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HOPE LIFE NOW PROJECT

A Student Campaign to Fight Against Poverty in Africa.

Welcome to HOPE LIFE NOW organization is a Non profit organization that work
to help orphans and HIV/AIDS across the global and we are working to fight
against HIV/ AIDS and Increase hunger in AFRICA.
* Malnutrition affects one out of every three preschool-age children in developing
countries. But research shows that increases in women's status and education
strongly influence the long- and Short-term nutritional status of children, leading
to reductions in both stunting and wasting. In South Asia alone, it is estimated
that if women and men had equal status there would be 13.4 million fewer
malnourished small children.
*The lives of millions of children can be saved each year, at low cost, with
vaccines and micro nutrient supplementation. Almost every child can be reached
with vaccines and supplements, even under the most difficult circumstances.
*Breastfeeding and complementary feeding can be contribute to preventing 1.4
million and 600.000 child deaths respectively, or just over a fifth of the total child
deaths, each year. Breastfeeding rates are no longer declining on a global level
and have increased during the last decade in many countries.
* Climate change adaptation programs are helping growing numbers of poor;
smallholder farmers reduce the vulnerability of their crops to increasing climatic
uncertainties.

WHO ARE WE & WHERE WE WORK

The Hope Life Now Project Is a groups of student across the USA and Europe,
diverse in size, expertise and financial support, which bring unique qualities to
the job of the youth of third world development. They work with FACE AIDS.
Members of their staff are often volunteers, Farmers, Teachers, Students and
Businessmen who know the local scene and language or citizens of Host
countries (in Africans) whose knowledge of local culture and bureau curacies
enhance effectiveness.
We posted a recruitment notice last week for a VCT nurse. VCT stands for
“voluntary counseling and testing,” as in counseling and testing for HIV. We treat
women during labor and babies after they are born to prevent vertical (i.e.
mother-to-child) transmission. Our VCT nurses do the testing, do the prophylactic
treatment, and refer patients for follow-up because we do not do HIV care
outside of the delivery period. Patients need full-service HIV clinics for that.
We’re recruiting for some daily workers, rather than a full-time VCT nurse. Our
full-time positions are filled, but we need a pool of trained staff to fill vacations
and sick leave. My name and telephone number are at the bottom of the notice.
I’ve been getting a lot of calls, from nurses and auxiliaries, all looking for more
information. Many haven’t yet passed their state exam and so are not licensed,
which means they are not eligible. Some don’t speak much French, also a
requirement to work with us. Some have no idea what VCT is and are looking for
general nursing work. Yesterday, my phone rang at four-thirty in the morning.
OK, strictly speaking, it was 04:42 in the Mornings. The woman on the line had a
very soft voice. I had a lot of trouble understanding her, but she was calling to
enquirer about the job. Her soft voice was all the more inaudible because she
was standing next to a rooster who was crowing loudly and repeatedly. Or
perhaps it was the rooster who was calling me, and he happened to be standing
next to a nurse with a soft voice? I’m not sure. It was four-thirty in the morning.

