11 July 2012

All Eyes on Washington Ahead of International AIDS Conference

Washington DC will host the International AIDS Conference at the end of this month. Attention turns to AIDS and America's capital city with some interesting reports from various media on HIV in America. Right now there are two dominating story lines. First, Washington DC will play host but has its own problem with HIV/AIDS. Second, the focus is largely on the rest of the world, but the AIDS problem in the US is a burden upon the Black community.

FRONTLINE from PBS has a two hour special on AIDS in America that premiered Tuesday. It focuses on the second story, the burden of HIV on African-Americans.

If you can't catch the full special, you can listen to Terry Gross from NPR chat with Renata Simone, who produced, directed and wrote the film, and Dr. Robert Fullilove, a professor of clinical sociomedical studies at Columbia University.
NPR is all in with its coverage in its series AIDS: A Turning Point. On Monday, a pair of reports from Jason Beaubein examines AIDS in Botswana. One is an overview of how the country has successfully campaigned to reduce the number of new infections.
Botswana has steadily increased its own spending on HIV. The Botswana government now spends more on health care per capita than any other country in Africa. 
Farmer Johane Setlhare started taking the drugs in 2007. "I would have been dead nowadays if I hadn't taken the treatment," Setlhare says. 
Just two years after going on the drugs, Setlhare built a new house for himself with his own hands. "I was surprised seeing myself going on top of the roof of the house and making some bricks for the house," he says. 
Setlhare gets his anti-AIDS drugs every month from the public health clinic in the center of the village. He credits the Botswana government AIDS treatment program with giving him back his strength and his life.
The second article is about the teens who were born to mothers with HIV in a time when prevention-of-mother-to-child-transmission efforts were not in place and now need treatment.
Caring for HIV-positive teenagers, health officials say, is more difficult than caring for children or even adults. A doctor at the main public hospital in the Botswana capital of Gaborone lists teenagers, along with battered women and drug addicts, as some of the most difficult patients to treat. 
One of the hardest things is making sure that teenagers take their medications regularly. 
Consulata says with her nephew, Moemedi, they have a strict routine. He takes his pills every day at 6 in the morning and 6 at night. "We call it a 'thing,' " she says. 
"I just remind him. Hey! Your thing. ... And he just remembers." 
Moemedi goes each month to the Botswana-Baylor Children's Clinical Center of Excellence — also known locally as the Baylor pediatric AIDS clinic — to refill his prescriptions. Dr. Marape Marape, the associate director for research at the Baylor clinic, says in the past his facility mainly treated babies, toddlers, young kids. But because the drug treatment has been so successful, Botswana is now seeing a boom in teenagers with HIV.
GlobalPost shares the same creative team as NPR with its identically named and in some ways superior series AIDS: A Turning Point. Veteran reporter John Donnelly leads the global coverage that has taken a turn towards the United States.

One article by Donnelly and Juliana Schatz examines how the work of programs like PEPFAR in Africa has informed efforts in Washington DC.
On a recent day not far from Capitol Hill and the White House, about a dozen HIV outreach workers toting bright yellow duffle bags stuffed with condoms and prevention information stood outside of the Anacostia Metro station, waiting for the next wave of passengers to arrive. 
When hundreds of commuters emerged from the subway, the outreach team fanned out to meet them, handing out free condoms and sharing facts and common misperceptions about AIDS. The process repeated itself about every 10 minutes with arrival of each new Metro train. After a couple of hours they had handed out hundreds of packs of condoms – and had persuaded 21 people to take an HIV test with an oral swab in a Chevy van parked nearby. 
“You have to know your status, man. I’d rather be safe than sorry,” said Alvern Harris, 25, as he waited for his results. “What we do is a reflection to the younger generation. If we don’t, they won’t, and that’s another generation’s curse, another generation dying.” 
This type of outreach mirrored programs in many African capitals, where young people, funded by the US government, routinely reach out to their peers in the street to engage them in discussion about AIDS and to pass on knowledge of how to protect themselves. The African efforts also included innovative ways to test people for HIV, including going door-to-door and setting up testing days in community centers and churches, tactics also started or being considered in Washington. But the first step — getting the data — was the most critical one. 
“PEPFAR set up a very structured model for evaluating programs and outcomes around the work being done in Africa to address the HIV epidemic,” said Tiffany West, who directs HIV surveillance for the D Department of Public Health. “[DC government] was really good at bringing some of those international best practices into the domestic realm.”
Another trend that sifts to the top of coverage is the success of PEPFAR. Nick Kristof tries to join the chorus in support of PEPFAR with his column on Lesotho. Unfortunately he reaches a bit too far by making the argument that the decline in coffin-making is the result of fewer AIDS deaths. That is then connected to US support through PEPFAR and the Global Fund. Readers are required to take a Friedman-esque leap of logic to make the connection between the gaps.
These coffin makers in the street markets are idle partly because American spending on programs to fight AIDS around the world means that vast numbers of people are no longer dying at a young age. So coffin makers sit dejectedly beside stacks of lumber, waiting for business. 
“Before, a lot of people were dying of AIDS,” said Moeketsi Monamela, a 33-year-old coffin maker here in Maseru, the capital of the mountainous kingdom of Lesotho. A half-dozen years ago, he sometimes crafted 20 coffins a month, he said. Now, he typically sells five or six. 
“Now there is medication, so fewer people are dying of AIDS,” Monamela explained. “I’m not very happy because this is my future.” 
Realizing that this did not sound quite right, he started again: “Although the medication has affected my business, I’m happy because I don’t want to see people dying of AIDS.”
Despite the poor attempt, the cheers for PEPFAR are well deserved.

Coverage continues with Voice of America, the Guardian, the Associated Press and the Boston Globe as more recent examples. With two weeks to go it seems safe for coverage to keep turning up the volume. Right now it feels like an 8. Is there a chance the media stole an amp from Spinal Tap to kick it up to 11?

Kidding aside, the reporting is exciting because this kind of buzz about international development and a problem that affects America's poor and minorities does not happen often. Hopefully the momentum can keep at it as major news outlets like CNN and ABC will get into the mix when the conference arrives.