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Dec 7, 2005

Hi Dr Bob ;

Today being World Aids Day I thought it pertinenet to let you know how much of a difference the work you do makes, and awareness it creates. Not only are you compassionate and understanding but throughout all your replies you never judge or criticise which is truely a unique gift for dealing with people. You rely totally on scientific evidence in all of your replies but the manner in which you do so adds that human touch. I was a worried well for quite some time and everyday I would check out the archives for reassurance and guidance ... something that means more than you will ever realise. I have devoted some time to helping out with AIDS hospice work, something that I could never of done without the strength and courage I have gotten from reading the archives. I believe the powers that be (or the man upstairs as I like to call him) look down on you with nothing but admiration and pride for all that you represent in the human race. I wish you and your family a blessed Christmas and may you have many more New Years to celebrate the gift of life. A message all the way from South Africa.

Response from Dr. Frascino


Thank you for your very kind words. They brightened my day.

I'll reprint a few articles that address the HIV/AIDS crisis in Africa for our readers.

Stay well. Stay safe. Thank you for devoting some of your time to a local AIDS hospice. Compassion like yours is what will eventually turn the tide against the pandemic.

Dr. Bob

Rage, remorse, but some hope in Africa on AIDS Day


JOHANNESBURG - Rage and remorse marked World AIDS Day in Africa on Thursday as the continent worst hit by the global crisis remembered millions of deaths in a pandemic that even new drug treatments are doing little to slow.

Across Africa AIDS patients criticized political leaders for failing to come to grips with the disease and the international community for doing too little to help.

"Money that has been earmarked for HIV/AIDS has gone into everything else but AIDS," fumed Meris Kafusi, a 64-year-old AIDS patient in Tanzania who only recently began receiving life-prolonging antiretroviral (ARV) drugs.

"Organizations that say they are dealing with AIDS are always in seminars or workshops. They should be buying food for widows and orphans ... but instead of that, you find them earning daily allowances of $50 for sitting in a room discussing us. Is this fair?" Some two decades into the epidemic, sub-Saharan Africa remains ground zero for worldwide HIV/AIDS deaths as well as for new infections -- a calculus of misery that has already cut life expectancy in many countries, left millions of children orphaned and reduced agricultural output in hungry countries.

The latest U.N. estimates say 26 million of the 40 million people infected with HIV worldwide live in Africa, and that Africa saw about 3.2 million of the almost 5 million new infections recorded in 2005.

Jack Yong Kim, the director of the HIV/AIDS department at the World Health Organization (WHO) who was visiting the tiny African kingdom of Lesotho for AIDS Day, said Africa's pain was due in large part to lack of proper planning.

"Current prevention, treatment and care efforts are too episodic, ad hoc, and lack the intensity, pace and rhythm needed to make an impact," he said in a statement.

Lesotho on Thursday sought to boost its AIDS campaign by launching a door-to-door drive to enlist the kingdom's entire population for voluntary HIV tests.

But in Swaziland -- which shares with Lesotho the grim distinction of having the world's highest adult HIV prevalence rate at some 40 percent -- King Mswati scrapped AIDS Day entirely in order to concentrate on other royal duties.


The introduction of ARVs, the only treatment proven to slow the progress of AIDS, is beginning to have an impact in Africa although officials say the drugs are only reaching 10 percent of the African patients who need them.

Diamond-rich Botswana, which pioneered public ARV treatment, said on Thursday it had enrolled almost 55,000 people on the drugs -- making it one of the few African countries to meet its national target. In South Africa, which with some 5 million HIV infections has the highest single caseload in the world, ARVs were credited with cutting the number of deaths of HIV-positive babies at one Johannesburg orphanage to just eight in 2005 from 51 in 2002. "Their fight to live, the pain they have had to endure and yet the smiles they still had for their caregivers have ensured that each one holds a special place in our hearts," Cotlands orphanage director Jackie Schoeman said at a memorial service on Thursday. But South Africa's roll-out of ARVs, which activists say is hobbled by government wariness over the drugs, has not stopped new infections and AIDS mortality continues to rise.

A projection by the research group Markinor said more South Africans were displaying high-risk sexual behavior and forecast cumulative AIDS deaths could hit 9 million by 2021.

Some countries, notably Uganda, Kenya and Zimbabwe, appear to be bringing overall infection rates down -- thanks in large part to condom campaigns.

In West Africa, which has far lower HIV infection rates than countries to the south, efforts are under way to widen availability of ARVs but even key Western donors conceded that not enough was being done.