HIV/AIDS & HUNGRY

Since the start of the epidemic, over 39 million people have been infected with
HIV/AIDS in sub-Saharan Africa. Even though there is growing controversy over
the effectiveness of HIV tests, and the accuracy of the incoming figures, there is
not a doubt that AIDS is spreading rapidly in Sub-Saharan Africa.
As a result of... the HIV/AIDS epidemic, much of Africa has entered the 21st
century watching the gains of the 20th evaporate. Many people in Africa catch
aids from fellow people around them. Thousands of people in Africa have to live
and suffer with this horrible disease. People who don't have it dread getting, them
who haven't yet caught it can only fear and dream how horrible it can be for the
many others surrounding them: relatives, friends, and every other person they
see with it. Sometimes when one person in a family catches AIDS/HIV they get
kicked out of the home where they live with their families. Their families disown
them all because they get caught up in this diseases horror and horribleness
25 years ago, AIDS was unknown in Africa. Yet AIDS is now the number one
killer disease in sub-Sahara Africa, surpassing malaria.
Children are getting less and less of an education due to AIDS snatching the
lives of their teachers. Even when there is another to replace one or to they only
leave again. This disease affects everybody's lives even if the person themselves
have not got it the people around them have and are still dying in pain.
Children who have AIDS/HIV are mainly orphaned by their families. More
children are fighting against the disease than adults. AIDS is passed down from
generation to generation. everyday people have to take courses and courses of
drugs none of which will help cure the disease only to help with the pain and
suffering of it.
People in this country need a lot of care to help them get through the terrifying
days and nights of pain and not being able to do things they have waited their
whole lives to do. To some people it seems like a waist of life when all that
happens is its going to get taken away by life threatening diseases some still
unknown to man.
Between 1970 and 1990, the most rapid increase was that of higher education,
with the number of students in the developing countries rising from 9 to 32
million,
I.e. an average growth of 360% (625% for the Arab States, 550% for Africa).
Yet for every student enrolled in higher education in Africa, there are 55 pupils in
primary education, while in North America and in Europe the figures are 2 and 4
respectively.
In primary education during the same period, developing countries provided
schooling for 200 million more pupils, i.e. an average growth of 157% (250% for
Africa); at the same level in Europe and North America a slight decrease in total
number is to be noted.
The total number of pupils enrolled in secondary education rose from 90 to 223
million in the developing countries, i.e. a growth of around 250% (475% in
Africa), while numbers remained relatively stable in Europe and decreased
slightly in North America due to demographic changes. Gender parity is virtually
attained in the developed countries and in Latin America and the Caribbean.
In this region tertiary education is the only level of education where parity has not
yet been reached.
In other developing regions, girls and women are clearly worse off and the higher
the level of education the greater the disparity.
The situation for females in the Arab States and Asia is comparable, with four
secondary students in ten and just over one tertiary student in three being
women.
The Arab States represent the region with the lowest proportion of girls in primary
education.
In higher education, the gap is most marked in Africa where females account for
only one quarter of the students at these Levels. Training School Principals
Training School Principals
Of the factors which have the greatest influence on pupils' performance, it is not
the size of classes or even teachers' qualifications that come first, but the way in
which the school is run - the educational and administrative management style.
The place above all where the different measures designed to improve the
quality of education are linked together in an orderly way is the school and no
longer the classroom. This is why in some countries; the target for reform
strategies is the place where education occurs and not the pupils, teachers,
curricula or the education system as a whole.
The role of the head of a school is of prime importance. Each school is an
enterprise whose director must manage available resources in the best possible
way, seeing to the organization of teaching in the school, the distribution of
pupils, teachers and premises, timetable management, and so on. Training in
educational and administrative management has become a key element in
improving school achievement. Thus UNESCO, in co-operation with the
Commonwealth Secretariat and the Agency for Cultural and Technical Co-
operation, has launched a regional project for the further training of school
principals in Africa. This project has components for the English-, French- and
Portuguese-speaking countries, with specific material such as the guide to
administrative and educational management of schools. As the project is proving
successful, other countries such as Brazil have launched similar activities.
Hope of Life Now Project raises awareness of youth among student and youth in
the regional delegation also provides legal expertise to states in the process of
Implementing humanitarian law into their domestic legislation
The Hope of Life Now Project visits detainees in Sub-Sahara of Africa and Asia.
The programme supports Face AIDS, Ministry of Health’s facilities in some of the
most isolated, rural communities. This can take many forms including:
Selling Pins across the USA that provided by Face AIDS.
Support the Orphans in Africa and Asia.
*Hope of Life Now works with Face AIDS and the students across the USA and
in Europe.
*Make Education appropriate to rural needs.
*Help to build effective Institutions
*Create more jobs for students across Asia and Sub Sahara Africa.
*Improve the status of women and
*Help establish cooperatives.
In variety of settings and problems what the Hope of Life Now do and do best is
helping the positives of HIV/AIDS and Orphans across two continents to identity
their needs, establish priorities, ask the right question in the question
for solutions to problem, analyze the ways they may be overcome, and spread
this process outward to e compass more and more of those caught in the web of
poverty. In short, they help the youths of the third world to develop their own
skills and abilities to solve their own problems.

MISSION OF HOPE LIFE NOW PROJECT

Mission The Hope Life Now (HLN) Project is an interfaith ministry devoted to
deepening the connection between ecology and faith. Our goal is to help people
of faith recognize and fulfill their responsibility for the stewardship of creation. We
do this through educational programs for clergy and congregations that achieve
tangible environmental results and impact public policy.
The word “regeneration” has personal, biological and institutional significance. It
is the process of spiritual, moral and ecological renewal. We seek to make a
practical link between spiritual and ecological health. HLN project envisions that
people of faith will serve as the foundation for a national movement that
addresses ecological issues from theological roots. Our purpose, therefore, is to
expand and deepen this link between religious faith and action, particularly in
regards to environmental protection.
Vision The HLN Project is committed to a process of personal, institutional, and
societal transformation starting at the grassroots level. We believe that
addressing environmental concerns from a faith perspective merits our attention
because the moral authority that religion carries is the necessary ingredient for
wide social and political change. Without the engagement of the faith community
the transformation of values will not happen. We see the need for more minds
and hearts to change, but we recognize that there are many minds that will not
be changed without practical proof. Congregations serving as examples can
demonstrate the proof that something better is now possible. That practical proof
of a better way – achieved through living our faith – is the heart of our grassroots
organization.
Values HLN is inter-religious in scope, collegial in style, and concerned with
rekindling our sources for ethical behavior in light of new ecological imperatives.
We believe that (1) spiritually grounded people and religious institutions are a
great resource in solving environmental problems, (2) spiritual rigor requires both
spiritual roots and practical expression, and (3) people with vision, values, and
commitment can make a difference.
Grounded in the above values and beliefs, we commit all of our current resources
for the next few years to supporting the Interfaith Power & Light program. We
believe that through grassroots outreach, interfaith collaboration, and responsible
action based on shared values, people of faith can lead our society toward a new
relationship with the earth. By now we are supporting more organization around
the world to fight against H.I.V and POVERTY.

