SOME PICTURES

A picture is worth a thousand words....so here are some recent ones to make up for the lack of words in the blog...

My mum and dad at the mass on 21 September 2008...

We had a nice dinner and some good singing - mandoline, guitar and Italian songs from yesteryears...

CARE-FRONTATION: A VIRTUE FOR CHRISTIAN COMMUNITY LIVING

(Homily for 23rd Sunday of the Year A)

Ezekiel 33:7-9; Romans 13:8-10; Matthew 18:15-20

(These thoughts were proposed and found useful by some who listened on 7th September 2008)

Today we have a Eucharistic celebration that is not going to allow us to return home untouched. The gospel has an important message for all of us on reconciliation. And this reconciliation will be made possible by CARE-FRONTATION = a word coined to describe an interaction in which there is a confrontation that arises from care. Let us spend some time unpacking this idea.

We live in a world which prides itself on individualism. You do your thing and I'll do mine....and you bloody well better not interfere with my thing. So we tolerate and leave things unsaid often leaving situations to get worse.

But Jesus is challenging us to take responsibility not only for our own lives but also for the lives of others. As Ezekiel reminds the people in the first reading - we are called to be sentries and watchmen. We cannot afford to sleep on our watch since we can place the entire community in danger.

A story is told of a young girl with polio who had to undergo extensive physiotherapy that often left her in excruciating pain. So she protests one day to her dad. "Dad don't you love me just the way I am - unconditionally?" And her dad replies: "Darling I love you - I love you too much to allow you to remain the way you are!" Now that is true unconditional love. To love the other into being a better person. At the root of our challenging others who err is LOVE. We do not correct to prove a point or to gloat over a person who is inferior to us. We reach out in love to someone we care about. St. Paul reiterates this in the second reading when he tells us that the summary of the law is love. When we truly love then our care-frontation becomes possible.

The gospel of today helps define this process of Care-frontation. It lays down steps for the journey and we will just highlight three of them.
1. True care-frontation begins as an encounter in love between two persons. When I see my brother or sister stray I am not called to publicise their failing or mistake. I need to go to them in a loving encounter - in private and bring to their attention the change that may be necessary for them to become better and more loving persons. The goal is to make them better - the motivation is love. So there is no room for blame and accusation. How often we lower the dignity of the other person by bringing their faults to light in public before people who respect them and thus belittling them. Needless to say this has the opposite effect of hardening positions and closing people from change and adaptability to rigidness and stubborness.
2. This care-frontation precludes gossip, rumour mongering and back biting. I have no right to tell others and to spread tales that I have not had the courage in the first place to share with the person concerned. How much harm we do when we do spread this evil spirit born often from half-truths that are presented as absolutely incontrovertible proof. We would do well to recall an incident from the life of Philip Neri. A woman once went to him for confession, accusing herself of badmouthing people. The saint absolved her but gave her a strange penance. He told her to go home, get a hen and come back, plucking the bird’s feathers as she walked along the street. When she had returned to him he said: “Now go back home and, as you go, pick up each feather that you plucked on the way.” The woman told him that it would be impossible since the wind had almost certainly blown them away in the meantime. But St. Philip was prepared: “You see,” he said, “just as it is impossible to pick up the feathers once the wind has scattered them, it is likewise impossible to gather gossip and calumnies back up once they have come out of our mouth.”
3. If a simple dialogue in private has not yielded fruit or brought about the desired change then we need to get the help of others to solve the problem. We need to get those who have some abililty to help and mediate and bring about reconciliation. But our brother or sister is always due respect and the intervention is once again always to be moved by LOVE. This makes the third key issue in Care-frontation.

So as we go into a new week let us ask the Lord for this ability to CARE-FRONT others. Care-frontation is moved by love and seeks the good of the other. It moves from personal private dialogue in which we point out to the other the error of his or her ways. It avoids all gossip and slander. When dialogue fails it seeks to bring about change and reconciliation by recourse to significant people who can help make things better. Let us go out to enjoy a week of CARE-FRONTING others.

ON VIANNEY SUNDAY - STRAY THOUGHTS...

(I have found this little poem so true and have cited it many times...if it brings a chuckle to your lips enjoy it...and spare a thought the next time you want to 'bad mouth' your priests...Happy Vianney Sunday to all - priests and flock!!!)

A PRIEST IS ALWAYS WRONG BECAUSE...