"How can you accept that 1.8 trillion dollars a day are traded on financial exchanges but we cannot find 50 billion euros a year for (AIDS) treatment? It is shameful morally, ethically and stupid politically," said French Foreign Minister Philippe Douste-Blazy on a visit to Dakar on Wednesday.

For some African AIDS patients, the yearly round of speeches, rallies and commemorations to mark World AIDS Day has already become a pointless distraction.

"There is no need to attend AIDS rallies if I come back and my children sleep hungry," said Esther Kanini, a 41-year-old HIV-positive mother of five who lives in a tin shack in the vast Ongata Rongai slum west of Nairobi (Additional reporting by Helen Nyambura in Dar Es Salaam, Brian Mohammed in Mbabane, Guled Mohamed in Nairobi, Ntsau Lekheto in Maseru) Copyright 2005 Reuters News Service. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Copyright © 2005 ABC News Internet Ventures

Message on the Occasion of World AIDS Day

By Dr. Peter Piot

December 1, 2005

On this 18th World AIDS Day, the world faces a choice in the global response to AIDS. We can either continue to accept that global efforts will fail to keep pace with ever increasing numbers of HIV infections and AIDS related deaths, including more and more women and girls.

Or we can recognize the exceptional global threat posed by AIDS and embrace an equally exceptional response.

The latest global AIDS figures show some signs of hope: Adult infection rates have decreased in a few countries, notably in Kenya, Zimbabwe and some Caribbean countries including Bahamas, Barbados, Bermuda, Dominican Republic and Haiti, and that changes in behaviour, such as increased use of condoms, delay of first sexual experience and fewer sexual partners -- have played a key part in these declines. However, globally, the epidemic continues to grow: The number of people living with HIV in 2005 has reached its highest level ever, at an estimated 40.3 million people, nearly half of them women.

The lessons of nearly 25 years into the AIDS epidemic are clear. Investments made in HIV prevention break the cycle of new infections. Investments made in HIV treatment and care give people longer, better and more productive lives. By making these investments, each and every country can reverse the spread of AIDS. The World Summit in New York last September, all UN Member States pledged to developing and implementing a package for HIV prevention, treatment and care with the aim of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it. Effective comprehensive prevention treatment and care programmes need to be scaled up on a massive scale so that everyone who needs them can benefit from them.

Yet, our efforts have to go even further if future generations are to live without AIDS. With a crisis as unprecedented as AIDS, we cannot afford to neglect any vital front. We must do whatever it takes to accelerate the pace of development of women-controlled prevention technologies, new generations of effective treatments, and a vaccine against HIV. And we must address the deeper-rooted factors that are driving the virus, including gender and income inequality.

The World AIDS Campaign has chosen "Stop AIDS, Keep the Promise" as its new theme, referring to the promises that we have all made to deliver the exceptional response demanded by AIDS. The commitment to resource and deliver effective prevention, treatment and care services for all who need them, is one we must all keep. There are no excuses.

Dr. Peter Piot is Executive Director of UNAIDS.

Bush Administration's Focus on Abstinence, Fidelity "Condemns" African Women to Die of HIV/AIDS, Opinion Piece Says March 31, 2005

Although the Bush administration's focus on sexual abstinence and marital fidelity is "well-meaning," it will cause "a lot of unnecessary deaths on the ground in Africa," where many women contract HIV from their husbands, columnist Nicholas Kristof writes in a New York Times opinion piece. "The stark reality is that what kills young women here is often not promiscuity, but marriage," Kristof writes, adding, "Indeed, just about the deadliest thing a woman in Southern Africa can do is get married." As a result, there is a need for condom promotion -- particularly in countries where there is a "disdain for condoms" -- to reduce the spread of HIV, according to Kristof. Although condoms have had a "crucial role" in "relatively successful" HIV/AIDS prevention campaigns in some countries, the Bush administration requires that U.S.-funded HIV/AIDS programs for youth focus on abstinence, Kristof writes. In addition, according to the Center for Health and Gender Equity -- a nongovernmental organization focusing on the effects of U.S. policy on women around the world -- the United States is "backing away from effective programs that involve condoms" in several countries, Kristof says. "Perhaps the White House thinks it has the moral high ground when it preaches, completely irrelevantly, to women ... about the need to be faithful," Kristof says, concluding, "But it strikes me as hypocritical to pontificate about virtue while pursuing an ideological squeamishness about condoms that risks condemning ... millions [of women] to die" of AIDS-related illnesses (Kristof, New York Times, 3/30).

thank you doctor
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