IFMSA Africa Regional Newsletter - Decmeber 2005

IFMSA-Africa Newsletter Means of communication for African Medical Students

December 2005, Volume 1, Number 2

Editorial

Upcoming Events in Africa

HIV knows no frontiers, no race, or social status and it spreads all over the world by people who often don’t consider the possibility of infection.

21st January-3rd February 2006 Winter school, Egypt

As future physicians, we should create ways of increasing the awareness of the different problems as well as the possible solutions.

8th – 12th May 2006 HIV/AIDS, Food Security and Nutrition Conference, Lusaka, Zambia

Through the different means of communication, we reach out to educate and involve as many people as possible in our Endeavour’s to find solutions to the global problems.

The theme of this 2nd issue of the IFMSA-Africa Newsletter is the World AIDS Day and the activities that were carried out around this important day.

You can find articles by our IFMSA-Africa members on their activities in the different parts of Africa, for example the AIDS focus groups that MedSIN Sudan organised. Also we pay special attention to different conferences on our continent and the results that come out of them.

19th -21st June 2006 2nd African conference on Sexual Health and Rights, Nairobi, Kenya 29th October – 2nd November 2006 Global Forum for Health Research, Cairo, Egypt

Enjoy reading!

Jennifer Mbabazi Editor in Chief

IFMSA-AFRICA Leadership 2005-2006 Regional Coordinator Africa Ahmed Ali, Sudan

Happy New Year!

Regional Assistants Africa • SCORA Jennifer Mbabazi, Rwanda Oluwatosin Omole, Nigeria • SCOPE Charles Obeng Mensah, Ghana • SCOPH Hossam Hamad, Sudan

May 2006 bring Africa prosperity and lots of successful projects Ahmed, Jennifer, Oluwatosin, Charles, Hossam, Tana, Mabashar and Serini

IFMSA-Africa Newsletter

December 2005

• SCORP Tana Mohammed, South Africa Mubashar Ahmed, Sudan • SCOME Vacant Liaison Officer WHO Serini Murugasen, South Africa

Page 1

IFMSA Official Statement on World AIDS Day "Stop

AIDS.

Keep

the

Promise."

Every year, people around the world designate 1 December, World AIDS Day, as a time of reflection - to remember the friends and loved ones lost to AIDS, to heed the lessons learned over the year, and to take stock of the progress made to provide a comprehensive response to the epidemic.

Acquired Immunodeficiency Syndrome (AIDS) has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive epidemics in recorded history.

Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic claimed 3.1 million (2.8-3.6 million) lives in 2005; more than half a million (570 000) were children. The total number of people living with the human immunodeficiency virus (HIV) reached its highest level: an estimated 40.3 million (36.7-45.3 million) people are now living with HIV. Close to 5 million people were newly infected with the virus in 2005.1 Research has shown that education programs implemented by young people typically have better results compared to programs with adult educators. Young people are more capable of communicating with their peers and of being a credible source of information once they are trained well.

Knowing this, medical students worldwide joined together in 1992 within the International Federation of Medical Students' Associations (IFMSA), and initiated new programming in a separate committee devoted entirely to reproductive health issues and HIVAIDS. The Standing Committee on Reproductive Health including HIV/AIDS (SCORA) aims to raise awareness on a variety of reproductive health issues amongst the wide public, to spread the knowledge regarding HIV/AIDS and other sexually transmitted infections and to decrease stigma and discrimination against people living with HIV/AIDS. The fight against HIV/AIDS cannot be won by working individually, and IFMSA has been co-operating with many intergovernmental agencies and non-

IFMSA-Africa Newsletter

governmental organizations in order to achieve her goal.

Many local, national and international projects are proceeding worldwide with one common emphasis: to make a change for a better future for those fighting this dreadful disease.

Yet much more is needed. Medical students today are trained as the future caretakers of global health; nothing is more likely to influence medical practice in the next generation than the HIV/AIDS pandemic. It is therefore incumbent upon medical students to become advocates of HIV/AIDS patients during their training, and to develop an understanding of the physical, psychological, and social challenges of those living with HIV/AIDS. Medical students organize numerous campaigns worldwide to raise awareness against HIV/AIDS within universities, among young people and among the general public. Distributing condoms, tshirts, leaflets and red ribbons, talking to people on the streets, carrying out questionnaires on condom usage worldwide are a few examples. Medical students act as advocates for improved HIV/AIDS education in medical faculties.

Medical students work for providing necessary care, psychological and social support to people and children living with HIV/AIDS. The "Godfrey's Children" project run by medical students in Tanzania, aims to support orphans and vulnerable children infected and affected by the pandemic.

Moreover, several HIV/AIDS peer-training programs were organized in Kenya by the Kenya Village concept project, in Uganda by the Uganda Village Concept project and in Rwanda by the Rwanda Village Concept project, all run by medical students.

collaboration with medical students in 2002 has been an effective guide for future physicians in their training. Medical students use peer methodologies as a tool in almost all of their activities mentioned above. They fulfil the knowledge of other medical students, students in other disciplines and in high schools, with the help of the peer education programs running all over the world.

Yet much more is needed. It is a situation that is not without hope. Today, we all know that there is not yet a cure, and there is not yet a vaccine -but HIV/AIDS can be prevented, and medical students can play an integral role in the education of their future patients with regards to responsible sexual practices.

From 2005 to 2010, the World AIDS Campaign will highlight the theme of "Stop AIDS. Keep the Promise" to encourage governments and the international community to meet their commitments to the Millennium Development Goals.

As physician-healers of the next generation, we must all take it as our personal mandate to become caring, compassionate, considerate practitioners.

We must take the fate of every person living with HIV/AIDS as our own, and we must do everything we can, right now, to end this global pandemic.

Through about volunteer network we must to promote public health awareness and contribute to the global initiatives.

