Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 44256-44260 987

Results: Of January to March of 1996, 6055 conventional hospitalizations were
made in 288 hospitals, and 1067 were accomplished in 19 ODC. In 1997, during
the same period, 6536 conventional hospitalizations were made in 310 hospitals;
and 1961 were accomplished in 39 ODC. The costs established by the report
were, in average, of R$ 580 (U$1 = R$1.8) for conventional hospitalization and
R$180 for ODC. In 1996, during this period, they were worn-out R$ 3,839,037
and R$ 176,442 respectively with patient hospitalized as in patients and in ODC.
In 1997, we observed respectively: R$4,141,443 and R$299,443.
Lessons Learned: These results need to be appraised with caution considering the reports' methodology used to estimate the costs of the interventions.
In both cases, those values don't include important procedures which should be
considered. This fact may have been modified the total values estimated. The
report is, however, an instrument of importance to allow preliminary analysis to
compare cost-effectiveness between traditional and alternative forms of care.
44256 Front line pioneer ASO's crusade despite resource
crunch
Vinay Vasta' 2, Bhimani2, I.S. Gilada2. 1Indian Health Orgn. Bombay Muncipal
School Bldg. J.J. Hospital Compd. Bombay-400008; 2Indian Health Organisation
Bombay-400008 MH, India
Issues: It's a major challenge to create mass AIDS awareness and an atmosphere conducive to caring people with HIV in India, which has- one billion people
spread over 3.3 million sq.KM area, 33 languages and 1652 dialects, 52% literacy
rate and GNP of US $150.
Project: With 15 years of experience in innovative IEC approaches from streetcorner meets to the World Congress; health care and support services; targeted
intervention; NGO networking and training, a novel AIDS awareness campaign
was devised to cost-effectively cover the entire country in a short span of time.
In a day long program in cities people from film and public life join scientists
in marching through main streets culminating in a public meeting, workshops
for media and health professionals and forming local group/network of NGOs to
sustain the activities.
Results: Programs have resulted in heavy turn outs of up to 200,000 people,
preceded and followed by media publicity; mobilization of youth; reduced inhibition
to discuss issues like sexuality, AIDS, condoms; and debates in state legislatures
and national Parliament. Making a modest beginning, organizing down-to-earth,
cost-effective pro-public programs, the NGO has come a long way to become
worlds largest NGO in coverage of population for AIDS Awareness and named as
the best NGO in India by US-India business council, Washington DC in 1997 for
its innovations, cost-effectivity and direct approach. Local NGOs were activated
and newer NGOs are born to fight AIDS. Marginalised groups are brought in the
mainstream.
Lessons Learned: Larger AIDS awareness in a coutry ridden with hippocracy
can only be achieved through high profile and cost-efficient mass mobilization,
making an united front of people against AIDS. Such an onerous task can only
be spearheaded by NGOs with commitment/dedication. Despite hostility and resistance our NGO now is described as torch-bearer/watch-dog in AIDS control
efforts. Sustainability is crucial and depends on its philosophy, achievements,
wider acceptability and focused approach, for which economical support needs
to be guaranteed.
104*/44257 Influencing government policy in Israel: A case
study in activism
Rommey A. Hassman, S. Fisher, P. Levy. Israel AIDS Task Force, Tel-Aviv, 6
Malchei Israel St., Tel-Aviv, Israel
Issue: Israeli government denies funding for Protease Inhibitors, preventing
thousands of PWHIV's access to treatment; Israeli AIDS NGO's rally coalition
to change government policy; Outcome of activism-national medication crisis,
national budget crisis, reversal of government policy.
Experience: Inadequate health budgeting forces Israeli national health funds
to cease distribution of medication treatment for HIV/AIDS, Diabetes, Alzheimer's
Disease and Ovarian Cancer. PWHIV's denied access to Protease Inhibitors
and other antiretroviral medication. In response Israeli AIDS NGO's establish
joint headquarters to oppose government policy. Joint headquarters decides on
strategy, organization structure, sourcing and funding, tactics and "Goes to War".
Mobilizing AIDS and gay communities nationally and internationally, health and
human rights NGO's. Scope of activities: (1) Lobbying Israeli Parliament; (2) Above
the line communications-working with media; (3) Below the line activism-petitions,
government ministries fax bombardment, World AIDS Day demonstration on Parliament grounds; (4) Legislation & Courts-proposals for legislation distributed
among Parliament Members, filing law suit against Israeli government.
Results: Battle begins. Momentum builds up gradually. From local press to
national press. From AIDS medication crisis to national medication crisis. From
non-issue to major government crisis impeding approval of Israeli 1998 national
budget. Finance Minister denounced on policy by general public, media and
Parliament Members. After 70 days of activism Minister backs down, compelled

by government to allocate $40 million to finance new medication. Outcome: All
currrent and future Israeli PWHIV's gain access to new medication and treatments.
Lesson Learned: Even a small group of activists, with scarce resources but
with wise strategy, belief in cause and high sense of determination, can influence
government policy on access to life-sustaining medication.

