http://www.pharma-lexicon.com/medicalnews.php?newsid=65110
14 Mar 2007
The International Labour Organization on Thursday called on the Indonesian government to improve knowledge about HIV/AIDS among migrant workers, particularly women, in the country, the Jakarta Post reports. According to Alan Boulton, ILO director for Indonesia, female migrant workers especially are susceptible to HIV infection and other problems, such as sexual abuse. "The challenge is to find ways of maximizing migration's contribution to growth and development while providing appropriate protection for" migrants, "including information and advice" about the risk of HIV, Boulton said Thursday at a talk to recognize International Women's Day. Boulton added that 450,000 migrant workers leave the country annually to work abroad, 75% of whom are women. According to data from the Association of Migrant Workers, in 2005, 161 out of 145,289 potential female migrant workers in Indonesia tested positive for HIV and in 2004, 203 out of 233,626 potential female migrant workers tested HIV-positive. Boulton said the country needs to "provide information and support for potential Indonesian migrant workers so that they can avoid contracting HIV/AIDS during their work or when they come back to Indonesia." He added that discrimination against HIV-positive workers also is an issue. A recent Women's Solidarity for Human Rights survey conducted in three Indonesian cities that have high migrant worker populations found many female migrant workers in the country have minimal knowledge about HIV/AIDS, how it is transmitted and how to prevent its spread. Although female migrant workers are vulnerable to HIV infection, data on prevalence among the group are not available, according to Halik Sidik of the National AIDS Commission (Jakarta Post, 3/9).
Wednesday, March 14, 2007
TB remains problem in Indonesia
http://www.thejakartapost.com/detailheadlines.asp?fileid=20070314.@01&irec=0
Headline News
March 14, 2007
The Jakarta Post, Jakarta
While Indonesia has reached the 2005 global cure rate target for tuberculosis, it still remains the most deadly communicable disease in the country, particularly in eastern regions.
A proactive approach is necessary in dealing with tuberculosis in eastern parts of Indonesia due to the often difficult geographical terrain and the lack of skilled human resources, Carmelia Basri, an official at Health Ministry responsible for tuberculosis, said Tuesday.
"We need to take an active approach for detection in this region, where the prevalence of TB is among the highest in the country. We can't just wait for patients to come to community health centers," she said on the sidelines of a symposium on tuberculosis hosted by the Coalition for a Healthy Indonesia.
Indonesia has reached the global cure target of 85 percent for TB, but a national survey found that eastern Indonesia had the highest prevalence of the disease with 210 cases for every 100,000 people, far higher than the national rate of 125. The lowest rate was recorded in Yogyakarta and Bali, with 64 cases per 100,000 people, while Java had 107 cases and Sumatra 160 for every 100,000 people.
"This year, we started a mobile health service program to detect TB cases and give proper treatment for patients. Under this program, the mobile health units will regularly visit kampongs once every three months," Carmelia said.
She said that due to a lack of financial and human resources, the program could only be implemented in turns in many regencies and municipalities in the eastern part of the country, with Papua the first target for the program.
In Papua, where the HIV infection rate is among the highest in the country, the number of co-infected people is 320 per 100,000, according to Carmelia.
Co-infection with HIV is extremely dangerous because TB is one of the leading factors in the deaths of people living with HIV. On the other hand, HIV is also the biggest risk in stimulating latent TB to become active.
The Coalition for a Healthy Indonesia said the government's efforts to combat TB, which focus on supplying free medicine, diagnostic equipment and laboratories, as well as providing training for medical personnel, allowed the country to reach the 2005 global cure rate target for the disease.
However, the detection rate only reached 68 percent, lower than the 2005 global target of 70 percent. The country recorded more than 210,000 new cases in 2004 and has estimated there will be 250,000 new cases and 300 deaths from tuberculosis annually.
Indonesia is still third in the world in terms of the TB mortality rate, after China and India.
People's lack of information about TB, its dangers and the free treatment available contributes to the high mortality rate, which is also due to the lack of political and financial support from local administrations, the coalition said.