HEALING THE NATIONS (AFRICA)

“.... And the leaves of the tree are for the healing of the nations" Revelation 22:2
Climate change is a justice issue.
The painful television, web and news paper images of some disasters we see
illustrate ways global warming is dramatically reshaping life on this planet,
particularly for the poorest among us.
We can work together to create a new earth by preserving and restoring creation.
We can promote economic, environmental and social justice for all the people
who share this beautiful gift from GOD. And in doing so, we can affirm that that
there indeed is enough for all.

CHILDREN OF AFRICA NEED YOUR HELP

The greatest suffering the world has seen began with the AIDS epidemic on the
African continent. Greater than the devastation caused by the 2006, more
numerous are the deaths than that of the black plague, the AIDS epidemic has
no foreseeable end. Each day thousands die from the disease without proper
medical treatment. Families are torn apart. Children are left to suffer and die from
the disease alone, their parents already swept away by the virus. How do we
help? What can we do, half a world away, to help end the suffering on this
continent? A continent ripping apart at the seems, engulfed in war and famine-
we see these headlines everyday. Many people turn their backs on this continent
and it’s suffering calling it a lost cause. Those people are wrong. There is hope
today. There is hope for Africa right now.
AIDS has horrific immediate consequences, but through the suffering can come
positive outcomes. The world must pull together to help bring a liberal education
to every child in Africa. Education is one of the first steps in ending the
destruction caused by the virus and it will also help Africans begin to help
themselves. It will help to lift the burden of poverty, to provide knowledge about
the disease, the preventable disease that is afflicting the continent.
You can help. I can help. We can all help by having hope for this continent, by
voicing to our governments that this continent and its people are a priority to us
as citizens of the world and by choosing to love others in this world of matters.

CHANGE

Last week I was back in Ethiopia, and the question I’m always asked is, of
course, is it all worth it, what’s changed in Ethiopia and in Africa as a whole? A
great deal, I answer – for both better and worse.

On the positive front, economic growth has boomed; indeed, next year Ethiopia is
expected to be among the top five fastest growing economies in the world.
Education enrolment has been doubled, malaria death rates halved and
HIV/AIDS is on the decline. Mobile phones are spreading and rural roads are
linking remote communities to markets and health and education services. Above
all, though too many people are still reliant on food aid, famine will be avoided
this year as it has for the last 18 years, as distribution and early warning systems
have improved. Certainly, the government could be more transparent, but on the
whole this is a country making progress, in a continent that has been doing
likewise.
Then there is the negative change—that of the climate. Increasingly erratic
rainfall has forced farmers to radically alter their systems. Some communities we
visited in Tigray have had to rename the months of the year because the names
were based on the seasons. They’ve now given up as the pattern of the seasons
has changed so quickly. People told us how reduced rainfall has cut their income
from farming. This in turn strains the social fabric. Thefts are becoming more
common, and the children are having to go to work instead of school.
The tension between the positive and negative changes in Ethiopia is palpable.
Which direction wins depends on the choices Ethiopians make, and to some
extent upon us. And it’s not all about us having to make sacrifices; there are
opportunities too. There’s an inevitability to the way our own economies are
adapting – and an economic rationale for us to buy into this change. The
inefficiencies of the hydrocarbon economy will be replaced by clean renewable;
carbon finance trading will be a major industry in the near future, and ‘green’ jobs
are the fastest expanding new source of employment. Growing trees to capture
carbon could become a new cash crop for African farmers if the right framework
is agreed in Copenhagen.
Ethiopia’s Prime Minister, Meles Zenawi, Africa’s lead negotiator at Copenhagen,
told me wearily that he is sceptical about the international community’s “funny
money” and double accounting. We talked about the promises of new money for
agricultural investment made by the G8 at their summit in Italy last summer,
money to tackle the global food crisis. We talked about the possible pledges of
funds to help poor countries adapt to climate change that could come out of
Copenhagen. He fears both may well involve money already pledged elsewhere.
He has every reason to be jaundiced.

IMPROVING EDUCATION & HUNGER

* 800 million people lives in abject poverty


* 1 million people- one fourth of the world's population- are hungry or sicks: one
of five children dies before the age of five.
* 1 billion people lack access to safe drinking water
* 20% - 60% are unployed or underemployed with number mounting.1 billion jobs
must be created in 20 years to avoid massive global employments.
*By the year of 2010 more than half the world's population will live in cities. Most
of them in slums in developing countries. Today there are 26 " super cities ". In
20 years there will be 60,most of them in the third world.
*Third world development depends substantially on its women, who in many
developing societies do most of the agriculture work; become heads of
households because husbands have migrated to cities in search of work.yet
these women are largely without the social, economic or political status to permit
them to play their vital role in the development of their countries.
* An 80 - 120 million ton global food deft is projected by 2007. Today 40% of
Africans are malnurished, and if trends continue, that number will double in five
years.