The "Northern European Co-operation of Sexual Education" projects meets once a year for a 4-day-workshop where participants exchange experiences, methods and ideas to combine their knowledge and to train each other in HIV/AIDS education. The "Children, AIDS and Medical Students" exchange program project in Romania aims to provide medical students with both theoretical knowledge and practical work concerning HIV/AIDS.

Contact: • Ahmed Khamis, Director of IFMSA Standing Committee on Reproductive Health including HIV/AIDS, scorad@ifmsa.org • Jana Kammeyer, IFMSA President, president@ifmsa.org • For further information about IFMSA World AIDS Day events visit us at www.ifmsa.org/scora

The UNESCO/UNAIDS Kit on HIV/AIDS and Human Rights, developed in

_______________________________ 1. UNAIDS, www.unaids.org

December 2005

Page 2

World AIDS Day in Sudan and SCORP, MedSIN-Sudan planned for the WAD 2005. Focussing on medical students to raise awareness and st nd recruitment for the newcomers from 1 , 2 rd and 3 years.

As MedSIN-Sudan represents more than 20 medical schools in Sudan, WAD 2005 had distinction that getting participation from many of these medical schools.

MedSIN-Sudan logo for WAD

AIDS in Sudan First repotred case in 1986.

What is the situation now?

12.000 case in may 2005.

Most affected category are those between 15-39 years old ( working people ).

Rate of spread 6.1%.

MedSIN-Sudan In collaboration between SCORA, SCOPH

Activities st th From the 1 to 10 of Dec. 1. AIDS focus groups for 5 groups of medical students; got training on AIDS discussion. They went to 5 secondary schools, Mosques and Prisons and did plenty of lectures for people about AIDS. There were a lot of competitions, leaflets, posters and presentations.

Teachers, religious leaders and police officers also aided in the preparation and presentation.

2. In the first 2 days there was a mobile fair for students, raising awareness and recruitment. This exhibition held in 5 medical faculties in Khartoum.(Khartoum University, Alahfad medical school, Alribat National university, Alzaeem Alazhary University and College of technical sciences). rd th From the 3 – 5 , there were 3 sessions *Unite Against AIDS by medical students from Alahfad medical school.

*AIDS and MDGs in Alahfad university. *HIV/TB co-infection in Khartoum University.

4. Publications: MedSIN-Sudan published a special edition for the WAD. 5. Movie and Play. A play held by a society of play getting themes about AIDS in University of Khartoum.

6. Workshop in collaboration with ministry of health and National program for AIDS prevention about the situation in Sudan.

MedSIN-Sudan always tries to link medical students to develop themselves and to serve the community. MedSIN-Sudan put in mind : We should make a difference.

Hossam Hamad Regional Assistant for SCOPH

AIDS focus groups for female secondary school

AIDS focus groups for female secondary school AIDS focus groups for people in the Mosque (Place where Moslims do their prayers)

AIDS focus groups for women

On the right: 1. Tahagod Hashim (NORA) 2. Mobile AIDS fair 3. (ex) NORA in AIDS fair

IFMSA-Africa Newsletter

December 2005

Page 3

Mandela urges Africans to acknowledge and speak out on AIDS By: Jafar Danesi Volunteer Correspondent ICASA, Abuja 12-08-2005

at

Source: Datelinehealth-Africa Service.

XIV

News

Elder statesman and former South African President, Nelson Mandela was one of several eminent personalities who graced the opening ceremony at the XIV International Conference on AIDS and STI's in Africa (ICASA), holding in Abuja, the capital city of Nigeria.

Welcoming delegates and fellow activists, Mandela praised conference organisers for choosing "HIV and the Family" as theme and said: "My own family like millions across the continent felt the impact of the pandemic. As a father, there is no shame in acknowledging that your son died of AIDS. AIDS has been with us for more than 25 years and it will still be with us for many years to come".

Calling for a unified approach, Mandela said, "The only way for us to confront the epidemic is for us as Africans to speak out and stand proudly together to address the greatest crisis confronting the continent".

Mandela urged conference participants not to forget the elderly, and advocated for an inclusive and elderly-directed approach to addressing the pandemic.

"Let us not forget the elderly, who use their meagre resource to care for their own children who are sick of AIDS and their orphaned grandchildren. By ensuring that pregnant women have access to ARVs to prevent their children from being born with HIV, by providing children with AIDS treatment, by preventing more people from being infected with HIV and by protecting and supporting children affected by HIV and AIDS so that they can go to school and also receive good nutrition, we can alleviate the plight of the elderly".

beyond mere speeches at conference rooms to action. We can keep families together if we can ensure those who need treatment have access to treatment. We can empower those who know whether they are positive or negative to make informed choices about how they live their lives and to choose the means that best suits them to prevent the further spread of HIV/AIDS", Mandela said.

The conference enters its final day of deliberations and ends Friday with a closing ceremony.

Jafar Danesi is also Executive Director, Centre for Enlightenment and Development Intervention (CEDI).

To review more DLHA daily reports from the XIV ICASA 2005 conference: http://www.datelinehealthafrica.net/betav1.0/infocus/detailinfocus.as p?infocus_id=177

"I am proud ICASA is focusing its attention on leadership, but leadership has to move

Kenya AIDS intervention prevention project group Welcome to the KAIPPG Community!

The Directors, Members, and Volunteers of KAIPPG-Kenya and KAIPPGInternational extend a heart-felt welcome and appreciation on behalf of all Africans affected by AIDS, and struggling to address issues of poverty, malnutrition, lack of general healthcare and education, the human rights of women, children and youth, and PWAS, and environmental sustainability.

Together with our African sisters and brothers we can make a big difference in the quality of people’s lives, and work cooperatively to “be the change” that will transform the crisis of AIDS in Africa from one of despair to an experience of hope and healing. Please join us, and many thanks to all!

IFMSA-Africa Newsletter

that will transform the crisis of AIDS in Africa from one of despair to an experience of hope and healing. Please join us, and many thanks to all!