However, the coalition, which has introduced TB communication and mobilization programs since 2005, says public understanding of the disease has improved and significantly more people are going to community health centers to be tested.Monday, March 12, 2007
The World Medical Association Statement on HIV/AIDS and the Medical
Adopted by the WMA General Assembly, Pilanesberg, South Africa,
October 2006
Introduction
1. HIV/AIDS is a global pandemic that has created unprecedented
challenges for physicians and health infrastructures. In addition to
representing a staggering public health crisis, HIV/AIDS is also
fundamentally a human rights issue. Many factors drive the spread of
the disease, such as poverty, homelessness, illiteracy,
prostitution, human trafficking, stigma, discrimination and gender-
based inequality. Efforts to tackle the disease are constrained by
the lack of human and financial resources available in health care
systems. These social, economic, legal and human rights factors
affect not only the public health dimension of HIV/AIDS but also
individual physicians/health workers and patients, their decisions
and relationships.
Discrimination
Unfair discrimination against HIV/AIDS patients by physicians must
be eliminated completely from the practice of medicine.
1. All persons infected or affected by HIV/AIDS are entitled to
adequate prevention, support, treatment and care with compassion and
respect for human dignity.
2. A physician may not ethically refuse to treat a patient whose
condition is within his or her current realm of competence, solely
because the patient is seropositive.
3. National Medical Associations should work with governments,
patient groups and relevant national and international organizations
to ensure that national health policies clearly and explicitly
prohibit discrimination against people infected with or affected by
HIV/AIDS.
Appropriate / Competent Medical Care
1. Patients with HIV/AIDS must be provided with competent and
appropriate medical care at all stages of the disease.
2. A physician who is not able to provide the care and services
required by patients with HIV/AIDS should make an appropriate
referral to those physicians or facilities that are equipped to
provide such services. Unless or until the referral can be
accomplished, the physician must care for the patient to the
best of his or her ability.
3. Physicians and other appropriate bodies should ensure that
patients have accurate information regarding means of transmission
of HIV/AIDS and strategies to protect themselves against infection.
Proactive measures should be taken to ensure that all members of the
population, and at-risk groups in particular, are educated to this
effect.
4. With reference to those patients who are found to be
seropositive, physicians must be able to effectively counsel them
regarding: (a) responsible behaviour to prevent the spread of the
disease; (b) strategies for their own health protection; and (c) the
necessity of alerting sexual and needle-sharing contacts, past and
present, as well as other relevant contacts (such as medical
and dental personnel) regarding their possible infection.
5. Physicians must recognize that many people still believe HIV/AIDS
to be an automatic and immediate death sentence and therefore will
not seek testing. Physicians must ensure that patients have accurate
information regarding the treatment options available to them.
Patients should understand the potential of antiretroviral treatment
(ART) to improve not only their medical condition but also the
quality of their lives. Effective ART can greatly extend the period
of time that patients are able to lead healthy productive lives,
functioning socially and in the workplace and maintaining their
independence. HIV/AIDS is increasingly looked upon as a manageable
chronic condition.
6. While strongly advocating ART as the best course of action for
HIV/AIDS patients, physicians must also ensure that their patients
are fully and accurately informed about all aspects of ART,
including potential toxicity and side effects. Physicians must also
counsel patients honestly about the possibility of failure of first
line ART, and the subsequent options should failure occur. The
importance of adhering to the regimens and thereby reducing the risk
of failure should be emphasized.
7. Physicians should be aware that misinformation regarding the
negative aspects of ART has created resistance toward treatment by
patients in some areas. Where misinformation is being spread about
ART, physicians and medical associations must make it an immediate
priority to publicly challenge the source of the misinformation and
to work with the HIV/AIDS community to counteract the negative
effects of the misinformation.
8. Physicians should encourage the involvement of support networks
to assist patients in adhering to ART regimens. With the patient's
consent, counselling and training should be available to family
members to assist them in providing family based care. Physicians
must recognize families and other support networks as crucial
partners in adherence strategies and, in many places, the only means
to adequately expand the care system so that patients receive the
required attention.
9. Physicians must be aware of the discriminatory attitudes toward
HIV/AIDS that are prevalent in society and local culture. Because
physicians are the first, and sometimes the only, people who are
informed of their patients' HIV status, physicians should be able to
counsel them about their basic social and legal rights and
responsibilities or should refer them to counsellors who specialize
in the rights of persons living with HIV/AIDS.
Testing
1. Mandatory testing for HIV must be required of: donated blood and
blood fractions collected for donation or to be used in the
manufacture of blood products; organs and other tissues intended for
transplantation; and semen or ova collected for assisted reproduction
procedures.
2. Mandatory HIV testing of an individual against his or her will is
a violation of medical ethics and human rights. Exceptions to this
rule may be made only in the most extreme cases and should be
subject to review by an ethics panel or to judicial review.
