SWAZILAND: Israeli surgeons helping Swaziland in drive to curb HIV

Small teams of Israeli doctors will travel to Swaziland to perform circumcisions for two-week stints this year under a program organized by the Jerusalem AIDS Project and financed by Hadassah, a US-based Jewish organization, and other donors.

The effort to circumcise Swazi men is being carried out in the hopes of curbing the spread of HIV/AIDS in a country with the world’s highest HIV infection rate.

Several studies have shown that circumcised men are at least 60 percent less likely to contract HIV. But in poor countries like Swaziland, public health systems already overtaxed by the AIDS epidemic are struggling to offer the procedure. “For us the major constraint is surgeons, doctors,” said Dudu P. Simelane, executive director of Family Life Association of Swaziland, a non-governmental group hosting the Israeli doctors.

Medical experts in the tiny kingdom, which has fewer than 100 doctors, want to offer the procedure to all 200 000 sexually active men, at a rate of approximately 200 circumcisions per day or 20 times faster than the country’s current pace.

No country has undertaken such a feat – except Israel, where after the fall of the Berlin Wall its doctors circumcised roughly 80 000 immigrants, mostly adults from Soviet bloc countries that prohibited Jewish rituals.

At a series of occasional “Circumcision Saturday” events, Swazi surgeons have demonstrated they can each do 10 procedures, each taking about 25 minutes, per day. If they can keep up that volume every weekday, experts believe it would take just four doctors at each of five separate clinics to reach the target of 1,000 circumcisions a week.

Melvyn Westreich, one of the first Israelis to arrive, said improving the flow of patients through the clinics is key. Saving even a few minutes via a new stitching technique, or injecting the men with local anesthesia in the waiting room rather than a busy operating room translates to more circumcisions each day, each week, each month, he said. (Washington Post)

CANADA: Needle exchange told to clean up or move out

AIDS Vancouver Island’s needle exchange program has been threatened with eviction by its landlord. “The clock is ticking; we need a solution quickly,” said Andrea Langlois, AVI spokesperson. “The solutions lie in the hands of the [Vancouver Island] Health Authority.”

The needle exchange, opened in 1988, has been served a notice of complaint that asks for the end of loitering and defacement of public and private property.

At issue is the fact that some homeless drug users loiter outside the exchange, urinate, defecate, and leave behind dirty syringes and blood. If conditions are not met, the eviction notice from landlords Yentel Property Management Inc. will be effective May 2008.

The exchange has 1 600 registered users and 25 000 visits a year. In 2006-07, it distributed 740 000 needles and had 104 percent returned, meaning more needles came into the center for disposal than were given out.

Victoria lawyer Stewart Johnson said the needle exchange is “inadequate” and cannot continue operating the way it is now. He said it must be shut down or moved so it can expand to run properly.

Marilyn Callahan, AVI board chairperson, said the landlords have been patient and that shutting down the needle exchange would be devastating. AVI has said it needs $585 000, more than double its current operating budget, to expand to an approximately 3 000-square-foot building for a supervised 50-person drop-in center, courtyard, toilets, showers, kitchen, counselors’ offices, and storage space.

Vancouver Island Health Authority COO Mike Conroy said a third-party review of best practices among needle exchanges, to address the “public order” problem, should provide recommendations soon. VIHA also expects recommendations from a task force set up by the mayor. (Cindy E Harnett, Victoria Times Colonist)

UNITED STATES: Graphic anti-Meth ads are catching on

Illinois, Arizona, and Idaho are replicating an ad campaign that began in Montana, centering on a series of shocking, graphic TV commercials that warn about the dangers of methamphetamine (Tik), a highly addictive drug linked to risky behavior and crime nationwide.

The states are using the ads because last month, Montana announced a nearly 50 percent drop in reported meth use among high school students since the Montana Meth Project introduced the ads two years ago. The project is a private advocacy organization founded by billionaire Tom Siebel.

“If it’ll work in Montana, it’ll work anywhere,” said Sen. Jon Tester at a recent news conference in Washington, where the state’s congressional delegation joined Seibel and CDC Director Julie Gerberding to announce the state’s meth decline and support the ads.

Alaska, California, Iowa, Indiana, Oregon, Kentucky, and Washington are taking steps toward airing the ads as part of an anti-meth initiative announced last month by the White House Office of National Drug Control Policy. Utah has created its own public awareness drive aimed specifically at women ages 12-45.

The current ads are the same as those created by Seibel’s Montana Meth Project in 2005. The organization provides the ads for free but states have to pay for airtime, often during prime time on channels popular with young people. The 12 separate TV commercials are accompanied by billboards, print ads, and radio spots; all feature the slogan “Meth: Not Even Once.” (John Gramlich, Chicago Sun Times)

CANADA: Sault Catholic Board votes against vaccinating girls for HPV

Trustees of the Huron-Superior Catholic District School Board voted 5-4 to deny access to Algoma Public Health officials to administer the human papillomavirus (HPV) vaccine free under a provincial program targeting all eighth-grade girls.

HPV is the primary cause of genital warts and the leading cause of cervical cancer. The district will be the only one in the province to refuse the school-based vaccine program.

Trustees opposed to the motion argued that providing a vaccine for an STD, rather than promoting abstinence, goes against their Catholic values and assumes premarital sex is occurring. “When someone says one thing and does another you’re called a hypocrite,” said trustee Grace Tridico. “Teaching abstinence and supporting the HPV vaccine clinics, for me is a clear case of hypocrisy.”

Randy Schuran, chairperson of the regional school council committee, questioned whether trustees who voted against the motion were taking the decision away from parents.

Several trustees voiced concerns over the cost to parents in procuring the vaccine elsewhere and questioned the board’s right to keep the province from using the schools for vaccines. “Other vaccinations never come in front of this board for approval, and I’m not sure why this one is, other than it being attached to promiscuity,” said trustee John Caputo.

Caputo said he believes parents and teachers are doing a good job of teaching Catholic morals and beliefs to students. He noted that the vaccine also protects abstinent females who may marry spouses who had contracted HPV prior to marriage.

Algoma Public Health Director Susan Kniahnicki said the free vaccination program is not available outside of schools. She noted that the first round of vaccinations at Algoma District School Board schools had shown no ill effects. (Canadian Press)