If he begins his mass on time, his watch is advanced;
If he begins a minute later, he keeps people waiting
If he preaches too long, he makes people get bored;
If his homily is too short, he is unprepared.
If he owns a car, he is luxurious;
If he does not own one, he does not go with the times.
If he goes out to visit families, he is always out:
If he does not, he has no time for them.
If he asks for donations, he is a moneymaker;
If he does not do it, he is too proud and lazy.
If he takes time in the confessional, he is too slow;
If he makes it too fast, he has no time for his penitents.
If he renovates the church, he throws away money;
If he does not do it, he allows everything to rot away.
If he is with the youth, he forgets the old.
If he is seen with women, he is a playboy;
If he goes with men, he is not normal;
If he is young, he has no experience;
If he is old, he should retire.
As long as he lives, there are always people who are better than him;

BUT IF THE PRIEST DIES....THERE IS NOBODY TO TAKE HIS PLACE!

AIDS 2008 - XVII INTERNATIONAL AIDS CONFERENCE (MEXICO) – 5

GLOBAL PUBLIC HEALTH GOALS THWARTED BY HUMAN RIGHTS VIOLATIONS, GENDER INEQUALITY AND STIGMA

(Condensed from the official press release of AIDS 2008)

9 August 2008 - As the XVII International AIDS Conference drew to a close yesterday, HIV experts from around the globe highlighted the dramatic negative impact that stigma and the denial of human rights, including gender inequality, continue to have on the effectiveness of HIV treatment and prevention scale up. Fear of violence and discrimination prevent many people living with or at risk for HIV from seeking testing and treatment.

“The voices of those who bear the brunt of this pandemic have been loud and clear in Mexico City this week,” said Pedro Cahn, International Co-Chair of AIDS 2008. “If the world does not heed the call to ensure the human rights and dignity of every person affected by HIV, we will not achieve our goal of universal access.” “Those most at risk, including injection drug users, men who have sex with men and sex workers, as well as women and youth, must never be seen simply as patients or prevention targets,” said Dr. Luís Soto Ramírez, Local Co-Chair of AIDS 2008. “Their experiences and contributions are central to the development and implementation of effective programmes.”

Tuberculosis is closely linked with the death of people living with HIV. At least one-third of the 33 million people living with HIV worldwide are co-infected with TB, and these individuals have up to a 15% risk of developing active TB every year. Dr. Chakaya Jeremiah (Kenya) gave an overview of the challenges presented by the dual epidemics of HIV and TB. He noted good progress being made to decrease the burden of HIV in TB patients through HIV testing of TB patients and the initiation of preventive therapy for HIV-positive TB patients. Jeremiah also profiled the emerging threats of multidrug-resistant and extensively drug-resistant TB, both a consequence of sub-optimal TB control and inadequate infection control practices in health care settings.

In his plenary remarks, Bruno Spire (France) identified reducing stigma, combating prevention fatigue, and diversifying HIV testing as key steps to prevent sexual transmission of HIV in concentrated epidemics. Spire proposed a “triple therapy” strategy to combat stigma and discrimination rooted in evidence of stigma’s negative impact on HIV risk reduction. The strategy includes fighting for better acceptance of PLHIV, improving laws and policies to protect those most vulnerable to infection, and implementing prevention programs that incorporate community mobilization and peer support. He cited examples of efforts in India, Chile and France as important examples of this successful strategy. He pointed to data showing that access to antiretroviral therapy and perceived good health have a positive impact on consistent risk reduction among PLHIV. Spire also emphasized the importance of a variety of HIV testing approaches as well as increased access to voluntary counseling and testing, particularly in community settings. In addition to facilitating earlier access to care, learning one’s HIV status enables earlier adoption of safer behaviors.

According to Edwin Cameron (South Africa) the enactment of laws that criminalize transmission of or exposure to HIV has become so widespread that they have become a crisis in efforts to deal rationally and effectively with HIV. Citing examples from locations as diverse as the US, Sierra Leone and Singapore, Cameron highlighted the irrational nature of these laws and their ineffectiveness in achieving their purported goal. They radically increase HIV stigma and become barriers to testing and treatment. Prosecutions often single out already vulnerable groups such as sex workers, MSM and others exposing them to ostracism and further stigma. Cameron stated that one of the outcomes of AIDS 2008 should be a major international pushback against such misguided criminal laws and prosecutions.