3. Physicians must clearly explain the purpose of an HIV test, the
reasons it is recommended and the implications of a positive test
result. Before a test is administered, the physician should have an
action plan in place in case of a positive test result. Informed
consent must be obtained from the patient prior to testing.
4. While certain groups are labelled "high risk", anyone who has had
unprotected sex should be considered at some risk. Physicians must
become increasingly proactive about recommending testing to
patients, based on a mutual understanding of the level of risk and
the potential to benefit from testing.Pregnant women should
routinely be offered testing.
5. Counselling and voluntary anonymous testing for HIV should be
available to all persons who request it, along with adequate post-
testing support mechanisms.
Protection from HIV in the Health Care Environment
Physicians and all health care workers have the right to a safe
work environment. Especially in developing countries, the problem of
occupational exposure to HIV has contributed to high attrition rates
of the health labour force. In some cases, employees become infected
with HIV, and in other cases fear of infection causes health care
workers to leave their jobs voluntarily. Fear of infection among
health workers can also lead to refusal to treat HIV/AIDS patients.
Likewise, patients have the right to be protected to the greatest
degree possible from transmission of HIV from health professionals
and in health care institutions.
1. Proper infection control procedures and universal precautions
consistent with the most current national or international
standards, as appropriate, should be implemented in all health care
facilities. This includes procedures for the use of preventive ART
for health professionals who have been exposed to HIV.
2. If the appropriate safeguards for protecting physicians or
patients against infection are not in place, physicians and National
Medical Associations should take action to correct the situation.
3. Physicians who are infected with HIV should not engage in any
activity that creates a risk of transmission of the disease to
others. In the context of possible exposure to HIV, the activity in
which the physician wishes to engage will be the determining factor.
Whether or not an activity is acceptable should be determined by a
panel or committee of health care workers with specific expertise in
infectious diseases.
4. In the provision of medical care, if a risk of transmission of an
infectious disease from a physician to a patient exists, disclosure
of that risk to patients is not enough; patients are entitled to
expect that their physicians will not increase their exposure to the
risk of contracting an infectious disease.
5. If no risk exists, disclosure of the physician's medical condition
to his or her patients will serve no rational purpose.
Protecting Patient Privacy and Issues Related to Notification
1. Fear of stigma and discrimination is a driving force behind the
spread of HIV/AIDS. The social and economic repercussions of being
identified as infected can be devastating and can include violence,
rejection by family and community members, loss of housing and loss
of employment, to name only a few. Normalizing the presence of
HIV/AIDS in society through public education is the only way to
reduce discriminatory attitudes and practices. Until that can be
universally achieved, or a cure is developed, potentially infected
individuals will refuse testing to avoid these consequences. The
result of individuals not knowing their HIV status is not only
disastrous on a personal level in terms of not receiving
treatment, but may also lead to high rates of avoidable transmission
of the disease. Fear of unauthorized disclosure of information also
provides a disincentive to participate in HIV/AIDS research and
generally thwarts the efficacy of prevention programs.
Lack of confidence in protection of personal medical information
regarding HIV status is a threat to public health globally and a
core factor in the continued spread of HIV/AIDS. At the same time,
in certain circumstances, the right to privacy must be balanced with
the right of partners (sexual and injection drug) of persons with
HIV/AIDS to be informed of their potential infection. Failure to
inform partners not only violates their rights but also leads to the
same health problems of avoidable transmission and delay in
treatment.
2. All standard ethical principles and duties related to
confidentiality and protection of patients' health information, as
articulated in the WMA Declaration of Lisbon on the Rights of the
Patient, apply equally in the context of HIV/AIDS.
In addition, National Medical Associations and physicians should take note of the
special circumstances and obligations (outlined below)associated
with the treatment of HIV/AIDS patients.
1. National Medical Associations and physicians must, as a matter of
priority, ensure that HIV/AIDS public education, prevention and
counselling programs contain explicit information related to
protection of patient information as a matter not only of medical
ethics but of their human right to privacy.
2. Special safeguards are required when HIV/AIDS care involves a
physically dispersed care team that includes home-based service
providers, family members, counsellors, case workers or others who
require medical information to provide comprehensive care and assist
in adherence to treatment regimens. In addition to implementing
protection mechanisms regarding transfer of information, ethics
training regarding patient privacy should be given to all team
members.
