treatment for the more than three million children living with HIV remains under-researched and underfunded. As part of efforts to boost access to paediatric HIV treatment, researchers are getting creative, moving to better pills, kid-friendly treatment “sprinkles”, micro-tabs and even medicine-dispensing pacifiers.

Ahead of the International AIDS Conference, Indian generic drug manufacturer Cipla announced that it would partner with the Drugs for Neglected Diseases initiative (DNDi), a not-for-profit research and development organization, to produce an improved first-line antiretroviral (ARV) combination therapy specifically adapted for infants and toddlers living with HIV. The partnership is just one of the developments in paediatric treatment highlighted at the 19th International AIDS Conference in Washington DC.

Mother-to-child HIV transmission rates have fallen by almost 25 percent globally since 2009, according to the latest UNAIDS report. Governments and donors celebrated these gains and pledged to eliminate mother-to-child – or vertical – transmission by 2015.

Former UN Special Envoy for AIDS in Africa, Stephen Lewis, speaking at the conference, criticized the lack of progress in improving treatment options for the 3.4 million children living with HIV.

“You can’t aim for the virtual elimination of paediatric HIV by 2015 at the continued expense of [treatment] scale-up for children living with HIV now, but that’s exactly what appears to be happening,” said Lewis. “[These children] deserve the right to life, they are not expendable causalities because they didn’t fit into prevention of vertical transmission programmes.”

The latest UNAIDS report shows that about 55 percent of adults living with HIV and in need of treatment are receiving ARVs globally, compared to just 25 percent of the children who need them. In some countries, patent laws still restrict access to some existing paediatric fixed-dose ARV combinations.

Paediatrician and researcher Dr Adeodata Kekitinwa, who works at the Mulago Referral Hospital in the Ugandan capital, Kampala, pointed out that HIV treatment for children is historically under-researched and less efficacious than adult formulations, making it harder to suppress HIV viral loads in children and infants compared to adult patients.

Promising pills and more

Cipla and the Clinical Trials Unit of the UK Medical Research Council have produced several ARV formulations for babies, and recently announced good results from a new granular, or sprinkle, formulation of lopinavir-ritonavir, a combination of ARVs.

In the recently released CHAPAS-2 trial, which compared the sprinkles with the conventional lopinavir-ritonavir syrup, caregivers reported that the sprinkles were easier for babies to swallow and easier for caregivers to transport and store than the syrup formulations.

According to Diana Gibb, a researcher on the study, the CHAPAS-2 trial also collected important data on how caregivers thought the sprinkles should be administered. For instance, many caregivers reported pouring sprinkles into the baby’s mouth and then immediately breastfeeding.

''You can’t aim for the virtual elimination of paediatric HIV by 2015 at the continued expense of [treatment] scale-up for children living with HIV now, but that’s exactly what appears to be happening''

While this data is yet to be analyzed, Gibbs said it was important for drug manufacturers and developers to understand what treatment options worked best for families. Kekitinwa said these considerations might also factor into trial designs, possibly looking at how drugs interact with breast milk.

Cipla’s newly announced proposed four-in-one therapy will also be developed in sprinkle-form and have a child-friendly taste. The company aims to register the drug by 2015.

As more paediatric ARV formulations are developed, drug companies may be able to move beyond syrups and sprinkles to dissolving microfilms or bulk powders that would make it easier for healthcare providers to calculate doses based on children’s rapidly changing body weight.

Bulk powders could also make drugs cheaper, as pharmaceutical companies would not have to alter the manufacturing process to cater for different age and weight groups. Better-tasting drugs could also eventually be administered in pacifier dispensers.

With an urgent need for more paediatric ARV formulations, the UN World Health Organization (WHO) recently formed a technical working group to draw up guidelines on formulation and dosing in an effort to help guide research and development, said Lulu Muhe, who works in WHO’s Department of Child and Adolescent Health and Development.

llg/kr/he

source http://www.irinnews.org

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