Welcome to the March 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

IMMEDIATE IMPROVEMENT INITIATIVE TARGETS MATERNAL HEALTH

When maternal mortality almost doubled in 14 years, health leaders in Namibia decided to make maternal health a priority and set up a pilot in Khomas region, Health-e reports. Acting on research findings that only a few patients need ambulances, the Ministry of Health and Social Services made a minibus available in Windhoek to transport clinic patients to the city’s two hospitals. This is one of the immediate improvement initiatives introduced by a multi-stakeholder team set up to address maternal health in Khomas. The project is underpinned by three principles: local leadership development, social innovation and improved system performance. It applies a business-consulting approach called the “Innovation Lab”. Through the Innovation Lab, multi-stakeholder teams are guided through an intensive leadership development and problem-based learning experience. The aim is to tackle a complex social and system problem through a multi-stakeholder and innovation response.
http://www.health-e.org.za/news/article.php?uid=20032653

Story ideas:

This "immediate improvement initiative" could be put in place to meet community needs in many places in Africa. In the community you serve, what problems (such as Namibia’s alarming maternal mortality rate) could be made priorities for this kind of action?
Who are the roleplayers / stakeholders in your area who would need to give the go-ahead for an initiative of this kind?
What does the community want done and what ideas do they have for resolving the problem they have identified as most important?
What role can your newspaper / radio station play in making this happen?

OUT-OF-THE-BOX WAYS TO UNBLOCK HEALTH SERVICE DELIVERY

Another Health-e story tells of an innovative process aimed at unblocking health service delivery that is being piloted in Namibia by a partnership of management and development organisations. The focus is on building a strong, united team of health leaders. Michael Likando is Regional Health Director of Caprivi, which has a very high HIV rate and poor infrastructure. He oversees 25 clinics, three health centres and a district hospital. “In the past, regions had their own plans but they were not well guided by the Ministry,” says Likando. “But now, with the health leadership initiative, we have developed a strategic plan. We understand where we are, where we want to go and how we have to get there.” The idea of the African Public Health Leadership Initiative was first mooted over three years ago. The Bill & Melinda Gates Foundation agreed to provide $7-million to fund an initiative that could engage leaders in poor countries to work on out-of-the-box ways to unblock health service delivery, and non-profit organisation Synergos set about looking for a country to pilot its vision. Namibian Prime Minister Nahas Angula received the idea enthusiastically when it was introduced to him by civil society leader Len le Roux.
http://www.health-e.org.za/news/article.php?uid=20032652

Story ideas:

Are civil society leaders in your country trying to get political leaders to sign up for this public health initiative, or another one like it? If so, try to interview people who are enthusiastic about its possibilities for your country / region.
Ask them what they have noted in the Namibia pilot and what they envision a similar project could focus on at home.
Note how the health director interviewed here talks about "they" when he talks of the past, and "we" when he refers to what’s happening now. Look for people who show that transformation when writing your story.

CAPACITY DEVELOPMENT OF LOCAL GOVERNMENT CRUCIAL

South Africa’s AIDS Law Project and Treatment Action Campaign said it is pleased that the country’s 2010/1 budget makes available additional funds for HIV programmes, but warned that to ensure that money is effectively spent and the policy is properly implemented, the Department of Health must develop the capacity of the provincial Departments of Health to effectively budget for the provision of health services. The TAC said the government must improve the monitoring and evaluation of its Highly Active Antiretroviral Therapy and Prevention of Mother to Child Transmission programmes so that it can more accurately budget for drug procurement of the programmes. It also noted its concern about a projected decline in funding for TB - the leading cause of death of people living with HIV.
Noting President Jacob Zuma’s pledge that several important updates to the treatment guidelines would be implemented in April 2010, including initiating TB/HIV patients, pregnant women and infants earlier onto treatment, the TAC said the government’s costing of the changes must be transparent and made publicly available to all relevant stakeholders including civil society.
http://www.health-e.org.za/news/article.php?uid=20032655

Story ideas:

If you are in South Africa, try to find out if your provincial Department of Health is making headway in effective budgeting. How are these funds for HIV programmes being spent in your area?
The work done in - and interesting aspects of - a local programme could be highlighted in a feature article.
Is the government heeding the TAC’s insistence that costing be transparent and available to stakeholders? If not, how are local civil society organisations lobbying for this?

JUDGES URGED TO USE LAW TO PROTECT RIGHTS IN CONTEXT OF HIV

The legal fraternity is being called on to do more to combat prejudice and discrimination against people living with HIV and AIDS, reports Health-e, noting that while most countries’ Constitutions proclaim everyone equal before the law, at least 18 countries in sub-Saharan Africa have laws that criminalise the transmission of HIV. In addition, some countries have laws or are tabling laws that criminalise same sex relations, drug use and sex work. In response to concerns that such laws will hamper national HIV prevention and treatment efforts to reach marginalised groups, the United Nations’ Joint Programme on HIV/AIDS (UNAIDS) has started a series of consultative meetings with judges across Africa to sensitise them about how they can use the law to promote human rights and to protect high-risk groups such as homosexuals, men in prisons, sex workers and injecting drug users from punitive laws. “In many countries we have either existing law that could be protective of HIV issues or we have very specific law that is either protective or punitive. In both cases we need the judges to take that law and ensure that it protects human rights in the context of HIV and that it reduces discrimination, reduces vulnerability to HIV infection and to the impact," says Susan Timberlake, Human Rights and Law senior advisor for UNAIDS.
http://www.health-e.org.za/news/article.php?uid=20032649

Story ideas:

Ask judges in your country what support they need to use their influence in the fight against AIDS. Do they need information on HIV issues and who would they want to provide this?
If you are in South Africa, you could ask Edwin Cameron his views on how this initiative could make an impact.
You could ask people affected by past judgements related to HIV what their hopes are for this project - what are potential pitfalls and how can these be avoided?

NO MEDICAL BASIS FOR PRISONER SEGREGATION

Human Rights Watch reports that, after 20 years of advocacy by itself and other rights groups, the Mississippi Department of Corrections (MDOC) has agreed to end the segregation of prisoners with HIV. This policy, which had prevented prisoners from accessing key resources that facilitate their successful transition back into the community, was reversed before the release of a report analysing the harmful impact segregation policies have had. Public and correctional health experts agree that there is no medical basis for segregating HIV-positive prisoners within correctional facilities or for limiting access to jobs, vocational training and educational programmes available to others. Prisoners with HIV will now be able to participate in kitchen work, for example, which can be beneficial to them in many ways. Many prisoners worked in kitchens, cafes, or restaurants prior to their incarceration, and continued employment in that area can help them upon re-entry. According to the US Centers for Disease Control, there is no medical basis for preventing persons with HIV from working in kitchens or other food service employment. Additionally, prisoners with HIV will no longer be assigned to a segregated HIV unit, which resulted in the public disclosure of their HIV status and left them at risk of being ostracised and subjected to hostility and violence at the hands of other prisoners.
http://www.hrw.org/en/news/2010/03/17/mississippi-stops-segregating-prisoners-hiv

Story ideas:

What is the situation regarding segregation in prisons in your country / area? Are there groups such as Human Rights Watch monitoring the situation and lobbying for change where there is segregation?
Ask people in your community for ideas on alternatives to segregating infected prisons from those who are not infected? In these interviews you can find out how widespread are myths such as those dispelled here, like the fact that is no medical basis for stopping HIV-infected people from working with food.
Perhaps include a facts sidebar with your article that would interest readers and help to dispel misinformation.

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