3. Physicians must make all efforts to convince HIV/AIDS patients to
take action to notify all partners (sexual and/or injection drug)
about their exposure and potential infection. Physicians must be
competent to counsel patients about the options for notifying
partners.
These options should include:
1. notification of the partner(s) by the patient. In this case, the
patient should receive counselling regarding the information that
must be provided to the partner and strategies for delivering it with
sensitivity and in a manner that is easily understood. A timetable
for notification should be established and the physician should
follow-up with the patient to ensure that notification has occurred.
2. notification of the partner(s) by a third party. In this case,
the third party must make every effort to protect the identity of
the patient.
3. When all strategies to convince the patient to take such action
have been exhausted, and if the physician knows the identity of the
patient's partner(s), the physician is compelled, either by law or by
moral obligation, to take action to notify the partner(s) of their
potential infection. Depending on the system in place, the physician
will either notify directly the person at risk or report the
information to a designated authority responsible for notification.
In cases where a physician must disclose the information regarding
exposure, the physician must:
1. inform the patient of his or her intentions,
2. to the extent possible, ensure that the identity of the patient
is protected,
3. take the appropriate measures to protect the safety of the
patient,especially in the case of a female patient vulnerable to
domestic violence.
4. Regardless of whether it is the patient, the physician or a third
party who undertakes notification, the person learning of his or her
potential infection should be offered support and assistance in
order to access testing and treatment.
5. National Medical Associations should develop guidelines to assist
physicians in decision-making related to notification. These
guidelines should help physicians understand the legal requirements
and consequences of notification decisions as well as the medical,
psychological, social and ethical considerations.
6. National Medical Associations should work with governments to
ensure that physicians who carry out their ethical obligation to
notify individuals at risk, and who take precautions to protect the
identity of their patient, are afforded adequate legal protection.
Medical Education
1. National Medical Associations should assist in ensuring that there
is training and education of physicians in the most current
prevention strategies and medical treatments available for all
stages of HIV/AIDS, including prevention and support.
2. National Medical Associations should insist upon, and assist with
when possible, the education of physicians in the relevant
psychological, legal,cultural and social dimensions of HIV/AIDS.
3. National Medical Associations should fully support the efforts of
physicians wishing to concentrate their expertise in HIV/AIDS care,
even where HIV/AIDS is not recognized as an official specialty or
sub-specialty within the medical education system.
4. The WMA encourages its National Medical Associations to promote
the inclusion of designated, comprehensive courses on HIV/AIDS in
undergraduate and postgraduate medical education programs, as well as
continuing medical education.
14.10.2006
http://www.wma.net/e/policy/a25.htm
October 2006
Introduction
1. HIV/AIDS is a global pandemic that has created unprecedented
challenges for physicians and health infrastructures. In addition to
representing a staggering public health crisis, HIV/AIDS is also
fundamentally a human rights issue. Many factors drive the spread of
the disease, such as poverty, homelessness, illiteracy,
prostitution, human trafficking, stigma, discrimination and gender-
based inequality. Efforts to tackle the disease are constrained by
the lack of human and financial resources available in health care
systems. These social, economic, legal and human rights factors
affect not only the public health dimension of HIV/AIDS but also
individual physicians/health workers and patients, their decisions
and relationships.
Discrimination
Unfair discrimination against HIV/AIDS patients by physicians must
be eliminated completely from the practice of medicine.
1. All persons infected or affected by HIV/AIDS are entitled to
adequate prevention, support, treatment and care with compassion and
respect for human dignity.
2. A physician may not ethically refuse to treat a patient whose
condition is within his or her current realm of competence, solely
because the patient is seropositive.
3. National Medical Associations should work with governments,
patient groups and relevant national and international organizations
to ensure that national health policies clearly and explicitly
prohibit discrimination against people infected with or affected by
HIV/AIDS.
Appropriate / Competent Medical Care
1. Patients with HIV/AIDS must be provided with competent and
appropriate medical care at all stages of the disease.
2. A physician who is not able to provide the care and services
required by patients with HIV/AIDS should make an appropriate
referral to those physicians or facilities that are equipped to
provide such services. Unless or until the referral can be
accomplished, the physician must care for the patient to the
best of his or her ability.
3. Physicians and other appropriate bodies should ensure that
patients have accurate information regarding means of transmission
of HIV/AIDS and strategies to protect themselves against infection.
