(WP)HSI/ICP/HSI/3.5/001 Report series number: RS/2003/GE/21/(LAO) English only
REP ORT MEE TING ON 100% CON DOM USE PRO GRA MME // FOR PRE VEN TION OF HIV/AIDS AND STI
WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC
Vientiane, Lao People's Democratic Republic 18-21 August 2003
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Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines September 2003
WHO/WPRO LIBRARY MA NTLA, P}I!LJ?PINES
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NOTE The views expressed in this report are those of the participants in the Meeting on 100% Condom Use Programme for Prevention of HIV/AIDS and STI and do not necessarily reflect the policies of the Organization
This report has been prepared by the World Health Organization Regional Office for the Western Pacific for governments of member states in the Region and for those who participated in the Meeting on 100% Condom Use Programme for Prevention of HIV/AIDS and STI, 18 to 21 August 2003.
CONTENTS
SUMMARY I 1. INTRODUCTION .................. ..... ... ..... ........ ..... ........... ................................. ... ............... ... ....... 2
1.1. 1.2. 1.3. 1.4. 1. 5.
Objectives: ........................... ......... .... .... ..................................... ............. .... ........ ···.·· ···· 2 Patticipants and Resource Persons ................... ............................................................. 2 Organization of the Meeting ................... ..................................... ....................... .......... 3 Welcome Statement ...................... .. ... ............ .......... ....................... ...·· ········· ·············-· 3 Opening of the Meeting ................. ............................. .............................. .................... 3
2. PROCEEDINGS .. ... ....... ..... ...... .................. ........................... ....... ..... ....................................... 3 2.1. 2.2. 2.3. 2.4 Introductory Presentations: ............................... ... ......... ................................. ........ ....... 3 Country Presentations .... .. ......... ........ ............................................... .............. .... ........... 4 Other Presentations ........ ....... ..... ... ..... ......... .. .... ... .... .... ....... ... .... ............ .... ................. ,. 7 Group Work ..... ..... ..... .... .................. ........ .... ... ....... .. ......................................... ............ 8
3. CONCLUSIONS AND RECOMMENDATIONS .......................................................... ......... 8 3 .I . Conclusions ............ ............................ ........ ............... .. ........... ...................................... . 8 3 .2. Recommendations ................. ........ ........... ............ .... ... ........ .............. .......................... 10 ANNEXES: ANNEX 1 - LIST OF PARTICIPANTS ANNEX 2 - DETAILED DAILY AGENDAS
Keyw01·ds: Condoms-utilization I HIV infections-prevention and control, transmission I Acquired immunodeficiency syndrome-prevention and control, transmission I National Health programsorganization and administration I Health promotion-methods I Prostitution I Asia, Southeastern I Western Pacific
SUMMARY
The WHO Western Pacific Regional Office organized a four-day meeting in Vientiane, Lao People's Democratic Republic (from 18 to 21 August 2003) to share experiences about the 100% condom use programme (CUP) that is being implemented in many countries in Asia. The meeting was attended by 45 participants including country representatives working in the national 100% CUP from Cambodia, China, the Lao People's Democratic Republic, Mongolia, Myanmar, the Philippines, Thailand and VietNam and a broad range of professionals, WHO staff and technical advisers as well as representatives from sex worker support groups, international organizations and partners. Participants discussed the STI/HIV situation in their countries; the extent, types and evolution of sex work; the status of the 100% CUP including the policies in place, sites where the programme is ongoing, implementing strategies, lessons learnt, problems being encountered and future plans; and challenges. A broad range of conclusions were reached at the meeting including recognition that ( 1) HIV transmission associated with sex work remains a great concern for many countries in the Region; (2) all evaluations of the 100% CUP in countries have thus far given good evidence that the programme is effective, replicable across different settings and scalable; (3) countries must implement the 100% CUP within local and national contexts but that there are essential elements of the programme that must b~ given priority; (4)'politica:l commitment both nationally and locally are vital to the success of the 100% CUP; (5) all stakeholders including sex workers should participate in the planning and implementation of the 100% CUP; and (6) the 100% CUP plays a complementary role to other ongoing or evolving programmes that seek to promote condom use and address the problems of sex workers in their communities. '
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Participants recommended to national governments and partners that they will continue to accord a high priority to the 100% CUP and to support national plans to strengthen and expand the programmes.