Citing violence against women as both a cause and consequence of HIV infection, Zonibel Woods (Canada) highlighted the fear of violence from partners as a reason that some women do not seek treatment for HIV. Woods declared that providing access to treatment must be linked with ensuring a woman’s right to live free from violence. Scaling up HIV treatment and working against stigma and discrimination must go hand in hand. The legal and policy environment to address violence against women must be strengthened along with the commitments to enforce, monitor and evaluate such policies. The three priorities Woods outlined were confronting gender-based violence, ensuring women’s right to sexual and reproductive health, and investing in women’s organizations so that women can participate effectively in decisions that affect their lives. She emphasized that success in gender transformative programs depends on the engagement of women’s organizations in setting in-country priorities, and the inclusion of experts in gender equality and women’s empowerment on review panels.

Conference Closes With Calls to Action
At the Closing Session, delegates heard summary remarks from AIDS 2008 Co-Chairs, Dr. Pedro Cahn and Dr. Luis Soto Ramirez, as well as from community representatives. Incoming IAS President, Dr. Julio Montaner, gave an inaugural address. At the end, Mexico City Mayor Marcelo Ebrard and Co-Chair Luis Soto Ramírez officially transferred the International AIDS Conference glass globe from Mexico City to Vienna, Austria, the host of AIDS 2010. Representatives from Vienna were happy to accept the challenge of hosting the next major gathering two years hence.

With more than 24,000 participants from over 190 countries, AIDS 2008 was the second largest in the history of the International AIDS Conference, and the first to be held in Latin America. The conference theme, Universal Action Now, emphasized the need for continued urgency in the worldwide response to HIV/AIDS, and for action on the part of all stakeholders.

AIDS 2008 - XVII INTERNATIONAL AIDS CONFERENCE (MEXICO) - 4

HIV EXPERTS UNDERSCORE THE NEED TO LINK AIDS RESPONSE WITH HEALTH SYSTEMS IN POOR COUNTRIES, TO WORK AT OPTIMAL TREATMENT STRATEGIES, AND TO WORK FOR GREATER INVOLVEMENT OF PEOPLE LIVING WITH HIV

(Condensed from the official press release of AIDS 2008)

8 August 2008 - Speakers at AIDS 2008 underscored the importance of simultaneously scaling up AIDS programs and strengthening health systems in poor countries, emphasizing that the two goals should be viewed as allies, not adversaries. They also stressed the importance of expanding the role of people living with HIV in the planning and provision of health care as a part of the solution.

“HIV and global health advocates have enough common enemies, chief among them political complacency and inadequate human and financial resources,” said Dr. Luís Soto Ramírez, Local Co-Chair of AIDS 2008. “In the struggle to recognize health care as a human right, we are natural partners.”

“If the urgency of AIDS and the sheer magnitude of human loss we are now experiencing is not enough to compel us to provide even the most basic level of health care to those living in low-income countries, then we, as a global community, are morally bankrupt,” said Dr. Pedro Cahn, International Co-Chair of AIDS 2008. “If, in the context of AIDS, we walk away from this challenge, we may never get another chance.”

According to Anton Pozniak (United Kingdom), when it comes to antiretroviral therapy (ART) the questions of “when to start?” and “what to start with?" remain central to people living with HIV and their clinicians. The move to start treatment earlier is gaining momentum in light of evidence that those untreated patients with high CD4 counts fall prey to many other non-AIDS related illnesses such as cardiovascular disease. He stated that clinical trials are needed to weigh the costs and benefits of starting ART earlier. Debates regarding which therapies to use in initiating treatment also continue in those countries where there is an abundance of choice. Cost considerations and toxicity of antiretrovirals need to be carefully concerned especially in resource-poor countries. Pozniak concluded that in situations where there is a choice of therapies, treatment of HIV has become focused on minimizing toxicities and maximizing convenience, and that this choice should be offered to all people living with HIV.

Morolake Odetoyinbo (Nigeria) opined that the greater involvement of people living with HIV (PLHIV) can be a key component of efforts to strengthen fragile health systems in low- and middle-income countries. Many of these weak health care systems have been further taxed by the HIV epidemic, with a depleted health workforce due to illness and death, thus magnifying the impact of existing malnutrition. Highlighting the existing involvement of PLHIV as counselors, peer educators, and spokespersons, Odetoyinbo explained how PLHIV can do even more to help strengthen health systems if their involvement is rooted in their existing capacities and skills, and not used to simply fill quotas. They should have multi-dimensional roles as advocates, watchdogs and managers, and should also be active participants in decision-making bodies responsible for the planning, implementation, monitoring and evaluation of programs.