25 of the 34 million people infected with AIDS worldwide live in Africa, so every effort counts!

children and youth (including orphans), and the very poor.

AIDS

See us on these sites: NETAID and the Oxygen Network's "BeFearless" http://www.netaid.org and http://befearless.oxygen.com For KAIPPG-International kaippg@earthlink.net

KAIPPG is an international NGO operating in several districts in Western Kenya, with a force of 50 online volunteers from 15 countries and locations in Kenya and the USA. We have hundreds of volunteers, members, and clients in Kenya, and we are partnered or networking with numerous organizations and individuals the world over. We have a special focus on women, Soapstone ornaments

December 2005

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Reflections on the Lessons from Uganda Mankind’s course was markedly redefined in the year 1983 with the discovery then, of a new virus that has continued to wage a seemingly unending war against humanity. In the decades that followed, this discovery proved to be to be a vital one to the definition of man’s activities in it’s entirety: form politics, economics, education, social services, to healthcare delivery, etc.

Since 1988, December 1 of every year has been set aside to be used to evaluate the progress made in this fight and to show solidarity to people living with HIV/AIDS. What troubles me most is that it appears as if the more the efforts to combat this iron-teeth monster called AIDS, the more it appears to swallow more lives – 18 million African lives have been lost already. Possibly on daily basis, more and more groups – governments, NGOs, community-based organizations, faith-based organizations, etc do get involved in this multisectoral fight and several conferences, workshops, seminars, projects, etc are organized yet the epidemic only gets worse in most countries. These and many more compel me to ask and seek an answer to the question: are these efforts really in the right direction?

For the purposes of this reflection I would like us to base our considerations on the continent of Africa – sub-Saharan Africa in particular – which is the region of the world hit hardest by the pandemic. More than 60% (25.8 million) of people living with HIV/AIDS in the world are from subSaharan Africa. In sub-Saharan Africa, the southern and eastern parts happen to the epicentre of the epidemic. The AIDS figures of South Africa, Swaziland and Mozambique are heart-rending. After India and South Africa, Nigeria has the highest absolute number of people living with HIV/AIDS in the world.

Presently, only few African countries – Uganda, Kenya & Zimbabwe1 – have their HIV figures on the declining side.

Results of several studies have shown that between the period 1991 to 2001, Uganda was notably the country with the greatest decline in HIV prevalence in the 2 world ; with a decline from about 15% to about 5% in 2001. In the same period,

IFMSA-Africa Newsletter

HIV prevalence amongst pregnant women in Kampala, Ugandan capital, dropped from a high of approximately 30% to about 3 10% . This was a really stunning feat achieved by Uganda, Under Dictator Museveni! The more profit-yielding question will then be: HOW DID UGANDA DO IT? Most programs aimed at preventing new HIV infections by sexual transmission in the continent of Africa and beyond, are in tow of the popular condom lines. Most U.S and foreign health organizations – including the USAID, Centers for Disease Control (CDC), UNAIDS and World Bank – focus on condom education and distribution to combat AIDS. They assume that the real problem is a “condom shortfall”4. Many argue that Africans are dying in their millions because of poor condom accessibility and poor education on usage where available. In the words of Ugandan President Yoweri Museveni, ‘We are being made to believe that only a thin piece of rubber stands between us and the death of our continent5”. Uganda’s success story (likewise Senegal) has proven otherwise.

The best evidence suggests that the crucial factor in Uganda’s success was a national campaign to discourage risky sexual behaviours that contribute to the spread of the disease. Beginning in the mid-1980s, the Ugandan government working closely with community and faith-based organizations delivered a CONSISTENT AIDS prevention message: Abstain from sex until marriage, Be faithful to your partner if married or use condoms if abstinence and fidelity were not practiced (i.e. for high risk groups – Sex Workers – not likely to change their attitude). This was popularly known as the ‘ABC’ approach.

Based on research data collected over the past decade, several lessons can be drawn from the success of Uganda’s strategy: • • • •

High-risk sexual behaviour can be discouraged and replaced by healthier lifestyles.

Abstinence and marital fidelity appear to be the most important factors in preventing the spread of AIDS. Condoms do not play the primary role in reducing HIV/AIDS transmission.

Religious organizations (FBOs) are crucial participants in the fight against AIDS.

December 2005

Note that the data supporting the effectiveness of Uganda’s approach have come from USAID, the joint United Nations Program on HIV/AIDS (UNAIDS), WHO, the Harvard Center for Population and Development Studies, the Ugandan government and numerous independent studies published in medical journals.

Considering its Limited resources, Uganda’s success is even more impressive. The United States spends about 40 times per capita on AIDS than Uganda spends on all its healthcare issues6. Yet in United States the incidence 7 of HIV/AIDS is again rising . The U.S. increase in HIV infection rates comes despite aggressive marketing of condoms (condoms are virtually accessible everywhere in the States) and heavy spending on ARV drugs.

What happened in Uganda is that a lot of ‘forces’ at the same time were promoting more responsible sexual behaviour, what some has described as a sort of ‘Social Vaccine’ against HIV – a set of cultural values that encouraged more responsible 8 sexual attitudes and behaviors . At some point all these message plus seeing more people dying, get people to change their sexual behaviour9. The message was consistently clear and unambiguous: for youths: Abstinence, for the married: Fidelity in monogamy and condoms as a last resort for high-risk groups (sex-workers).

The following points more towards the evidences that abstinence & fidelity and not condoms, did it for Uganda: • • • •

The condom usage in Uganda is only 10 average for Africa .

Even after distribution campaigns, condom usage remains stable at low 11 rates .

Of the condoms distributed to high-risk groups in Uganda, 91% were 12 unused .

In one rural-population-based cohort, there was “no overall protective effect against HIV acquisition in women who 13 reported condom use ”.