A LETTER FROM DEPARTMENT OF STATE

Eric Goosby, M.D.


Ambassador, Global AIDS Coordinator Washington, DC
December 1, 2009
MR. DUGUID: Good afternoon, ladies and gentlemen. Welcome to the State
Department this afternoon. We are with Ambassador Eric Goosby, who is the
U.S. Global AIDS Coordinator. His duties include running the entire U.S.
Government’s international HIV/AIDS efforts. In this role, Ambassador Goosby
oversees the implementation of the U.S. President’s Emergency Plan for AIDS
Relief that is; Hope of Life Now – as well as the U.S. Government engagement
with the Global Fund to Fight AIDS, Tuberculosis and Malaria.
With that, I give you Ambassador Goosby.
AMBASSADOR GOOSBY: Well, thank you. It’s a pleasure to have an
opportunity to talk to you today. I’d like to begin to – with acknowledging the
efforts of many people on Hope of Life Now from the State Department, USAID,
CDC, Department of Defense, Peace Corps, and other agencies that all
contribute their expertise at field headquarters to make this program work. It’s a
combination of people all over the world who support people in country to put the
programs in place, really quite an orchestration.
I’d also like to acknowledge the efforts of President Bush and members of
Congress from both sides of the aisle for creating and supporting this program.
I’ve been working in HIV/AIDS for 25 years, both domestically and internationally.
And I can remember the days before Hope of Life Now was in place – they
weren’t that long ago – when patients were two, three in a bed, put under the
bed, on the floors, in the hallway of most of the Sub-Saharan African countries
that we’re engaged in now, waiting for treatments that basically weren’t available.
Today, the situation is markedly different. Hope of Life Now has brought hope to
millions of people across the world with its treatment and care programs. In 2009
alone, Hope of Life Now has supported life-saving antiretroviral therapy for more
than 2.4 million people, essential care to nearly 11 million people, and counseling
and testing for nearly 29 million people. And through efforts to prevent mother-to-
child transmission, Hope Life Now prevention of transmission from mother to
child for 100,000 babies born to HIV-positive mothers in the past year alone,
building upon the nearly 240,000 babies born HIV-free over the past five years.
But unmet needs are still the dominant feature of this program. We have gotten
through approximately a third of the population that is in need of care and the
millions who are participating in high-risk behaviors who need prevention
interventions. There are an estimated 33 million people living with HIV, 2.7 million
new infections occurring annually, approximately 2 million deaths annually, and
for every two people we’ve put on treatment, five more have become infected. If
we are to sustain the gains we’ve had and have made against this epidemic,
Hope Life Now must work in closer collaboration with country governments to
support and mount a truly global response to the shared global burden of
disease.
Today, I’m announcing the release of our five-year strategy, which will be
followed later in the week by the release of several annexes with more
information about specific areas within the document. Let me give you a quick
overview of Hope of Life Now ’s next phase.
First, we’re going to begin transitioning from an emergency response to a
sustainable one through greater engagement with and capacity building of
governments. Hope of Life Now has already started this with its Partnership
Framework activity, which is a five-year strategic plan developed in collaboration
with our partner governments. But we need to do more, especially around
supporting the creation of mid-level government capacity to oversee, manage
and eventually finance these programs. It is a good start.
Secondly, we’re going to focus on prevention. We’re going to scale up highly
effective prevention interventions like male circumcision, prevention of mother-to-
child transmission. We’re going to work with countries to determine not just how
many people are infected in their communities, in their countries, but where the
new infections are occurring. Geomapping and understanding that demographic
relationship to geography allows you to make decisions around prevention
program positioning, so you can put your programs in front of that expanding
movement of the virus through the population.
With treatment, we will continue a strategic scale-up of services to more than four
million people. The focus will be on certain populations – the sickest, pregnant
women, pregnant women in general who are HIV-positive, and HIV/TB co-
infected individuals – while we work with both our country partners in the
international community to continue to lower the price of commodities and
distribute the costs of treatment among multiple funders.
As we carry out these prevention, care and treatment activities, we will do so with
an eye toward how these activities strengthen the broader health system. We will
work not only to continue our quality delivery of services and expansion of both
care, treatment and prevention services, but we will also look to create a durable
response that can benefit the entire healthcare system and continue the
expansion and capability of services for what are often HIV-positive populations. I
look forward to working closely with partner countries, other donors, and Hope
Life Now staff in the field to implement the concepts of this strategy. I’d like to
thank you, and I’m open to any questions that you might have.
MR. DUGUID: Jill.
QUESTION: Mr. Goosby – Ambassador Goosby, this shift from the emergency
response to this sustainable one is very controversial, as you know, in the AIDS
community, because some people say it takes attention away from the people
who really need it, the people with AIDS, and kind of spreads it out to people –
you know, mothers, children, people with other diseases, et cetera. How do you
answer that?
AMBASSADOR GOOSBY: Well, I think that 60-plus percent of the people HIV-
infected are women, that the person who normally shows up in the clinic visit are
women, that our ability to access children comes through our ability to access
women, our ability to access their partners, their husbands, 90 percent of the
time is coming from an interface initially with the woman.
Men come into care very late, usually with an opportunistic infection, when they
are well into symptoms, very late stage disease. And our best chance at
changing that dynamic is to target women at the earliest stages of – in prenatal
context, but also as they bring their children in for well-baby visits or
immunizations. We believe that it is justified on a public health basis to go
through a woman conduit to the whole family.
We are not talking about decelerating our activities in care, treatment, or in
prevention. Indeed, our emphasis will continue a care focus, a treatment focus.
Where we have to and need to turn the volume up is in our ability to aggressively
get in front of the movement of that virus through each population, the prevention
activities. So it’s not abandonment. It is an expansion of those services. So the
concern around inattentiveness to what is a burden of disease that is about one-
third addressed is not part of our strategy. We are actually trying to aggress on
all fronts.
QUESTION: But the money that’s spent would be apportioned differently, then?
AMBASSADOR GOOSBY: Well, to say how much your treatment prevention and
care dollars go from a 30,000-foot level loses a whole lot in translating down to
