1. The Greater Involvement of People living with HIV in health care
Morolake Odetoyinbo
Positive Action for Treatment Access (PATA)
Alice Welbourn & David Stephens

2. FELA ANIKULAPO-KUTI

3. "Statistics don't have sex, they don't eat, they are cold
"Statistics don't have sex, they don't eat, they are cold. We are not statistics. I may not have financial resources, but I have an inner empowerment resource that can overcome the social and cultural conditions that I live in." The late Brigitte Syamalevwe, HIV positive activist, Zambia; died February 2003 aged 44.

4. 1994 Paris GIPA declaration
42 national governments signed GIPA declaration
GIPA is critical to ethical and effective national responses to the epidemic
GIPA means recognizing the important contribution people living with HIV/AIDS can make
GIPA is creating space within society for involvement and active participation in all aspects of response.
Contribution can be at all levels in all sectors.
Roles of Networks HIV and community-based organizations was emphasized.

5. “The man dies in all who keep quiet in the face of tyranny”
“Our lives begin to end the day we become silent about the things that matter”
Dr. Martin Luther King
“The man dies in all who keep quiet in the face of tyranny”
Prof Wole Soyinka

6. Health systems include all the activities with a primary purpose of protecting, promoting, restoring or maintaining health.
The fundamental objectives of health systems are to protect people against the threats of ill-health and injury and to improve the health of the population in a way that responds to people's expectations and provides financial protection against the costs of ill-health and other consequences…. WHO

8. THE SPECIFIC CRISIS IN RELATION TO HIV
1) High prevalence of HIV positive health care workers in high prevalence areas and the effects of this on an effective HIV response

9. In Uganda….
“mortality data for a cohort of Ugandan doctors showed that, of 22 doctors who died, 11 died of AIDS, and 5 committed suicide because of a known or suspected HIV diagnosis.” (Uebel et al) 2007

10. “I was working as a psychiatric nurse and
we had an HIV positive patient. The nurses working with me were really worried about looking after him, and they made some really negative comments…It made me feel so scared…What if they knew about me? I just couldn’t be open about my status at work.”
PozFem UK member, January 2008

11. THE SPECIFIC CRISIS IN RELATION TO HIV
High prevalence of HIV positive health care workers in high prevalence areas and the effects of this on an effective HIV response
Lack of Support for HIV positive health staff from peers and employers

12. Health workers often add to stigma too…
“My dream, what I was – a nurse known by all, with prestige, loved by everyone – had gone. I fell into depression and forgot everyone in the world”
(ICW Latina member)

13. Raoul Fransen & Yinka Jegede

14. THE SPECIFIC CRISIS IN RELATION TO HIV
High prevalence of HIV positive health care workers in high prevalence areas and the effects of this on an effective HIV response
Lack of Support for HIV positive health staff from peers and employers
Lack of quality of care for people with HIV in health care facilities

16. THE SPECIFIC CRISIS IN RELATION TO HIV
High prevalence of health care workers living with HIV in high prevalence areas and the effects of this on an effective HIV response
Lack of Support for HIV positive health staff from peers and employers
Lack of quality of care for people with HIV in health care facilities
Lack of integrated health care for people with HIV – eg TB, malaria, other STIs, SRH services, violence support, psychosocial support

17. THE SPECIFIC CRISIS IN RELATION TO HIV
High prevalence of HIV positive health care workers in high prevalence areas and the effects of this on an effective HIV response
Lack of Support for HIV positive health staff from peers and employers
Lack of quality of care for people with HIV in health care facilities
Lack of integrated health care for people with HIV – eg TB, malaria, other STIs, SRH services, violence support, psychosocial support
Health systems – lack of links beyond the clinic door into the communities which they are supposed to serve – violence, criminalisation…

18. “When he learns that I went to the health centre for medication, he beats me saying that I am embarrassing him, that I am showing everybody that we are sick. Now I fear going for services.”
- ICW member Uganda

19. Two extracts from the Model AIDS Law:
ARTICLE 18: Prohibition of the Requirement to Undergo HIV test… this prohibition is revoked: … e) When a pregnant woman undergoes medical checkup
ARTICLE 26: Spouses and Revelation to Sexual Partners The testing center shall be required to make the disclosure in the event of the expiration of the six weeks, provided all efforts are made to enable the partners to have full understanding of the situation.

20. THE SPECIFIC CRISIS IN RELATION TO HIV
High prevalence of HIV positive health care workers in high prevalence areas and the effects of this on an effective HIV response
Lack of Support for HIV positive health staff from peers and employers
Lack of quality of care for people with HIV in health care facilities
Lack of integrated health care for people with HIV – eg TB, malaria, other STIs, SRH services, violence support, psychosocial support
Health systems – lack of links beyond the clinic door into the communities which they are supposed to serve – violence, criminalisation…
Immense and chronic effects of burden of care on women and girls worldwide, irrespective of the main cause of transmission

23. “In South Africa…..
13.7% of health care workers are HIV-positive and 18.9% of them have a CD4 count below 200.
Currently 1,896 nurses a year are qualifying in South Africa, whilst an estimated 2,745 a year are succumbing to AIDS.
Supply of nurses is not meeting demand.
This is before we consider emigration of nurses or their exit to other professions.”
Olive Shisana, President and CEO, Human Sciences Research Council, Cape Town, in South African Medical Journal, Feb 2007

26. Special Thanks Alice Welbourn – Co author David Stephens – Co author
Ron McInnis
Sophie Dilmitis
Kate Thompson
Babatunde Ahonsi
Uwemedimo Esiet
ICW
GNP+