A draft report for UNAIDS puts the failure rate of condoms at about 10%14 (that is even when ‘perfectly’ used by the ‘most informed’). This is obviously quite an unacceptable alternative sure path to the >

Page 5

death of a continent that is at the same time being threatened to the point of extinction by such other factors as extreme poverty, wars, Malaria, etc. “We should remember that the biggest predictor of any STD is the number of lifetime partners; the more partners the more risk; fewer partners less risk; and one uninfected partner in a faithful relationship – virtually no risk15.”

Fellow Africans, you will all agree with me that we cannot afford to be handling this HIV/AIDS phenomenon as though it were another man’s problem. It is OUR’S; right in our doorsteps. Our brothers and sisters are looking up to us as future healthcare professionals to take decisions and formulate policies that will define the future of Africa’s health. Our destiny lies in our very hands; let us arise with a unique and clear message of abstinence on this year’s World AIDS Day celebration, to save our future when it is still possible. More than 18 million Africans have already gone, how many more shall this AIDS monster eat before we act? Here is the challenge – Uganda has set the pace. Remember that there is no learning if there is no change.

Charles Chima, Nigeria

Acknowledgements: The Heritage foundation’s research paper on the ‘White House Initiative to combat AIDS: Learning from Uganda’.

Reference: 1. UNAIDS/WHO AIDS Epidemic Update: December 2005.

2. Prevalence is a measure of the proportion of people in a population affected with a disease at a given time.

Incidence is the number of new cases of a disease occurring in a given population over a certain period.

3. Ministry of Health of Uganda, "HIV/AIDS Surveillance Report," STD/AIDS Control Programme, June 2001.

4. Donald G. McNeil, Jr., "Global War Against AIDS Runs Short of Vital Weapon: Donated Condoms," The New York Times, October 9, 2002.

5. Y. K. Museveni, What Is Africa's Problem? (Minneapolis: University of Minnesota Press, 2000).

6. Shepherd Smith, "Why Uganda?"

Institute for Youth Development, April 7, 2003, at www.youthdevelopment.org/articles/op0407 03.htm.

7. Rob Stein, "AIDS Cases in U.S. Increase," The Washington Post, July 29, 2003, p. A1.

8. Daniel Low-Beer and Rand L.

Stoneburner, "Behavior and Communication Change in Reducing HIV: Is Uganda Unique?" African Journal of AIDS Research, Vol. 3 (2003).

9. Arthur Allen, "Uganda v. Condoms," The New Republic Online, June 30, 2003.

10. R. M. Kamya et al., "Barriers to Condom Use in an Urban Village of Kampala-Uganda," International Conference on AIDS, June 6, 1993.

11. J. K. Londe-Lule et al., "Condom Use Trends in a Rural District in Uganda, 19891992," International Conference on AIDS, June 6, 1993.

12. P. Waibale et al., "Comparison of Two Condom Education Approaches for Prostitutes in Jinja District, Uganda," International Conference on AIDS, July 19, 1992.

13. Rakai Project Study Group, "Hormonal Contraceptive Use and HIV-1 Infection in a Population-Based Cohort in Rakai, Uganda." AIDS, Vol. 17 (January 24, 2003), pp. 233-240.

14. "Condoms," AIDS Policy and Law, Vol. 18, No. 13 (July 22, 2003).

15. Shepherd Smith, President Institute for Youth Development, testifying before the U.S House sub-committee on health.

Forcing patients to pay for AIDS care endangers treatment success

Many patients reported erratic consumption of medicines, , including skipping or sharing doses, which can lead to insufficient drug levels in the blood.

Abuja, December 6, 2005 - - Having to pay for HIV/AIDS care increases the risk of treatment failure, according to new research from Médecins Sans Frontières (MSF) presented this week at the International Conference on AIDS and Sexually transmitted infections in Africa (ICASA), in Abuja, Nigeria.

The research revealed that in Lagos, Nigeria, among patients who had to pay for their own AIDS care, 44% had multiple treatment interruptions or took insufficient dosages due to lack of funds.

The medical effects of this are extremely worrying.

Once enrolled in MSF´s programme, where care is free, these “treatment interrupters” had only half the immune system recovery (measured by rise in CD4 count) compared to those receiving treatment for the first time.

IFMSA-Africa Newsletter

"These patients are more vulnerable to AIDS-related infections such as pneumonia or tuberculosis", said Dr Jens Wenkel of MSF. "So forcing people to pay, and thereby risking treatment interruptions, can make this life-prolonging treatment less effective. If we want people to survive on treatment, we have to ensure access to free care."

The Nigerian government is insisting that public hospital patients pay for at least part of their own AIDS care including drugs and monitoring. "This is ludicrous. According to our survey, nearly 50% of these patients live on less than US$36 per month, yet they are paying between US$8 and US$67 per month for a recommended package of care," said Dr Wenkel.

To pay for their care, 39% of respondents reported borrowing or begging, while 18% said they had been forced to sell property.

December 2005

The research was conducted between August and November 2005 among 122 patients who previously had to pay for their AIDS drugs and diagnostics and were later enrolled in the MSF program in General Hospital Lagos , Lagos Island .

A similar trend was found in Kinshasa , Democratic Republic of Congo, where a user fee proved to be a significant barrier to accessing care. When MSF abolished the clinic fee, the regularity of attendance in the ARV clinic improved considerably.

MSF currently provides antiretroviral treatment to over 57,000 people living with HIV/AIDS in 29 countries. In Nigeria , MSF is treating more than 950 patients with ARVs in a comprehensive care clinic in Lagos .

Source: http://www.icasa2005.org.ng/english/index.

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TAMSA did it again superbly!

Poverty and the burden of diseases, the Scientific Conference experience…

TAMSA Scientific Conference is an idea that crossed our minds for the first time in 2004. Then we had a revitalized scientific journal which had been dormant for quite some time in the past largely due to the deteriorated morale among medical students and TAMSA leaders in upholding the culture of research writing, doing and publishing. Due to lack of credible students research findings to publish and the challenging nature of the academic life in a medical school the production of students’ medical journal seized. However the need for medical students to conduct and disseminate research findings was too important to ignore and hence with the support from the MUCHS Principal the TAMSA journal resumed with a rejuvenated strength which focused on not only just producing a good quality journal but also encouraging and promoting the culture of conducting research and disseminating findings.