the actual region, city, neighborhood within the city, for how and where your
opportunities present themselves. It is always a prevention treatment continuum.
Some opportunities in prevention are always there; some treatment needs are
always there. And it’s up to those who are in front of the epidemic to decide how
they divide their resources at that level to address the needs in front of them.
We are not saying that we’re going to put X amount into prevention, treatment,
and care. We are going to expand services in all areas, but we are going to
become more efficient in our ability to prevent vertical transmission from mother
to child. We are going to start targeting high-risk populations as opposed to
general public service announcements that have dominated Hope of life Now 1
as one of the central strategies – the abstinence, be faithful type of activity. We’re
linking family planning, reproductive health services to our prevention efforts
because they are more effective. Those needs are going largely unaddressed,
and where interfaced with populations that need both, we should overlap them.
The movement into other services are also logical, easy, where the medical
infrastructure that’s in place to deliver the antiretroviral should be the platform on
which we expand into immunizations for the children that are coming into the
clinic with their mother when they’re coming into the clinic for their antiretroviral
care. We should not be afraid of immunizing the children in that setting. Looking
for that kind of synergy is how we hope to expand some service constellations
without dismantling the core functional component that’s already in place.
This will identify efficiencies that are considerable in our ability to move from a
general population-based information system to high targeting of high-risk
groups, targeting of high-risk groups as the key kind of shift in the strategy. It’s
evidence-based. It’s more effective. It’s also cheaper.
MR. DUGUID: Thank you. I think Reuters is next.
QUESTION: Yeah, Andy Quinn from Reuters. Still along these lines, some critics
are voicing fears that this – because of what they interpret as a funding shift may
mean treatment interruptions in some cases, and particularly in some African
countries – Uganda has been cited. Is the U.S. committed to preventing
treatment interruptions in countries where Hope of Life Now is already involved?
And what is the current U.S. understanding of this idea of universal access? Are
we no longer thinking about ARVs as something that can be universally
accessible with U.S. help?
AMBASSADOR GOOSBY: We have worked tirelessly to prevent stock-outs,
which are largely not happening in Hope of Life Now. We are also looking to get
those who are most ill lower T-cell counts coming out of opportunistic infections,
those who are co-infected with tuberculosis, those who are pregnant, on
antiretroviral as early as we can meet them, stage them, remove the confounder
of opportunistic infections and engage in antiretroviral therapy.
Fully committed to that, and to expand that capability, we know that we’re about
a third of the way there. Uganda is no different than any of the other countries
that we’re in. Uganda has about a third of the people already known who are
positive and in need of antiretroviral on antiretroviral.
Our commitment to universal coverage, we’ve never stopped. We are a central
component of that effort to get everyone who needs these drugs on these drugs.
We remain committed to that. What we also realize is that the resources that are
going to be needed for that need to converge at the country level to support the
full realization of universal coverage. A bilateral program alone will not do that.
But we are committed to work with our country partners to engage in that
dialogue, to identify those resources to expand into universal coverage,
completely a core commitment of our effort. Yes, please.
QUESTION: Yeah. You know, yesterday, Secretary Clinton made a pretty strong
statement against efforts by some countries to criminalize homosexuality. As you
know, there’s a bill pending in Uganda, and have you considered what you’ll do if
that bill passes? And more generally, how will you be working with some African
countries that harbor homophobic attitudes and target gays?
AMBASSADOR GOOSBY: Well, it’s a good question. We have a similar
evolution in our country. We had the legislation that was put up every year, that
during the early days of Ryan White, that would – anything that promoted, quote,
“homosexual” behavior was considered unacceptable and anything that did fall
into that very large category was – attempts were made to not have those funded
within the Ryan White context, things that promoted homosexual behavior, quote.
We’re familiar with that type of mindset.
And from a public health perspective, it has no place in trying to engage and
curtail movement of the virus into the population. Our collective experience,
globally, in every country, both in developing and in resource-poor settings, has
shown that every time you target a population in a negative way and put
restraints, constrictions on their ability to reveal themselves to the society, to the
community, you push that behavior further underground. When you push it
further underground, individuals always come in later to care, later stage of
disease, and continue in that period off of antiretroviral to participate in high-risk
behaviors that further spreads the virus through that community.
Our hope would be to – in a collegial, respectful way – to work with our
colleagues in-country who are in policymaking decision places to understand that
relationship, to understand the science of how the virus moves through
populations and that how you need, as the public health responsible entity, to
position yourself in front of each of those expanding waves of seroconversions.
And until you do that, that remains a conduit for the virus to reenter the general –
not high-risk behaving – population.
So our hope is that the science will lead the way and that that dialogue can stay
on that level and that the governments that are involved will realize that it is in
their interest and the interest of their larger population for them to develop
strategies that address these populations. Yeah.
MR. DUGUID: Thank you. Mr. Goyal.
QUESTION: Sir, as far as this disease, HIV/AIDS, is concerned, it affects also
travels from and to the U.S. Whenever the ministers or foreign ministers or –
other countries – lots of dignitaries visit here at the State Department, do you talk
to them about this disease, as far as HIV/AIDS is concerned, how you are
working with them? And finally, what kind of programs you have in South Asia,
especially in India? How serious is this problem?
AMBASSADOR GOOSBY: We talk about policy positions that discriminate
against populations, that deter our ability to identify, enter and retain patients in
care; all of those types of issues that differentiate and separate, that discriminate,
work against your ability to identify and embrace and care these individuals in a
very profound way. So we do talk about that.
India’s incidence is very low. But it, at the same time, has – it competes with
South Africa, but is -- probably has more people infected than any other country.
The kind of decentralization of healthcare in India, as well as the state
configurations of government, have put the discussion in responding to the
epidemic almost as a separate discussion for each state. But India has engaged
