Ahad, 3 November 2013

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The Star Online: World Updates

Could concentrated HIV epidemics make AIDS unbeatable?


LONDON (Reuters) - HIV epidemics are becoming more concentrated in marginalised groups such as sex workers, drug users and gay men, and could defy global attempts to combat AIDS without a change in attitudes, according to a U.N. special envoy.

Michel Sidibe, formerly head of UNAIDS and now tackling HIV and AIDS in Eastern Europe, says he would like to be able to celebrate without reservation vast global progress made in the past decade, but stubborn infection rates and alarming growth of outbreaks in hard-to-reach populations make that difficult.

The risk, he says, is that as the world turns the tide of the generalised global AIDS epidemic, the virus will return to being a disease that plagues only certain groups, and the political will to overcome it there may fade.

"If we do not address the roots of the problem, if we do not address stigma, discrimination and inappropriate legislation, if we don't look at these people from a public health perspective, rather than from a delinquent, criminal perspective as we do now, then the trend will only go on," Sidibe said in an interview.

"Then the AIDS epidemic will become more and more a sum of these concentrated epidemics."


Some 35.3 million people worldwide are infected with the human immunodeficiency virus (HIV) that causes AIDS, but the rising number of patients reflects great strides in recent years in developing sophisticated HIV tests and combination AIDS drugs and getting them to many of those who need them to stay alive.

The annual AIDS death toll is falling, dropping to 1.6 million people in 2012, down from a peak of 2.3 million in 2005, and there are also steadily declining rates of new HIV infections: a third fewer in 2013 than in 2011.

The progress has generated much hope - and many headlines - about the possible end of AIDS, or a potential world without HIV, or the chance of an AIDS-free generation, in our lifetimes.

Sidibe refers to this - both the progress and the hope - as "extraordinary".

"I'm really concerned about the future of the AIDS epidemic, especially at a time when we are perhaps a little too optimistic because of the huge progress we are making from a technological and scientific perspective," he said.

"As we celebrate the extraordinary progress, we should also be conscious that we will not stop HIV and AIDS by just having more sophisticated drugs and only focussing on the generalised epidemic and not focussing enough on the complexities of the concentrated epidemics."

The worrisome groups are fairly clearly defined: Injecting drug users, who can pass the AIDS virus to each other by sharing needles and syringes, prostitutes and sex workers, who are often criminalised and have little access to health service, and gay and bisexual men - the population in which the HIV epidemic first started.


To illustrate how little has changed in the battle against HIV among drugs users - particularly in regions such as Eastern Europe and central Asia - Sidibe tells the stories of two women.

The first is Andrée, a drug user he met in Paris in 1986 who had no hope of effective HIV treatment, since there was none yet developed, and who ultimately died a lonely death. The second was Larissa from Yekaterinburg in Russia, a drug addict repeatedly arrested and locked up, deprived of medications for years and at one time sentenced to five years in a labour camp.

"These stories are remarkably similar," he said. "But Larissa's is not from 1986, it's from this year. Some 25 years passed between my meeting these two women, but their predicament was depressingly, tragically, the same."

Among gay men, Sidibe said, the situation is little better.

In poor and middle-income countries, men who have sex with men and female sex workers are 19 and 13 times more likely to have HIV, respectively, than the rest of the population.

Even in wealthy regions like western Europe and North America, HIV rates among gay men - or men who have sex with men (MSM) as Sidibe refers to them - stubbornly refuse to shift.


"In MSM populations, there is no sign it has decreased," said Sidibe. "It has either been a stable number of new infections every year for 10 years, or it is an increasing trend. And this, in western Europe at least, is in the context of basically free and easy access to therapy and services."

Elsewhere, in China, for example, gay men alone account for more than 33 percent of new HIV infections, and projections indicate that gay men may account for half or more of all new infections in Asia by 2020.

Sidibe admits that he is as frustrated and worried now, faced with these smaller but relentless HIV epidemics, as he was more than a decade ago when the vast generalised HIV and AIDS outbreak in Africa looked too overwhelming to begin to tackle.

"We are a bit in disarray. We don't know quite what it is that we should do. Here we are, we have all the technology, we have extraordinary scientific progress, and we just cannot translate that into making a difference in these populations."

Yet if nothing changes, the AIDS virus may never be beaten.

Sidibe called for a "shift in the collective mindset" to put equity and human rights at the centre of the battle against HIV in these groups: "If we do not deliver the right response, we will fail to deliver an end to AIDS," he said.

(Reporting by Kate Kelland; editing by Ralph Boulton)

India throws rings of protection around divisive candidate Modi


NEW DELHI (Reuters) - - Indian security forces are preparing for one of their most challenging assignments in decades, protecting prime ministerial candidate Narendra Modi in a country with a grim history of political assassinations.

A series of small bombs killed six people at a rally the Hindu nationalist leader held in the city of Patna on October 27.

Authorities said the home-grown Indian Mujahideen (IM) group was responsible. While Modi was not in the immediate vicinity of the explosions, the message was clear.

"Narendra Modi is way above everyone else on their hit list," said an officer in the Intelligence Bureau, who declined to be identified as he is not authorised to speak to the media.

"The IM cadre say he is actually 1 to 10 on their list. The rest come after that," said the officer, citing confessions of captured militants.