A periodic scientific conference is one among the ideas that emerged thereafter and early in 2004 work started to organize the 1st TAMSA Scientific Conference. In October the same year a 1 day historic event happened for the first time, The TAMSA Scientific Conference on “The future of young medical professionals”, held at the Karimjee hall in Dar es Salaam.

Then it involved students from Muhimbili University College of Health Sciences (MUCHS) Hubert Kairuki Memorial University (HKMU), and other invited guests. Despite the difficult challenges faced the event was a great success commended by not only students themselves but also various dignitaries such as the Vice Chancellor of University of Dar es Salaam Prof. Luhanga who was the Guest of Honour, the Principal of MUCHS Prof. Pallangyo, Dean of school of medicine at MUCHS Prof. Mkony, President of the Medical Association of Tanzania (MAT) Prof. Kahamba and many others.

On 8th and 9th October 2005 TAMSA held its Second Annual Scientific Conference themed, “Poverty and the burden of diseases, Where do Medical Students Stand”. The event was a great success and showed clear elements of Improvement from the last year’s. It was conducted in two days, it involved many more students from more Medical Universities i.e. IMTU, HKMU and KCMC, and one element of special

IFMSA-Africa Newsletter

The Guest of honour together with the principal of MUCHS and TAMSA president looking at the TAMSA book project exhibition.

significance was that it had by far many more paper presentations from medical students, which was a sign of success to the goal of promoting research doing and dissemination among students.

The event focused on discussing among the commonest diseases and causes of death in our community including Malaria and HIV/AIDS which are the leading killer diseases of children and adults in Tanzania, Tuberculosis (TB), Malnutrition which claims lives of millions of children in the Africa and Tanzania each year, and Mental Health diseases which are still largely unacknowledged and ignored by our community. The success of this conference was made possible through the support from NSSF, MUCHS, AXIOS Foundation, MOI, NIMR, MAT, HKMU, COSTECH, NACP, NMCP, NTLP, TFNC, MoH, PSI, Coca Cola Bottlers, GGM, Bakhresa Group of Companies and others whose contribution is highly valued and appreciated.

Of special importance was the debate among medical students on their role in combating these diseases in the community. This required medical students to not only point fingers at other stakeholders in the health sector but also commit themselves to identifying and performing their role as medical student and members of the intellectual community, who are entrusted with the nation’s financial and material resources to be inquisitive innovative and self motivated young professionals in an effort to improve the health and lives of their people. Among the ideas that emerged from the debates

December 2005

were; more student researches, public health education projects, and increased involvement and participation of medical students as key stakeholders in the planning and implementation of policies that address and/or affect the health sector. From the resolutions gathered TAMSA also aspires to draw community based research proposals, plans and programs to be implemented not only at MUCHS but also by our other chapters at HKMU, IMTU and others.

It is no doubt that some important discoveries in the world have originated from students-in fact, just recently a student from the University of Dar es Salaam contributed to an important innovation in combating malaria mosquitoes, a discovery that generated international attention.

The late Mwl. Nyerere once identified Diseases as among the three major enemies of the nation and declared war against them. TAMSA may have been a little sluggish in taking up arms and joining in the fight, but with the new spirit and morale in us we bring hope to the community as fully armed and ready to be front liners in the fight against diseases.

TAMSA invites you to support its effort in contributing towards ensuring good health in our community.

Goodluck Lyatuu Chairperson Standing Committee of Publicity and Information (SCOPI) Tanzania Medical Students Association (TAMSA)

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IPPNW African Regional Student Conference

by Mansur. A. Ramalan.

Day 2: Friday, 17th of December The conference resumed with presentation from Dr. Nwadike Uche, former Regional Coordinator for Africa, International Federations of Medical students Associations (IFMSA) on the “Role of medical students in conflict resolution and violence prevention”.

“War and the African child” was the next presentation by the representative of the president of the Federations of African Medical Students Association (FAMSA).

16th - 19th December 2005, Jos, Nigeria. Preliminary Report.

The African Regional Student Conference of the International Physicians for the Prevention of Nuclear War (IPPNW) was held on the 16th - 19th of December 2005 at the city lodge hotel Jos Plateau state with representations from Nigeria, Ghana and Cameroon, Representative of the president of Federation of African medical students Association (FAMSA) and the Vice President of the Nigerian Medical Student Association (NIMSA).

Below, you will find the program of the conference as well as references to the speeches and presentations. Please also read the closing communiqué drafted at the conference and take a look at the photos in the photo gallery.

presented to the participants which later followed up with questions and answers session.

Plenary session 1 then resumed with an introduction to IPPNW and instructions on starting an IPPNW affiliate by Mansur A Ramalan, IPPNW National Student Representative Nigeria.

Advocacy and Team Building was presented by Dr. Tuko Moses (former president Nigerian Medical Students Association (NIMSA).

The One Bullet Story project was presented

by Mansur A. Ramalan on behalf of Dr. Bob Mtonga of IPPNW Zambia. The conference proceeded to a Q&A session.

The conference resumed later that day with a workshop session on Small Arms, Light Weapons and Injury Prevention anchored

The presentation of the “Brain drain in Africa” was then followed up by Mr. Mansur Ramalan and the conference proceeded to questions and answers session after which was the tea break.

The conference resumed later in the day for a workshop period on “Preventing Wars and violent Conflicts in Africa” anchored by Dr. Uche Nwadike.

The presentation on the Millennium Development Goals was not made due to the fact that the presenter was unable to come and also was not able to send his presentation to the conference for distribution among participants.

Participants were then informed about the IPPNW World Congress scheduled to take place in Helsinki, Finland on 5-10th September 2006 and the need to have a greater African participation.