Proactive measures should be taken to ensure that all members of the
population, and at-risk groups in particular, are educated to this
effect.
4. With reference to those patients who are found to be
seropositive, physicians must be able to effectively counsel them
regarding: (a) responsible behaviour to prevent the spread of the
disease; (b) strategies for their own health protection; and (c) the
necessity of alerting sexual and needle-sharing contacts, past and
present, as well as other relevant contacts (such as medical
and dental personnel) regarding their possible infection.
5. Physicians must recognize that many people still believe HIV/AIDS
to be an automatic and immediate death sentence and therefore will
not seek testing. Physicians must ensure that patients have accurate
information regarding the treatment options available to them.
Patients should understand the potential of antiretroviral treatment
(ART) to improve not only their medical condition but also the
quality of their lives. Effective ART can greatly extend the period
of time that patients are able to lead healthy productive lives,
functioning socially and in the workplace and maintaining their
independence. HIV/AIDS is increasingly looked upon as a manageable
chronic condition.
6. While strongly advocating ART as the best course of action for
HIV/AIDS patients, physicians must also ensure that their patients
are fully and accurately informed about all aspects of ART,
including potential toxicity and side effects. Physicians must also
counsel patients honestly about the possibility of failure of first
line ART, and the subsequent options should failure occur. The
importance of adhering to the regimens and thereby reducing the risk
of failure should be emphasized.
7. Physicians should be aware that misinformation regarding the
negative aspects of ART has created resistance toward treatment by
patients in some areas. Where misinformation is being spread about
ART, physicians and medical associations must make it an immediate
priority to publicly challenge the source of the misinformation and
to work with the HIV/AIDS community to counteract the negative
effects of the misinformation.
8. Physicians should encourage the involvement of support networks
to assist patients in adhering to ART regimens. With the patient's
consent, counselling and training should be available to family
members to assist them in providing family based care. Physicians
must recognize families and other support networks as crucial
partners in adherence strategies and, in many places, the only means
to adequately expand the care system so that patients receive the
required attention.
9. Physicians must be aware of the discriminatory attitudes toward
HIV/AIDS that are prevalent in society and local culture. Because
physicians are the first, and sometimes the only, people who are
informed of their patients' HIV status, physicians should be able to
counsel them about their basic social and legal rights and
responsibilities or should refer them to counsellors who specialize
in the rights of persons living with HIV/AIDS.
Testing
1. Mandatory testing for HIV must be required of: donated blood and
blood fractions collected for donation or to be used in the
manufacture of blood products; organs and other tissues intended for
transplantation; and semen or ova collected for assisted reproduction
procedures.
2. Mandatory HIV testing of an individual against his or her will is
a violation of medical ethics and human rights. Exceptions to this
rule may be made only in the most extreme cases and should be
subject to review by an ethics panel or to judicial review.
3. Physicians must clearly explain the purpose of an HIV test, the
reasons it is recommended and the implications of a positive test
result. Before a test is administered, the physician should have an
action plan in place in case of a positive test result. Informed
consent must be obtained from the patient prior to testing.
4. While certain groups are labelled "high risk", anyone who has had
unprotected sex should be considered at some risk. Physicians must
become increasingly proactive about recommending testing to
patients, based on a mutual understanding of the level of risk and
the potential to benefit from testing.Pregnant women should
routinely be offered testing.
5. Counselling and voluntary anonymous testing for HIV should be
available to all persons who request it, along with adequate post-
testing support mechanisms.
Protection from HIV in the Health Care Environment
Physicians and all health care workers have the right to a safe
work environment. Especially in developing countries, the problem of
occupational exposure to HIV has contributed to high attrition rates
of the health labour force. In some cases, employees become infected
with HIV, and in other cases fear of infection causes health care
workers to leave their jobs voluntarily. Fear of infection among
health workers can also lead to refusal to treat HIV/AIDS patients.
Likewise, patients have the right to be protected to the greatest
degree possible from transmission of HIV from health professionals
and in health care institutions.
1. Proper infection control procedures and universal precautions
consistent with the most current national or international
standards, as appropriate, should be implemented in all health care
facilities. This includes procedures for the use of preventive ART
for health professionals who have been exposed to HIV.
2. If the appropriate safeguards for protecting physicians or
patients against infection are not in place, physicians and National
Medical Associations should take action to correct the situation.