S44258 Sex workers collective influencing the government to
change the policy
Nayanita Dattal, S. Jana', S. Pal2, M. Dutta2, R. Moulik', S. Jana2. 18/2
Bhawani Dutta Lane, STD/HIV Intervention Programme, Calcutta; 2Durbar
Mahila Samanwaya Committee, Calcutta, India
Issue: The female sex workers wanted to register a cooperative society of their
own.
Project: A peer based STD/HIV Intervention programme was launched in a
red light districts in Calcutta having sex workers population of 5000 in the year of
1992 based on behaviour change communication strategy. Soon it was realised
that various structural constraints (social, economic, legal etc.) hinder safer sex
practices. Economic instability is one such, over & above in exigencies they have
to take loan from the money-lenders with an exorbitant interest rate (as high as
3000% p.a.). So they wanted to start their own cooperative and banking system,
but the existing law and policies did not allow any sex worker to register their own
society on the ground that they do not bear good moral character.
Result: Initial attempts to influence Govt. official failed, then the issue was
brought to the Minister incharge of the cooperative society, who ultimately succummmed to the arguments of the sex worker & law was modified in favour of
sex workers & sex workers cooperative got registered.
To influence the government policy, it is of paramount important to mobilise the
community. They could succeed in changing the policy issues relevant to their life
and profession what can influence the prevention programme.
S44259 | Model for bridging the gap: United States, Canada and
Mexico develop joint initiatives on HIV affected families
Elaine Daniels1, Gerry Bally2, J. Saavedra3, D. Garmaise2, H. Schetinger4,
E. Goosby4. '200 Independence Ave. SW, Room 736 E; 4 Washington DC;
5Dept. Health and Human Services, Washington, DC, USA; 2Health Canada,
Ottawa, ON, Canada; 3Conasida, Mexico, Mexico
Issue: The Secretaries of Health of the United States and Mexico, and the Minister
of Health of Canada, signed a joint Declaration at a meeting of government officials
and representatives of people living with HIV at the 11th International AIDS Conference. The governments pledged to implement the Delaration through a series
of activities related to HIV affected families in full cooperation with representatives
of people living with HIV from each country.
Project: Government officials from the three countries assessed and incorporated input from representatives of people living with HIV through: 1) the
development and administration of a questionnaire; and 2) facilitation of a workshop at which joint initiatives were selected.
Results: Input from questionnaire responses was used to develop the issues
explored at the workshop in September 1997. Scores of issues were synthesized
into six joint initiatives: 1) an internet project on information sharing, 2) harmonization of the drug approval process, 3) building skills, 4) compiling data on the cost
effectiveness of treatment regimens, 5) women's issues, and 6) human rights.
Full partnership between government officials and people living with HIV to
work on joint activities can serve as an effective model for bridging the gap
between North and South.
44260 "Are you going to believe some nutty professor or a kid
on the street"? Taking research back to young homeless
people
Jennifer Walsh, Doreen Rosenthal, D. Warr, L. Hillier, L. Harrison. Centre for the
Study of STDs., Latrobe Univ, Locked Bag 12, Carlton; South VIC, Australia
Issues: This presentation illustrates ways to maximise the uptake of research
outcomes by practitioners, policy makers and research participants, in this case
homeless youth. It uses as a case study a research dissemination strategy for
homeless youth who participated in the 1997 Sexuality, Homelessness and Young
People Research Project.
Project: In 1997 over 870 Australian homeless youth were surveyed and 70
interviews conducted, providing many insights into the issues, knowledge gaps
and potential strategies devised by them in protecting their sexual health. Given
the seriousness of the risk practices identified, we developed a strategy to present
these findings more directly to them. In consultation with young people and servcies, and using their artwork and stories we produced a comic-style booklet. A
broader strategy was developed from this to ensure that new knowledge was
successfully 'marketed' to policy makers and practitioners.
Outcomes: Because of its popularity with young people, organisations across
Australia have requested copies of the booklet. This has created a national interest in our findings, ensuring that the research has gone immediately back into
the field of practice.
Lessons: Developing a research report for young people using their stories
and artwork has had the additional benefit of presenting the research to practitoners and policy makers in an easily accessible form. This model of dissemination
has enhanced the research process by bridging the gap between research and

practice.