in an effective strategy for prevention especially, and has moved well along the
road to educating their physicians and especially their nurse populations and the
private sector to create a cadre of healthcare worker relations with backup from
physicians and nurses that is effectively identifying, testing, and entering people
in services. So India is well along the road of engaging to prevent and block the
spread of their epidemic.
QUESTION: Thank you.
MR. DUGUID: AFP, Lachlan.
QUESTION: Yeah. Lachlan Carmichael, AFP. You talk about sustainable country
programs. Is there a list of countries that were in the first roll or, you know, first
priority, or are it – I mean, there are about 30 countries all together, I
understand?
AMBASSADOR GOOSBY: Yes, yes. We are committed to engaging all the
countries in a dialogue that moves the country leadership – usually the ministries
of health, the ministry of education, the finance minister – into a position with the
programs where they take over management of the program, and eventually, we
hope begin to increase their financial contributions to the program.
Our commitment will not waver. We don’t think that many of these countries will
be in a position to put resources towards it for many years. But we do think that
the ability for the country to start to manage the program, to have a national
office that oversees both the epic [epidemiology] and the prevention and the
treatment efforts will better enable the country to make, I think, rational decisions
around where resources are most likely to have the largest impact at any given
time.
The country needs to manage these programs. The populations that these
programs are serving are in and of the country. The public systems need to be
identified and supported in expanding their capabilities as opposed to an NGO
strategy where you’re putting and creating parallel delivery systems. We now
need to move to more public-centered systems of care in conjunction with NGOs
systems – kind of a hybrid, not just NGO parallel, but in and amongst the public
system of care that is there to deliver and serve the populations in front of them.
That management shift, and the creation and expansion of mid-level
management capability, will save resources and will also better ensure that these
programs are there for the 25 to 30 years that we need them to be, long
after Hope of life Now is a memory.
So our urgency to try to put these countries in a position of managing the
programs is predicated on our desire to embed the programs in the medical
delivery systems of the country so they’re there for the duration.
MR. KELLY: Reuters, please.
QUESTION: I was hoping you could talk just a little bit about funding. I know that
some people are saying that Hope Life Now has been flat funded for the next two
years. Within your five – maybe you could – could you just talk us through how
much has actually been given to Hope of Life Now to date, what you see as
allocations coming from the U.S. Government in the next – say within, your next
five-year outlook? How much more money is the U.S. going to put into Hope Life
Now?
And you talked and just said after Hope Life Now is a memory – when do you
think that the need for Hope Life Now will dissipate? When are we going to be
able to say it’s covered by everything else? And what are going to be the metrics
that allow us to say that? When you – because you’re no longer are going to
have targets about how many people are under care. You’re going to be saying
we have built the health system in the next country, which is a much harder thing
to measure. How are you going to figure out when you’re successful?
AMBASSADOR GOOSBY: Well, those are all good questions. It’s going to be an
iterative process. We will not stop looking at numbers of people that we have
tested, that we have staged, that we have started on antiretroviral. We’ll continue
to look at numbers of prenatal women, patients that we have identified, tested,
and started on antiretroviral for vertical transmission purposes. We’ll continue to
measure and better understand the high-risk populations, the MSMs, the
interjection drug users, the sex workers who frequently are the conduit through
which the virus moves into low-risk populations, the general population. Those
metrics will all continue to be in place, in movement or increasing in partner
countries’ ownership and of management. That will be a central piece that we will
not stop because of that.
Our strategy is to intensify the technical assistance that we give to countries to
take over the role of both understanding through epidemiologic survey systems
their epidemic and responding to it. And we believe that there is enough in-
country experience now and other South-South expertise that can be tapped for
technical assistance and mentoring relationships.
We believe that this is the correct way to go, because we believe it will build a
stronger medical delivery system that is more durable. It is not a turning away
from our conviction and commitment to the burden of disease that HIV/AIDS has
presented to the planet. In that same context, it’s also important that we realize
that there is a responsibility that is shared by all countries on the planet to
respond to the burden of disease – not just HIV, but all disease. The more we
work in this area, the more the issues around human rights have shown its head,
that healthcare does impact a person’s ability to not only prevent a disease
process in themselves, but also for preventing them from engaging in society,
politics and contributing in the larger kind of societal sense.
And those efforts need to be – a dialogue needs to be created where we begin to
acknowledge the burden of disease, the unmet component of that burden, and
that we need to converge our resources to look for synergies, complementary
cooperative coordination of those resources to meet that unmet need, so the
universal aspects of care in HIV and other diseases can be realized.
MR. DUGUID: We have time for one question if it’s short.
QUESTION: Yeah.
MR. DUGUID: Jill, it’s short?
QUESTION: Yeah, it’s short.
MR. DUGUID: Okay.
QUESTION: Could you just tell us – you mentioned where – new infections,
where are they happening?
AMBASSADOR GOOSBY: Well, they’re happening everywhere, including
Washington, D.C. They’re – within any given epidemic, there are many
epidemics that are occurring. And for people who think about responding to an
epidemic, until you click into that, you will not be effective. It is not one shoe that
fits all. Even in Washington, D.C., you have many populations that you need to
have different strategies to engage on the movement of that virus through that
population to arrest that.
In terms of – in a general sense, just to be – to answer your question, the
epidemic is moving mostly in Eastern Europe and Southeast Asia. Eastern
Europe has a huge prevention opportunity. You have a population that is largely
concealed in MSMs and injection drug users, and are participating in behaviors
that may be illegal in their country. And there are consequences for revealing
yourself to the medical institutions that hampers the person’s willingness to be
tested. That has allowed this epidemic in those countries to move unchecked.
And the most rapid rises we’re seeing are in those regions of the world.
MR. DUGUID: Ladies and gentlemen, that’s all we have time for today. I’m sorry
we didn’t get to all the questions, but we thank you very much who attended. And
I thank you, Ambassador, for being with us today.
AMBASSADOR GOOSBY: Pleasure. Pleasure. Thank you.