3. Physicians who are infected with HIV should not engage in any
activity that creates a risk of transmission of the disease to
others. In the context of possible exposure to HIV, the activity in
which the physician wishes to engage will be the determining factor.
Whether or not an activity is acceptable should be determined by a
panel or committee of health care workers with specific expertise in
infectious diseases.
4. In the provision of medical care, if a risk of transmission of an
infectious disease from a physician to a patient exists, disclosure
of that risk to patients is not enough; patients are entitled to
expect that their physicians will not increase their exposure to the
risk of contracting an infectious disease.
5. If no risk exists, disclosure of the physician's medical condition
to his or her patients will serve no rational purpose.
Protecting Patient Privacy and Issues Related to Notification
1. Fear of stigma and discrimination is a driving force behind the
spread of HIV/AIDS. The social and economic repercussions of being
identified as infected can be devastating and can include violence,
rejection by family and community members, loss of housing and loss
of employment, to name only a few. Normalizing the presence of
HIV/AIDS in society through public education is the only way to
reduce discriminatory attitudes and practices. Until that can be
universally achieved, or a cure is developed, potentially infected
individuals will refuse testing to avoid these consequences. The
result of individuals not knowing their HIV status is not only
disastrous on a personal level in terms of not receiving
treatment, but may also lead to high rates of avoidable transmission
of the disease. Fear of unauthorized disclosure of information also
provides a disincentive to participate in HIV/AIDS research and
generally thwarts the efficacy of prevention programs.
Lack of confidence in protection of personal medical information
regarding HIV status is a threat to public health globally and a
core factor in the continued spread of HIV/AIDS. At the same time,
in certain circumstances, the right to privacy must be balanced with
the right of partners (sexual and injection drug) of persons with
HIV/AIDS to be informed of their potential infection. Failure to
inform partners not only violates their rights but also leads to the
same health problems of avoidable transmission and delay in
treatment.
2. All standard ethical principles and duties related to
confidentiality and protection of patients' health information, as
articulated in the WMA Declaration of Lisbon on the Rights of the
Patient, apply equally in the context of HIV/AIDS.
In addition, National Medical Associations and physicians should take note of the
special circumstances and obligations (outlined below)associated
with the treatment of HIV/AIDS patients.
1. National Medical Associations and physicians must, as a matter of
priority, ensure that HIV/AIDS public education, prevention and
counselling programs contain explicit information related to
protection of patient information as a matter not only of medical
ethics but of their human right to privacy.
2. Special safeguards are required when HIV/AIDS care involves a
physically dispersed care team that includes home-based service
providers, family members, counsellors, case workers or others who
require medical information to provide comprehensive care and assist
in adherence to treatment regimens. In addition to implementing
protection mechanisms regarding transfer of information, ethics
training regarding patient privacy should be given to all team
members.
3. Physicians must make all efforts to convince HIV/AIDS patients to
take action to notify all partners (sexual and/or injection drug)
about their exposure and potential infection. Physicians must be
competent to counsel patients about the options for notifying
partners.
These options should include:
1. notification of the partner(s) by the patient. In this case, the
patient should receive counselling regarding the information that
must be provided to the partner and strategies for delivering it with
sensitivity and in a manner that is easily understood. A timetable
for notification should be established and the physician should
follow-up with the patient to ensure that notification has occurred.
2. notification of the partner(s) by a third party. In this case,
the third party must make every effort to protect the identity of
the patient.
3. When all strategies to convince the patient to take such action
have been exhausted, and if the physician knows the identity of the
patient's partner(s), the physician is compelled, either by law or by
moral obligation, to take action to notify the partner(s) of their
potential infection. Depending on the system in place, the physician
will either notify directly the person at risk or report the
information to a designated authority responsible for notification.
In cases where a physician must disclose the information regarding
exposure, the physician must:
1. inform the patient of his or her intentions,
2. to the extent possible, ensure that the identity of the patient
is protected,
3. take the appropriate measures to protect the safety of the
patient,especially in the case of a female patient vulnerable to
domestic violence.
4. Regardless of whether it is the patient, the physician or a third
party who undertakes notification, the person learning of his or her
potential infection should be offered support and assistance in
order to access testing and treatment.
5. National Medical Associations should develop guidelines to assist
physicians in decision-making related to notification. These
guidelines should help physicians understand the legal requirements
and consequences of notification decisions as well as the medical,
psychological, social and ethical considerations.