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1. INTRODUCTION
The "Regional Meeting on 100% Condom Use Programme for Prevention ofHIV/AIDS and STI" was held in Vientiane, Lao People's Democratic Republic from 18 to 21 August 2003. The meeting was organized by the Western Pacific Regional Office of WHO. ~
1.1
Objectives The objectives of the meeting were: (a) to share and discuss the experiences and lessons leamt from the 100% CUP and to obtain consensus on appropriate approaches or practices for the implementation of the 100% CUP;
(b) to review the findings of assessments and evaluations conducted in the different countries; (c) to establish a support mechanism through partnership networks for the expansion of the 100% CUP; and
(d) to increase political and financial support from member countries, partners and donor agencies for implementing and expanding the 100% CUP. 1.2 Participants and resource persons
There were a total of fotty-five (45) persons who participated in the meeting (please refer to Annex 1 of this report) including: 1. eighteen (18) participants from six (6) selected countries ofthe WHO Western Pacific Region: Cambodia, China, the Lao People's Democratic Republic, Mongolia, the Philippines, and VietNam. Participants represented a broad range of officials involved in the design and management of the 100% CUP in their respective countries; 2. three (3) Tempormy Advisers from Myanmar, Thailand and Cambodia to assist with reports on 100% CUP activities in these countries; 3. four (4) Temporaty Advisers from associations of sex workers in Thailand and Cambodia; 4. thirteen (13) observers from agencies interested and involved in 100% CUP in the countries: Australian Agency for Intemational Development (AusAID), DKT Intemational, Family Health Intemational (FHI), Futures Group, Ministry of Health, Labour and Welfare of Japan, Program for Appropriate Technology, Policy Project, PSI, Joint United Nations Programme for HIV/AIDS (UNAIDS), United Nations Population Fund (UNFPA); and the United States Agency for Intemational Development (USAID); 5. two (2) consultants to assist with media and documentation; and 6. five (5) WHO staff from offices in Westem Pacific Region, Geneva, China, Mongolia and Myanmar.
1.3
Organization of the meeting
The meeting was held at the Lane-Xang Hotel, Fa ngum Road, Vientiane, Lao People's Democratic Republic from 18 to 21 August 2003. It incorporated (1) country presentations on status of their 100% CUP, (2) evaluation of three countries 100% CUP, (3) working groups and working group reports on selected issues, (4) technical presentations and (5) plenary discussions. Please refer to Annex 2 for the daily detailed agenda. 1.4 Welcome statement
Dr Giovanni Deodato, WHO Representative in the Lao People's Democratic Republic delivered a welcoming statement to the meeting on behalf of Dr Shigeru Omi, Regional Director, WHO Regional Office for the Western Pacific. Dr Omi observed that there had been remarkable results with the 100% CUP in Thailand and Cambodia and that WHO is advocating this strategy elsewhere in the Region in view of the fact that the sex industry is widespread and growing in many countries. 1.5 Opening of the meeting
H E Dr Ponmek Dalaloy, Minister of Health of the Lao People's Democratic Republic, formally opened the meeting with a statement observing that although Laos currently has a low prevalence ofHIV/AIDS, the country was wonied about the level ofSTI and recognized the need to do more. He looked forward to ·sharing ideas about strategies needed to promote condom use and pledged support to the 100% CUP in the Lao People's Democratic Republic.
2. PROCEEDINGS
2.1
Introductory presentations
Dr Bernard Fabre-Teste, WHO Regional Adviser, Sexually Transmitted Infections including HIVI AIDS, led an introduction of all participants and observers. A rotation of Chair and Co-chairpersons for the meeting was also agreed . Ms Gaik Gui Ong, WHO Technical Officer, WHO Sexually Transmitted Infections including HIV/AIDS, presented a brief history of the 100% CUP in the Asia region. Ms Ong also discussed the objectives of the meeting stressing the need to strengthen and indeed expand efforts through collaboration and sharing of experiences. Dr B. Fabre-Teste presented an overview of the HIV/AIDS and STI situation in the Western Pacific Region. Noting that it is the largest WHO Region, he stressed that the "high potentiality" ofHIV/AIDS was a source of great concern. Dr Wiwat Rojanapithayakorn, WHO Short Term Professional, currently working with the Ministry of Health in Mongolia, made a presentation on the principles of the 100% CUP observing that sexual transmission, most linked to sex work, was the principal mode of HIV spread in many Asian countries. He observed that general education on condom promotion has shown only limited results but that the 100% CUP had shown remarkable results in increasing
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condom use and reducing STI when first implemented in Thailand in 1989. Dr Wiwat expressed confidence that the programme was one of the most effective and efficient ways to reduce HIV transmission linked to sex work that was applicable to a broad spectrum of countries in the Region. Dr Wiwat had added that there were some recent controversies about the programme which were the results of misunderstanding about the programme strategies. A document to clarify the controversies was distributed in the meeting. Mr Ichiro Kamoshita, Senior Vice-Minister of Health, Labour and Welfare, and leader of the Special Japanese Delegation to the Meeting, addressed the meeting, observing that HIVI AIDS is not only a health care problem, but also a great obstacle for social development. Expressing confidence that promoting condom use will also be useful in Japan, he thanked the Government of the Lao People's Democratic Republic and WHO for hosting this useful meeting. 2.2 Country presentations