They concluded that there is a need to start adequate preparations very early to attend and to spread the information around their schools and countries. >

Program: Day 1: Friday, 16th of December The official opening ceremony of the conference was held. A welcoming speech was held by the National Student Representative of Nigeria, Mansur A. Ramalan and a welcoming message from the International Students Representatives of IPPNW, Khagendra Dahal of Nepal and Alex Rosen of Germany was read to participants.

A guest lecture sanitation and Rosemary Enie WICO- Women Organizations.)

was given on water, public health by Dr. (Secretary General of International Coalition

The presentation by Dr. Ime John on “The impact of small arms and light weapons on health in Africa” was

IFMSA-Africa Newsletter

December 2005

Page 8

Day 3: Saturday, 18th of December The post conference tour was made between Saturday 17th December to Sunday 18th December 2005 to the Yankari National Park, Bauchi State Nigeria about 280km from Jos in order to allow participants socialize and relax after brain storming plenary sessions and workshop periods.

Day 4: Sunday, 19th of December Participants then converged at the conference hall of the Yankari National Park for the African Regional Meeting.

Matters discussed include the greater participation of African students in IPPNW and how to involve African doctors in the Advocacy and awareness about IPPNW and its activities.

The elections of the new African Regional Student Representative were held.

Students from Ghana, Nigeria and Cameroon agreed that Mr. Mansur Ramalan should be the regional representative since he has more knowledge and experience about the organization.

Finally, presentations were made by the representative of the president of the Federations of African Medical students Associations (FAMSA) on how IPPNW and FAMSA can work together in the area of war and health in Africa emanating from the participation of FAMSA at the African regional meeting of IPPNW in March 2003, and the presentation of Mr. Mansur Ramalan on “The African Refugee Crisis”

at the FAMSA regional conference on “War and the African child” at Ibadan, October, 2004.

Thereafter, a communiqué was drafted and signed by participants from Nigeria, Ghana and Cameroon.

Conclusion The organizing committee chairman and NSR IPPNW-Nigeria then informed the participants about the problems encountered during the preparations for the conference and the need to correct them for the future: Visa problems, funding and late registration

by Participants.

Finally the participants were then informed about the efforts of Mr. Alex Rosen, ISR towards ensuring the success of the conference and the contribution by IPPNW Norway, IPPNW Germany and the student groups of Magdeburg and Düsseldorf. To them, the participants extend their warm appreciations for their concerned efforts.

Mansur A. Ramalan African Regional Student Representative IPPNW

Forcing patients to pay for AIDS care endangers treatment success New MSF data presented at ICASA Abuja, December 6, 2005 Having to pay for HIV/AIDS care increases the risk of treatment failure, according to new research from Médecins Sans Frontières (MSF) presented this week at the International Conference on AIDS and Sexually transmitted infections in Africa (ICASA), in Abuja, Nigeria.

The research revealed that in Lagos, Nigeria, among patients who had to pay for their own AIDS care, 44% had multiple treatment interruptions or took insufficient dosages due to lack of funds. The medical effects of this are extremely worrying.

Once enrolled in MSF´s programme, where care is free, these “treatment interrupters” had only half the immune

IFMSA-Africa Newsletter

system recovery (measured by rise in CD4 count) compared to those receiving treatment for the first time.

"These patients are more vulnerable to AIDS-related infections such as pneumonia or tuberculosis", said Dr Jens Wenkel of MSF. "So forcing people to pay, and thereby risking treatment interruptions, can make this lifeprolonging treatment less effective. If we want people to survive on treatment, we have to ensure access to free care."

The Nigerian government is insisting that public hospital patients pay for at least part of their own AIDS care including drugs and The Nigerian government is insisting that public hospital patients pay for at least part of their own AIDS care including drugs and monitoring. "This is

December 2005

ludicrous. According to our survey, nearly 50% of these patients live on less than US$36 per month, yet they are paying between US$8 and US$67 per month for a recommended package of care," said Dr Wenkel.

To pay for their care, 39% of respondents reported borrowing or begging, while 18% said they had been forced to sell property.

Many patients reported erratic consumption of medicines, including skipping or sharing doses, which can lead to insufficient drug levels in the blood.

The research was conducted between August and November 2005 among 122 patients who previously had to pay for their AIDS drugs and diagnostics and were later enrolled in the MSF program in General Hospital Lagos , Lagos Island .

A similar trend was found in Kinshasa, Democratic Republic of Congo, where a user fee proved to be a significant barrier to accessing care. When MSF abolished the clinic fee, the regularity of attendance in the ARV clinic improved considerably.

MSF currently provides antiretroviral treatment to over 57,000 people living with HIV/AIDS in 29 countries. In Nigeria , MSF is treating more than 950 patients with ARVs in a comprehensive care clinic in Lagos .

Source: http://www.icasa2005.org.ng/english/index.htm

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HIV/AIDS, Food Security, and Nutrition Conference in Lusaka, Zambia Please see below the application and all information needed to participate in the forthcoming HIV/AIDS, Food Security, and Nutrition Conference, from May 8th-12th 2006 in Lusaka, Zambia. The conference will be very much focused on African nonprofits and other practitioners at the grassroots, so please spread the word to organizations and individuals you know who may want to participate, but who do not have email, eforum, or Internet capability!

For more information, see below, and also write to Gwen O'Donnell, who is in charge of overall coordination, at Project Concern International. PCI is an international health and development organization that helps to save lives by preventing disease and providing access to clean water, nutritious food, and other necessities of human well-being. Hope to see many of you there, and note the deadline: JANUARY 15th, 2006!