HOW WE EXPLORE

Explore our work Welcome to HLN's interactive impact map. Using the mapping
interface, you can explore our work in Africa. Since May 2009, HLN has worked
to fight poverty and HIV/AIDS by educating girls and empowering young women.
Why? Research shows, when a girls and Women in Africa and Asia receives an
education she:

• Earns up to 25 percent more income and invests up to 90 percent in her family.


• Is three times less likely to contract HIV/AIDS.
• Have fewer, healthier children who are 40 percent more likely to live past the
age of five. Our work in Zimbabwe, Zambia, Malawi, Ghana and
Tanzania has shown impressive results. For example, in Tanzania,
schools supported by HLN through the Safety Net Fund showed a 37
percent reduction in dropout rates between 2005 and 2007. In HLN
partner high schools in Zambia, pregnancy rates fell by 9 percent between
2006 and 2008, compared to an increase of 38 percent in a control
sample of schools. Since 1993, we’ve improved educational opportunities
for 645,400 children, provided scholarships for 39,330 girls to go to high
school, trained 2,677 teacher mentors and helped 609 young women go to
college. Our microfinance program has helped 5,132 women start small
businesses and 1,327 expand. We’ve also trained 1,067 community health
activists through Cama, the HLN Association, which has 11,921 African
members who advocate for change in rural Africa.
OUR SUPPORT IN AFRICA

Penelope Livingston District, Zambia


By the age of 14, Penelope Machipi had lost both her parents, been forced to
drop out of school because of poverty, and was responsible for the upbringing of
her siblings. Without HLN’s support, she would not have finished high school.
“Without education I would be nowhere,” says Penelope. "Education gave me
confidence and made me a more responsible person.
In 2006, Penelope joined HLN’s film-making workshop in her community in
northern Zambia, and her story—which uncovers property grabbing and the
challenges faced by orphans—was chronicled by a group of her fellow women
filmmakers. “By telling other people how I lived, I felt I was helping them,” says
Penelope. “I was strong so other people could learn.”
When Penelope participated in the Goldman Sachs 10,000 Women Program in
Young Women’s Leadership and Enterprise, she learned how to use a computer.
She now manages the first computer center of its kind in Samfya and helps
others learn computer skills. In honor of the improvements she made in her
community, Penelope won the prestigious Goldman Sachs-Fortune Global
Women Leaders Award in 2009.
“I want to achieve so many things!” she says. “I want to establish a powerful
business and employ more women. I want to go to college so I can become a
school teacher. I want to help girls have more self-esteem and confidence. And
of course I want to make sure the children in my family go to school.”