6. National Medical Associations should work with governments to
ensure that physicians who carry out their ethical obligation to
notify individuals at risk, and who take precautions to protect the
identity of their patient, are afforded adequate legal protection.
Medical Education
1. National Medical Associations should assist in ensuring that there
is training and education of physicians in the most current
prevention strategies and medical treatments available for all
stages of HIV/AIDS, including prevention and support.
2. National Medical Associations should insist upon, and assist with
when possible, the education of physicians in the relevant
psychological, legal,cultural and social dimensions of HIV/AIDS.
3. National Medical Associations should fully support the efforts of
physicians wishing to concentrate their expertise in HIV/AIDS care,
even where HIV/AIDS is not recognized as an official specialty or
sub-specialty within the medical education system.
4. The WMA encourages its National Medical Associations to promote
the inclusion of designated, comprehensive courses on HIV/AIDS in
undergraduate and postgraduate medical education programs, as well as
continuing medical education.
14.10.2006
http://www.wma.net/e/policy/a25.htm
Indonesia's AIDS epidemic among the fastest growing in Asia
JAKARTA (AP): Indonesia's AIDS epidemic is among the fastest growing
in Asia, especially among intravenous drug users and commercial sex
workers, and half of new infections have been found in the
easternmost Papua province, the World Health Organization said.
"Indonesia is facing a huge threat," Bjorn Melgaard, WHO's senior
health consultant, said Saturday after an independent review team
spent nearly two weeks surveying efforts to fight theAIDS virus in
several provinces across the sprawling archipelago.
The team found that the government has put in place good strategies
and intervention programs to handle the epidemic, but more needs to
be done on a local level to secure long-term funding to fight the
spread of HIV, the virus that causes AIDS, and to improve access to
condoms, testing and counseling.
Surveillance of sexually transmitted disease also needs to be stepped
up, the team found.
There were 2,873 new AIDS cases in Indonesia in 2006, a 140 percent
increase from 1,195 in 2004, with most cases found in intravenous
drug users and commercial sex workers, the team said.
Papua, the country's most remote province geographically and
politically, had by far the largest population of people living with
the AIDS virus, accounting for 20 times the national average- around
50 percent of the country's total number of cases.
"More than 2 percent of the population in Papua were infected with
HIV/AIDS," the report said, adding that health centers in the
province must work especially hard to strengthen programs to prevent
mothers from spreading the virus to their children.
WHO warned late last year that Indonesia showed a trend that its AIDS
epidemic was still not under control, compared to neighboring
Thailand and Cambodia, where rates of infection appear to
stabilizing.
"Its HIV/AIDS epidemic is among the fastest growing in Asia,"
Melgaard said.
HIV has infected an estimated 169,000 to 216,000 in the nation of 220
million. (***)
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in Asia, especially among intravenous drug users and commercial sex
workers, and half of new infections have been found in the
easternmost Papua province, the World Health Organization said.
"Indonesia is facing a huge threat," Bjorn Melgaard, WHO's senior
health consultant, said Saturday after an independent review team
spent nearly two weeks surveying efforts to fight theAIDS virus in
several provinces across the sprawling archipelago.
The team found that the government has put in place good strategies
and intervention programs to handle the epidemic, but more needs to
be done on a local level to secure long-term funding to fight the
spread of HIV, the virus that causes AIDS, and to improve access to
condoms, testing and counseling.
Surveillance of sexually transmitted disease also needs to be stepped
up, the team found.
There were 2,873 new AIDS cases in Indonesia in 2006, a 140 percent
increase from 1,195 in 2004, with most cases found in intravenous
drug users and commercial sex workers, the team said.
Papua, the country's most remote province geographically and
politically, had by far the largest population of people living with
the AIDS virus, accounting for 20 times the national average- around
50 percent of the country's total number of cases.
"More than 2 percent of the population in Papua were infected with
HIV/AIDS," the report said, adding that health centers in the
province must work especially hard to strengthen programs to prevent
mothers from spreading the virus to their children.
WHO warned late last year that Indonesia showed a trend that its AIDS
epidemic was still not under control, compared to neighboring
Thailand and Cambodia, where rates of infection appear to
stabilizing.
"Its HIV/AIDS epidemic is among the fastest growing in Asia,"
Melgaard said.
HIV has infected an estimated 169,000 to 216,000 in the nation of 220
million. (***)
http://www.thejakartapost.com/detailtoplatest.asp?
fileid=20070218150244&irec=0
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