With thanks and all best wishes, Janet Feldman, KAIPPG International, kaippg@earthlink.net Gwen E. O’Donnell MA, MHS D.C. Office Director/Food Security Technical Officer Project Concern International 1140 Connecticut Ave., Suite 500 Washington D.C. 20036 Phone: (202) 223-0088 Fax: (202) 296-2888 godonnell@projectconcern.org http://www.projectconcern.org/zambiafor um2006.org

Conference Themes The topics listed below are the four principal themes of the Forum. They should be used to help facilitate a decision on conference attendance, as well as guide those interested in contributing to the Forum (refer to the Call for Participation below).

Theme 1: Impact of HIV/AIDS on Household Food Security & Nutrition -Food aid safety nets for households affected by HIV/AIDS. -Dietary diversification and year-round food security for PLHA and HIV/AIDSaffected persons.

IFMSA-Africa Newsletter

-Programmatic experiences with smallscale agricultural production as part of HIV/AIDS programming.

-Achieving optimal nutrition for PLHA. -Foods advocated and produced for PLHA. -Programmatic responses to the issue of immunity in the context of traditional medicine.

-Community participation in the organization and delivery of nutritional support services for PLHA. -Sustainable food security and nutrition interventions initiated and/or adopted by communities.

Theme 2: Community Resiliency -Positive coping mechanisms and resiliency successes in the context of HIV/AIDS. -Community planning and strengthening of community capacity to build resiliency.

-Developing and implementing exit strategies from food/nutrition security programming, in the context of HIV/AIDS. -Building and/or protecting community assets (social, physical, other) for the purpose of strengthening community resiliency in the context of HIV/AIDS. -Traditional mechanisms that make communities more resilient in the context of HIV/AIDS. Theme 3: Livelihood Interventions that Improve Health -Appropriate & effective livelihood strategies for PLHA & HIV/AIDS-affected persons within households and communities.

-Increased collaboration and integration between programs/interventions serving PLHA and HIV/AIDS-affected persons.

-Models developed by local practitioners working to address both livelihood and health needs of PLHA. -Strengthening traditional systems of food production and distribution in support of PLHA and HIV/AIDS-affected persons.

-Appropriate technologies in agricultural practice (conservation farming, irrigation, animal rearing, low labour intensity methodologies etc.) in the context of HIV/AIDS programming -Youth and child friendly & appropriate livelihood activities.

Theme 4: Monitoring and Evaluation in HIV/AIDS, Food Security & Nutrition Programming -Monitoring integrated HIV/AIDS & food security/nutrition programs in various

December 2005

various cultural, social and economic environments.

-Community participation in the monitoring and evaluation of HIV/AIDS and food security programs.

-Program experiences in monitoring the health outcomes of children under 5 years of age in the context of HIV/AIDS and food security/nutrition programming.

-Program experiences in determining entry and exit criteria for food aid assistance for PLHA and HIV/AIDS-affected persons.

-Effective use of M&E strategies for programmatic improvement and securing financial resources for livelihood, community resiliency, and/or food security/nutrition programming.

Call for Participation The organizing committee is seeking contributions related to the conference themes. If you are able to participate as a contributor, please choose the style of activity most conducive to learning about your topic and provide a description according to the outlines provided.

Contributions are invited in any of the following styles: 1. Presentation of a case study, lessons learned, or an innovative program; 2. Panel organization and/or facilitation; 3. Skills building workshop organization and/or facilitation; and/or 4. Site visit organization and/or facilitation.

Descriptions submitted should fall under at least one of the four conference themes. If your description falls outside a theme, clearly and concisely state the focus of your contribution. All submissions must be in English as the Forum will be in English and translation services will not be available.

Contributions not directly related to projects or interventions will not be considered.

Applications to contribute are due no later than January 15, 2006. Notification of selection will be confirmed by January 31, 2006 (please note that acceptance for participation does not automatically guarantee acceptance to contribute).

1. Presentation of a Case Study, Lessons Learned, or an Innovative Program In the space provided below, please describe the programmatic work you would like to present in a maximum of 250 words.

Be sure to clearly state: >

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-Program title and dates of duration -Program purpose and objectives -Forum theme and/or sub-theme addressed -Presenter(s) -Issues for further investigation -Preferred presentation medium – oral, poster, or both.

2.

Panel Organization and/or Facilitation In the space provided below, please describe the panel you would like to organize and/or facilitate in a maximum of 250 words. Be sure to clearly state: -Title -Purpose and objectives -Forum theme and/or sub-theme addressed -Presenter(s) -Preferred presentation medium – oral, poster, or both.

3.

Skills Building Workshop Organization and/or Facilitation Each afternoon of the conference will feature skills-building workshops based on participant interests and needs assessed prior to the Forum. These sessions will help participants acquire specific skills or strategies that they can apply to their work after the Forum.

Emphasis will be on cross-learning to address the diverse needs of integrated HIV/AIDS, nutrition and food security programming. During these sessions, contributors will share specific skills and experiences with participants.

Submission of Registration & Call for Participation Form **PLEASE CHOOSE ONE METHOD OF SUBMISSION** 1) Email Submission to: zambiaforum@projectconcern.org 2) Fax Submission to: Project Concern International Attn: 2006 Zambia Forum Registration FAX Number: 202-296-2888 3) Mail Submission to: Project Concern International Attn: 2006 Zambia Forum Registration 1140 Connecticut Ave. NW, Suite 500 Washington, D.C. 20036 USA - OR Project Concern International Attn: 2006 Zambia Forum Registration Plot #9086 Kasiba Road Longacres Lusaka, ZAMBIA

Deadlines: Registration & Call for Participation Form and Scholarship Application: January 15, 2006.

Notification of acceptance to participate and/or to contribute: January 31, 2006.

Forum Registration Fee : $250 Upon receiving notification of acceptance to participate in the Forum, participants will be required to pay a $250 registration fee in addition to reserving and paying for hotel accommodations. Do not send a registration fee or reserve hotel accommodations until you have received notification of acceptance to participate. Specific information on where to send the registration fee will be included in the acceptance package.