Modi will lead his Bharatiya Janata Party into a general election due by May and his enemies will almost certainly be looking for another opportunity to strike.

The militants hold Modi responsible for riots in 2002, during his first term as chief minister of Gujarat state, in which at least 1,000 people, most of them Muslims, were killed.

Modi denies any role in the riots or bias against minority Muslims.

Communal animosity has led to several high-profile assassinations in India, beginning months after independence when a Hindu fanatic gunned down Mahatma Gandhi, the leader of a non-violent struggle to throw off British rule.

Prime Minister Indira Gandhi, who was not related to Mahatma Gandhi, was killed by Sikh bodyguards in 1984 and her son, former Prime Minister Rajiv Gandhi, was killed by an ethnic Tamil suicide bomber in 1991.

The election is shaping up to be a highly charged clash with Modi and his aggressive Hindu nationalist supporters facing off against their Congress-led rivals, who say the vote is a fight to preserve India's secular foundations.

Much of the battle will be waged at public gatherings. Even in these days of 24-hour news channels and the Internet, Indian election campaigns hinge around rallies.

Modi will address countless throngs in coming months in his race against the Congress-led coalition which is expected to put up Rajiv Gandhi's son, Rahul Gandhi, as its prime ministerial candidate.

An elite team protecting Modi has been ordered to secure all public meetings using the same tactics of the Special Protection Group that guards former and serving prime ministers and their families along the lines of the U.S. Secret Service.

Spotters in disguise will mingle in the crowds while an advance team will "sanitise" sites six times, the last time an hour before Modi's arrival, a security official said.

"Sewage pipes, manholes, you plug every hole in the ground and above," said the official.

Gandhi has spoken of the deaths of his father and grandmother and said recently he could be next to fall to the politics of hate. He is guarded by the top-level Special Protection Group.

An attack on either Modi or Gandhi could spark waves of reprisal violence.


Modi, the three-time chief minister of Gujarat arouses strong passions among supporters and rivals. He is a hero of the Hindu right, and seen as a tough, business-friendly administrator who can help steady a nation in economic drift.

Critics accuse him of a deep-seated bias against Muslims and say he turned a blind eye to attacks during the 2002 riots. The Supreme Court absolved him of any wrongdoing.

The Indian Mujahideen has ties to Pakistan-based militants who have launched numerous attacks in India including the 2008 assault on several targets in the city of Mumbai.

Four days before the explosions at recent Patna rally, the Intelligence Bureau sent a letter to state authorities warning them of the threat to Modi, although they did not have specific information.

"Narendra Modi being perceived as a leader of Hindus, may be targeted by rabid elements," the bureau said. "Modi is also a target in the list of various terrorist organisations."

He is now protected by 108 Black Cat commandos of the National Security Guard (NSG), the anti-terrorism force that fought the militants who mounted the Mumbai attack.

Originally, Modi had a small NSG group trained to whisk him away in case of attack, a Home Ministry official said.

But his security has been stepped up and he now has three layers of protection: one group to take on any attackers, a second to provide cover and a third to get him to safety.

Ajay Sahni, head of the Delhi-based Institute of Conflict Management, said that given the rings of security, the chance of a direct attack on Modi or Gandhi was low.

"The inner core is very heavily protected," said Sahni, whose institute studies South Asian militant groups.

"It would be hard to penetrate unless the groups have the capacity to project explosives such as missiles. Those are difficult to smuggle around."

The biggest risk was the politicians themselves pushing against the security bubble as they bid to reach out to voters, Sahni said. Unlike in the West, powerful leaders in India at times overrule their security agents and wade into crowds.

(This story was refiled to correct date of Patna attack)

(Editing by Robert Birsel)

China sends graft busters to more provinces, government departments


BEIJING (Reuters) - China has sent anti-corruption investigators to six more provinces and four government departments, the Chinese Communist Party's corruption watchdog said on Monday, in the government's latest move to tackle graft.

The Central Commission for Discipline Inspection has dispatched inspectors to government departments that include official news agency Xinhua and the Commerce Ministry, the watchdog said in a statement on its website.

Other targets include the southern economic powerhouse of Guangdong, coal-rich Shanxi and the Ministry of Land and Resources.

Since taking office in March, Chinese President Xi Jinping has called corruption a threat to the ruling Communist Party's survival and vowed to go after powerful "tigers" as well as lowly "flies".

Authorities have already announced the investigation or arrest of a handful of senior officials. Among them, former executives from oil giant PetroChina are being investigated in what appears to be the biggest graft probe into a state-run firm in years. These investigations are unrelated to this new round of probes, or the previous one, which began in May.

The May probes, which lasted through the summer and reported back in September, targeted five regions and five departments, including the poor southern province of Guizhou, the southeastern province of Jiangxi and coal-rich Inner Mongolia, as well as the state-owned China Grain Reserves Corporation and the China Publishing Group Corp.

The party has so far given few details of the outcome of the first round of investigations, in line with its secretive nature, though the anti-corruption watchdog publishes website reports of a steady stream of minor officials being probed.

Speaking to officials in October ahead of this new round of probes, Wang Qishan, the head of the Central Commission for Discipline Inspection, urged colleagues to spare no effort in rooting out corruption.

(Reporting by Adam Rose; Editing by Jeremy Laurence)

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