With 3 million people in low- and middle-income countries now receiving antiretroviral therapy, Gregg Gonsalves (United States) called this feat one of, the most ambitious public health undertakings of our lifetimes. This milestone was reached despite powerful critics, and in the face of many operational and political barriers to sustained and expanded access to AIDS treatment. He called on those who have attacked AIDS funding and programming to recognize the innovations and momentum the AIDS response has brought to the entire field of global health. In fact, thanks to this enterprise "health for all" — the provision of comprehensive primary care to all who need it — which was central to the Declaration issued by WHO member states 30 years ago, is being gradually realized. Gonsalves urged a new covenant between communities, governments, United Nations agencies, academics, health care workers and scientists to build on what has been achieved in AIDS to make health, not a privilege for a few, but a fundamental human right for all.

AIDS 2008 - XVII INTERNATIONAL AIDS CONFERENCE (MEXICO) - 3

AIDS 2008 SPEAKERS HIGHLIGHT THE PERSISTENCE OF HIV AS CENTRAL CHALLENGE TO A CURE, THE NEED FOR A FAMILY-CENTERED APPROACH TO AFFECTED CHILDREN AND RESPECT FOR THE RIGHTS OF SEX WORKERS

(Condensed from the official press release of AIDS 2008)

7 August 2008 - Researchers, community and political leaders gathered in Mexico City for the XVII International AIDS Conference (AIDS 2008) today received an update on the future prospects of eradicating HIV, and were urged to give greater attention and resources to the needs of affected children, and to reject unproven strategies that ignore the realities of sex workers’ lives.

“The persistence of HIV in latent reservoirs presents a major challenge to the ultimate goal of eradicating HIV from the human body,” said Dr. Pedro Cahn, International Co-Chair of AIDS 2008. Thus, while researchers seek answers to this and other key scientific questions, it is important that the prevention and treatment knowledge that already exists today not be squandered. Dr. Luís Soto Ramírez, Local Co-Chair of AIDS 2008 warned against ignoring the needs of children affected by HIV, and continuing to marginalize groups at greatest risk for infection, which will only lead to more new infections and fewer people on treatment. “We will pay for such foolishness in the future,” he said.

Dr. Robert Siliciano (United States) presented data on HIV persistence in people on highly active antiretroviral therapy (HAART) and the prospects for eradication of HIV. Siliciano demonstrated that HAART can stop viral replication of HIV but cannot eradicate it from the body because of the persistence of HIV in a reservoir of CD4 cells even during HAART. According to Siliciano, HAART’s demonstrated ability to stop replication is one of the three steps needed to cure HIV. The other two are identifying all the stable reservoirs for the virus, and finding ways to subsequently eliminate them.

An estimated 2.1 million children younger than 15 years were living with HIV in 2007, 90% of whom are in sub-Saharan Africa. More than 90% were infected through mother-to-child transmission. While access to treatment has increased substantially, it has been substantially lower for children than for adults. In her plenary address, Linda Richter argued that, while affected children have been highly visible in photo opportunities and headlines about AIDS, their real needs have been consistently overlooked. An estimated two million children are living with HIV today, and many millions more are directly affected by the epidemic through the illness and death of their parents or caregivers, emotional distress, material deprivation, and lack of access to treatment, support, basic health services and education. Richter called for the development of family-centered approaches to address the needs of all children affected by HIV/AIDS. She advocated that social protection services that support families and communities; economic assistance for poor families, particularly through income transfers; and, other steps be taken to alleviate the lot of children affected by HIV in both low- and high-prevalence settings.

Elena Reynaga (Argentina) issued a stirring call for the full recognition of sex workers’ (SWs) rights and for the ability of sex worker organizations to develop and implement effective HIV/AIDS programs rooted in the realities of their lives. According to Reynaga, current efforts to reduce HIV prevalence among SWs are hampered by inadequate funding and the misdirected investment of limited funds into programs that do not meet SW’s actual needs. Reynaga cited evidence that HIV prevalence has been lowered in regions such as South America, where sex work is actually recognized as “work” and SW organizations receive direct support. In Brazil, strategies that incorporate peer outreach, promotion of SW rights and the abolition of laws that repress sex work, have helped to control epidemics. Reynaga said that SWs are dying because of a lack of health services and HIV treatment. Fighting stigma and discrimination, and freedom from repression build an effective response to HIV among SWs.