Representatives of the countries attending the meeting made presentations on the status of the 100% CUP in their respective countries. Special attention was given to lessons learnt and future challenges within the programmes. 2.2.1 Thailand
Dr Anupong Chitwarakorn, Senior Expert in Preventive Medicine, Depatiment of Disease Control, Ministry of Public Health, reviewed data from Thailand's long experience with the 100% CUP, beginning first as a pilot project in 1989 in Ratchburi Province and then expanded nationwide from 1991. Evaluation of the programme showed almost immediate increases in reported regular condom use by sex workers and their clients and a corresponding reduction of STI and HIV in these two groups. More general indicators of the population burden of HIV (e.g. seroprevalence among military recruits and pregnant women) have also declined in Thailand, a result that stands in contrast to a continuing increase ofHIV seroprevalence among injecting drug users. Although 80% of men with STI are still a result of exposure to sex workers, there has been a noteworthy reduction in visits to STI clinics by both men and sex workers since 1992. Also noteworthy in Thailand has been a steady reduction in the number of men who report visiting sex workers (from almost 60% in 1993 to less than 5% in 1999). Looking to the challenges of the future, Dr Anupong observed that more sex workers in Thailand were shifting from direct to indirect types of employment (which required stronger efforts in working with indirect sex establishments) and that more persons were engaging in "casual" rather than commercial sex. Dr Anupong also worried about the impact that vaccines and Highly Active Antiretroviral Therapy (HAART) might have on encouraging more risky sexual practices. 2.2.2 Cambodia
Dr Ly Penh Sun, Deputy Chief of Technical Bureau, National Center ofHIV/AIDS, STD and Dermatology, Ministry of Health, reviewed Cambodia's experience with the 100% CUP. Dr Ly reported that 90% of HIV transmission in Cambodia was the result of heterosexual exposure and that, according to 2002.data, 3.0% of direct sex workers were HIV positive.
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The 100% CUP was piloted in the harbour town of Sihanouk Ville in 1998. Data presented from Sihanouk Ville showed a dramatic reduction in STI between 1996 and 2000 with continuing downward trends since then. It was concluded that the decline was the result of a "combination" of interventions (including both the 100% CUP and improved STI care) and it was decided to expand both services nationwide. Based on initial results of Sihanouk Ville, the Cambodian Prime Minister endorsed the nationwide expansion of the programme in 2000. Twelve provinces were selected for priority expansion because of their HIV prevalence among direct or brothel-based sex workers and their clients. The programme was further expanded to cover the rest of the country throughout 2001 and 2002. Cambodia is looking forward to the challenges of ( 1) ensuring proper monitoring and supervision; (2) extending services to both direct and indirect sex workers; and (3) providing for a greater involvement of sex workers in the programmes. 2.2.3 Myanmar
Dr Tun Myint, Assistant Director/Medical Epidemiologist, National AIDS Programme, reported on Myanmar's 100% Targeted Condom Promotion (100% TCP) programme launched in 2001. Currently being implemented in 58 townships, the 100% TCP started initially in four pilot townships and expanded to 11 additional townships in 2002, and an additional 43 townships in 2003. Dr Tun explained that six agencies (UNAIDS, WHO, UNFPA, United Nations Development Programme, Fund for HIV/AIDS in Myanmar and Japanese Intemational Cooperation Agency) have been providing financial assistance to this expansion. Early evaluations ofthe 100% TCP programme have demonstrated an ongoing and consistent increase in the condom use rate among sex workers and a concurrent decrease in the STI rates in this same population in one area (Tachileik) as well as a general conclusion that the 100% TCP programme is feasible, culturally acceptable and sustainable in the Myanmar context. Myanmar is now looking towards enhancing its cooperation with donors and UN agencies so as to expand this programme nationwide, to expand the availability and distribution of condoms and to translate information, education and communications materials into national languages. 2.2.4 China
Dr Wang Xiaochun, Director, Department oflntemational Cooperation ofNational AIDS Centre (NCAIDS), presented a review of the 100% CUP in China. Beginning with a pilot project at two sites (Wuhan and Jiangsu) in 2000, the programme expanded to Hainan and Hunan in 2002. Despite the problems confronted in the initial phase of the pilot programme (including the high mobility of sex workers and difficulties in verifying condom use), Dr Wang presented 2003 evaluation data which clearly demonstrated an increase in condom use and decrease in STI among sex workers in Wuhan, Jingjiang of Jiangsu and Lixian of Hunan. Data collection from Danzhou of Hainan was interrupted by the severe acute respiratory syndrome epidemic. The focus at the pilot sites was on fostering the 100% CUP policy, especially at the local level, and in drafting national strategies. Dr Wang also recognized that the four project sites are attempting to institute finn policies to ensure the achievement of the final stage of implementation of "No Condom- No Sex."