More Information: Please visit www.projectconcern.org or contact Brooke Reese at breese@projectconcern.org

APPLICATION FOR REGISTRATION & CALL FOR PARTICIPATION REGISTRATION FORM Fields marked with an * are required. Registration forms must be typed and submitted by January 15, 2006 (see below for submission instructions).

Notification of acceptance to participate will be confirmed by January 31, 2006 at which time applicants will be required to submit a $250 conference participation fee. Small grants are available for participants from local African organizations (see website link).

In the space provide below, please provide a description of the skills building workshop that you would like to facilitate in a maximum of 250 words. Please also describe the methodologies and key types of activities you will use in your session. Be sure to clearly state: -Title -Purpose and learning objectives -Forum theme and/or sub-theme addressed -Presenter(s) -Methodology & key activities

*Last Name: ___________________ *First Name: _________________________

4. Site Visit Organization and/or Facilitation (in Lusaka, Zambia) In the space provided below, please describe your Lusaka program site, target beneficiaries, programmatic objectives and objectives of the site-visit.

In a maximum of 250 words, be sure to clearly state: -Title -Program purpose and objectives of the program to be visited -Forum theme and/or sub-theme addressed -Presenter(s) -Location of project & maximum capacity for visitors

an X.)

IFMSA-Africa Newsletter

Title: (Dr, Prof, Mr, Mrs, Ms) _________________ *Organization/Institution: _____________________________________________ *Job Title: _________________________________________________________ *Work Address: ____________________________________________________ *City: __________*State: __________Other___________ Zip Code___________ *Country: __________________ *Telephone with area code: _______________ Cellular Phone:_______________ Fax with area code:_________________*Email Address: ___________________ I am applying to participate in the following way: (Please mark all that apply with ___ Attendee only ___ Presentation of case study/lessons learned/innovative program ___ Panel organization/facilitation ___ Facilitate a skills building (hands-on) workshop ___ Organize/facilitate a site visit (in Lusaka, Zambia) All applicants must provide a brief biographical sketch of themselves in a maximum of 200 words. In the space below, please include a brief summary of your current work experience, experience and interest in the area of HIV/AIDS, Food Security & Nutrition, as well as what your hope to gain from the Forum.

December 2005

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Global Forum for Health Research

The Global Forum for Health Research announces a call for abstracts of presentations for its 2006 annual meeting.

Theme: Combating promoting health.

disease

and

29 October-2 November, 2006 Cairo, Egypt The health challenges faced by people around the world are manifested in the global threats from emerging and reemerging infectious diseases and in the rapidly increasing levels of noncommunicable diseases and injuries seen in developing countries. Among the many obstacles to be overcome in achieving better health, especially for the poor and marginalized, key factors are the need to improve health systems and services and to ensure equitable and affordable access to these and to good quality, safe and effective medicines.

Beyond the treatment of ill health, much more attention is needed to creating the conditions that enable individuals, communities and countries to promote better health - e.g. through information about good practices and avoidance of risk behaviours, and through improvements in the physical and social environments in which people live and work.

Health research has a vital role to play in all these areas, as an originator of new knowledge and technologies; as an essential ingredient in the successful identification of problems and solutions; and as a key element in ensuring effective and equitable implementation of interventions.

IFMSA-Africa Newsletter

The Forum meetings of the Global Forum for Health Research have become established as a premier annual event that brings together policy makers, development partners and the resources, directors and users of research, to debate critical gaps and energize movements for action to address the health needs of the poor and marginalized. We are pleased to announce that, at the invitation of the Egyptian Minister of Health and Population, Dr. Tag El-Din, Forum 10 will take place in Cairo from 29 October to 2 November 2006. The programme for the meeting, on the theme of 'Combating Disease and Promoting Health' is being developed in consultation with an Advisory Committee of distinguished leaders in health and research in Egypt and with the participation of the Council on Health Research for Development and other close collaborators.

The Global Forum for Health Research invites you to submit an abstract for Forum 10 in any area of health research relevant to promoting health, combating diseases and improving global health in general and the health of poor and marginalized populations in particular.

Papers addressing these areas from a national, sub-national or regional perspective are particularly invited. The Global Forum welcomes submissions from all parts of the world and encourages participation from lower income countries.

Submissions of abstracts from students are especially encouraged and the best papers will be specially featured in Forum 10.

Mission of the Organisation: More health research needed We believe that more health research needs to be devoted to improving the health of people in developing countries.

The Global Forum is working to: - Change the priorities governing how existing resources for health research are used - encourage new resources that will be directed to research in the neglected areas - foster research in the neglected areas to reduce the burdens of disease and disability.

Colophon Editor in Chief Jennifer Mbabazi, Rwanda Authors Charles Chima, Nigeria Goodluck Lyatuu, Tanzania Hossam Hamad, Sudan Mansur A. Ramalan, Nigeria Proof reader Ahmed Ali, Sudan Lay-out Sophie Gubbels, the Netherlands If you are organising a project or activity, please share it with us! Also, if you want to ask attention for certain topics, do write it down for our newsletter. You can send your articles to ifmsa-africapublications@yahoogroups.com

Deadlines 31 January Deadline for receipt of abstracts 15 May Confirmation of acceptance or rejection will be sent to the submitting author/presenter 30 June If the abstract is accepted, the presenter is asked to confirm participation by return e-mail and to pay the participation fee 31 August Submission of full papers

For details and submission, please see our website at http://www.globalforumhealth.org

December 2005

Addresses/Websites for NMO’S www.emsa-ethiopia.org (Ethiopia) www.fgmsaghana.org (Ghana) www.nimsanigeria.org (Nigeria) www.medsar.org (Rwanda) www.rmsa.org.rw (Rwanda) www.samedsa.org (South Africa) www.ifmsa.org www.ippnw-students.org/africa ifmsa-africa@yahoogroups.com ifmsa-scora@yahoogroups.com ifmsa-scorp@yahoogroups.com ifmsa-scope@yahoogroups.com rvcp@yahoogroups.com (Rwanda)

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