Coming up tomorrow are sessions on the future of the epidemic and new directions in HIV research; building global and national commitments for evidence-based approaches; financing sustainable national health care; and, a family and community approach to prevention and care for sexual minorities.

A full list of all sessions and activities is available through the online Programme-at-a-Glance at www.aids2008.org.

AIDS 2008 - XVII INTERNATIONAL AIDS CONFERENCE (MEXICO) - 2

CALL FOR A MULTI-PRONGED APPROACH TO HIV PREVENTION – ‘MARRYING PREVENTION AND TREATMENT’

(condensed from the official press release of AIDS 2008)

6 August 2008 - In light of promising evidence of the potential impact of antiretrovirals on HIV prevention, and recent setbacks in other biological interventions, HIV experts at the XVII International AIDS Conference today called for a reinvigorated commitment to prevention research and accelerated implementation of proven prevention strategies. In 2007, 2.7 million people were newly infected with HIV worldwide, nearly 7,400 each day.

“Today, there are many effective strategies to prevent HIV, and all nations of the world must commit fully to their implementation,” said Dr. Luís Soto Ramírez, Local Co-Chair of AIDS 2008. He pointed out that too often stigma and discrimination continue to fuel counterproductive laws and policies that undermine prevention and treatment. Changing these attitudes needs to be a central component of any HIV prevention strategy.

Pointing out that in the recent past there have been some setbacks in the areas of vaccine and microbicides research, Dr. Pedro Cahn, International Co-Chair of AIDS 2008, decried the tendency to abandon all efforts to find other means to prevent new infections. Other speakers provided insights into current prevention research and programming, while highlighting the harmful effects of oppressive attitudes and policies, which inhibit the implementation of effective prevention programs. We need to increase basic science and vaccine research so as to reverse the course of the epidemic.

Despite important increases in HIV treatment access worldwide, it will be impossible to “treat our way out of the epidemic,” according to Dr. Myron Cohen (United States). Citing the central role that clinical and other HIV treatment providers have played in averting mother-to-child transmission with antiretroviral drugs, he mooted a greater partnership between treatment providers and those working in public health campaigns to prevent HIV. Reflecting on the need for a multi-pronged approach to prevention, Cohen iterated the urgent need to develop combination primary prevention strategies; reinvigorate research on HIV vaccines, other immune-based strategies, and antiretroviral prevention; and encourage people to learn their HIV status for the own health and the benefit of their sexual partners and communities. Cohen urged that once and for all, the HIV community marry HIV treatment and prevention.

Dr. Adeeba Kamarulzaman (Malaysia) highlighted the sorry plight of injecting drug users (IDUs) who are disproportionately less likely to have access to antiretrovirals. They are often faced with stigma and discrimination, inadequate health infrastructure, as well as a lack of access to HIV treatments during incarceration or internment in detoxification centres. To address these obstacles, Kamarulzaman urged the development of care models located in non-traditional health care settings that integrate HIV services with substance abuse, psychiatric, and primary care services. She also pointed out the lack of access to harm reduction strategies such as needle exchange programs (NEP) which have proven value in arresting the epidemic. Widespread prejudice and moralistic criticisms are a major obstacle. This is also reflected in the implicit contradictions between the United Nation’s public health approach to HIV, and the punitive focus of its drug control policies which tend to undermine efforts to provide HIV services to IDUs.

As part of Tuesday’s plenary, Dr. Jorge Saavedra (Mexico) delivered the Jonathan Mann Memorial Lecture, named in memory of scientist Jonathan Mann, who is credited with building the WHO’s AIDS Programme from the ground up. Saavedra provided a multi-dimensional overview of the HIV epidemic in men who have sex with men (MSM), specifically highlighting hidden epidemics among MSM in low- and middle- income countries, and factors that increase HIV risk and vulnerability across cultures. He profiled current budget outlays for MSM prevention programs, and provided examples of effective prevention strategies, including community-based interventions. Saavedra called for some specific policy changes including greater involvement of MSM in the planning of national AIDS responses, and the inclusion of MSM prevention strategies in the strategic plans of low- and middle-income countries. There is a great need for donors to both fund MSM programs, and include measures of responsiveness to MSM needs in programme evaluation.

For additional information, including programme information, abstracts, rapporteur and scientific summaries, transcripts and presentations from key conference sessions, please visit http://www.aids2008.org/