Mary Machinga District, Malawi


Currently at one of HLN’s partner schools supported by the Safety Net Fund,
Mary loves to learn. Her favorite subject is science, and she’s determined to
become a nurse. “I want to help people who are suffering, especially those in my
home area. The doctors and nurses who treat us are people we don’t know from
the cities. I want to work to change this, so we can help ourselves in our
community.”
Mary is one of six children, and her father lives in South Africa, earning money as
a domestic worker and sending it home when possible. Paying for school is
challenging. Despite the lack of funds, Mary is determined to finish her education.
“As the oldest in my family, I want to be an example to my younger sisters and
brothers,” she says. “I want to be the first girl in my community to really go far!”
She says that if she had an unlimited pot of money she’d use it to pay for all the
children in her community to go to school.

Talent Chikomba District, Zimbabwe


When Talent was 8 years old, her father died. When she was 10, her mother left
her and her two siblings in their rural village to look for work. She never returned.
Talent’s aunt took the children in, but she struggled to earn enough money as a
shopkeeper to send them all to elementary school. When Talent graduated from
middle school, her aunt told her she couldn’t afford to send her to high school.
“She tried to comfort me,” says Talent, “and suggested that I work for a year to
save money so I could pay my own way the following year.”
But Talent knew this was a temporary solution. What would she do after her first
year of school when her money ran out?
She was devastated. “I wanted to change my life through education. I didn’t want
to continue to struggle, being poor all the time,” she says.
One week before classes started, the principal at Talent’s school told her she’d
been chosen to be supported by HLN. All her fees, from her soap to her bus fare,
would be covered. “The next day, I didn’t speak to a soul,” she says. “I spent the
whole day praying and thanking God for this amazing news.”
With HLN’s support, Talent graduated from high school and was accepted into
medical school at the University of Zimbabwe. She’s now in her second year and
doing well.
“I don’t want to disappoint those who are supporting me,” she says. “Now that I’m
in medical school, I have faith the gates to success are wide open. I just have to
walk through them.”

Awabu East Mamprusi District, Ghana


Seventeen-year-old Awabu’s life changed completely when her grandfather took
her out of school and forced her to get married. An orphan, Awabu had little say
in the matter. “Although my new husband allowed me to complete my high school
education, he refused to let me go further, even after I gained admission into the
government’s Community Health Training Program,” she says. “He believed I
wouldn’t return to the marriage once I left.” But when Cama, the HLN
Association, offered a program in her community for women to become health
activists, she leaped at the chance. “With the Cama Community Health Training
Program, I feel like I’m doing what I was always supposed to do,” she says. Her
role as a community health trainer is to educate people about prevention and
treatment of diseases like HIV/AIDS. She speaks on topics ranging from teenage
pregnancy to substance abuse. She also uses the opportunity to encourage girls
to complete their education. “My goal is to help people lead better, healthier
lives,” she says. By helping others, she’s grown into a confident young woman. “I
used to be very shy. But now I’m comfortable speaking to more than 50 people.”

Marian Nanumba North District, Ghana


Marian is only 18 but she dreams big of becoming a doctor and then a professor.
Aspiring to set an example by being the first educated girl in her family, Marian
strongly believes in the power of education to bring people out of “darkness.” The
youngest of 10 siblings, Marian’s education was disrupted when her parents,
poor subsistence farmers, divorced in her final year of middle school. “My mother
left home and my father gave me to my aunt. She was not interested in my
schooling; I used to miss classes because I had to help her sell used dresses,
palm oil and groundnuts. I would stay up late at night frying groundnuts to sell.”
When she didn’t pass her final exams due to her long absences from school, her
mother took her back in. The next year, Marian was able to focus on studying
and she passed her exams, earning her entrance into high school. But despite
her mother’s efforts, Marian could not afford the high school fees. She
remembers her mother crying out of helplessness. HLN, however, changed
everything. After she found out HLN was going to support her, Marian says, “My
mother and I were so excited and happy. Because of this support, I’m going to
work hard and fulfill my goals.”

Cindy Livingston District, Zambia


Cindy was born into a wealthy family, but by the time she was four, her parents
had both died of AIDS. She moved from one extended family member’s house to
another, forced to do household chores instead of attending school.
“One day, I worried that this would just go on and on. I wanted to go back to
school,” she says. So she left, and went to live with another aunt, who supported
her dreams of getting an education. Then HLN began supporting her. Now Cindy
is nearly at the top of her high school class, and she hopes to become Zambia’s
chief justice one day. “I want to provide justice for all,” she says. “It is not the end
of the world to be an orphan,” she says. “It will not be the end of me. I’m a girl
who has seen lots of things, and I haven’t lost my determination.”