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Chinese programme staff are cuuently looking toward the potential of expanding and integrating its 100% CUP with the National HIV/AIDS Comprehensive Care and Prevention Project targeting 100 counties (China CARES). Other international partners such as UNFPA (one site in Guangxi) and Future's Group under project funded by Depa1tment for International Development (four sites in Sichuan and Yunnan) have started or are under planning for the replication of the CUP. NCAIDS is also putting on agenda to mobilize sufficient resources from both central and provincial levels to support scaling up in the current four provinces. 2.2.5 VietNam
Dr Nguyen Van Kinh, Programme Officer, Administration for Preventive Medicine and HIVI AIDS Control, Ministry of Health, discussed VietNam's nascent, but growing efforts, with the 100% CUP strategy. With support of WHO, Luxembourg, FHI, Asian Development Bank and the World Bank, VietNam now has 100% CUPs in 17 sites around the country, beginning first in 2001. Thus far, VietNam's 100% CUP is being built around advocacy and IEC, condom social marketing and cooperation with STI services. Baseline data on HIV, STI and condom use have been established and, in data presented by Dr Nguyen, there has been initial indication that HIV and STI declined among sex workers between 2001 and 2002. Challenges for the future of VietNam's 100% CUP include strong anti-prostitution laws in the country, unavailability of condoms in some places and maintaining quality STI services. 2.2.6 Mongolia
Dr Bavuu Enkhjin, Officer in Charge ofHIV/AIDS and STJ, Ministry of Health, reported on Mongolia's initial experience with the 100% CUP in its pilot site in Darkhan aimag which began with WHO assistance in July 2002. 0 • 0
Noting that Mongolia has only four repmted cases ofHIV between 1992 and 2003, Dr Bavuu observed that all were linked to heterosexual exposure. The pilot site in Darkhan was selected because STI rates in the area were above national averages, local authorities were cooperative; STI services and condom social marketing were already in place and it was estimated that there were at least 300 freelance sex workers. Mongolia's 100% CUP has the distinction of working with freelance sex workers through a registration process (issuance of "green cards") which renders them immune from arrest by police as long as they continue to collaborate with the programme. Between 2002 and 2003, Dr Bavuu presented evaluation data that showed a reduction of STI rates among sex workers. Mongolia has plans to expand the 100% CUP to an initial two sites (aimags) in 2004 with support from the WHO and Global Fund. There is also hope that four more aimags can be included in the programme in 2004 and an additional five aimags" a year can be initiated each year between 2005 and 2007. 2.2.7 Lao People's Democratic Republic
Dr Chansy Phimphachanh, Director, National Committee for the Control of AIDS Bureau, Ministry of Health, reported on Laos initial plans for the 100% CUP. A pilot site in Savannakhet Province was initiated several weeks before the meeting.
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Observing that prostitution is illegal and that there are no brothels in the Lao People's Democratic Republic, it was nonetheless recognized that sex is negotiated in a variety of places (night clubs, guesthouses, bars, etc.) and by street workers. Baseline data on sites and number of sex workers has been documented for the pilot site. The future challenges and plans for the Lao People's Democratic Republic revolve around effectively implementing their pilot project within a context of the distinctive cultural and legal climate of the country. 2.2.8 Philippines
Dr Roderick Poblete, Medical Specialist II, Philippine National AIDS Council, discussed the 100% CUP in the Philippines. Building on a long history of routine STI screening of females working in registered entertainment establishments, and a sentinel surveillance system that has been in place since 1997, authorities launched a 100% CUP in three pilot sites in January 2003. The 100% CUP in the Philippines will include a comprehensive package of STI/IEC services and condoms will be promoted and distributed largely through the country's ongoing system for condom social marketing. The greatest problems confronting the programme in the Philippines include the low level of public visibility of HIV in the country, opposition from important conservative groups and the general political unattractiveness of working with sex workers. Despite these constraints, authorities have plans to expand the 100% CUP into additional towns and areas. 2.3 2.3.1 Other presentations Research on the 100% CUP in the Dominican Republic
Dr Gilles Poumerol, Department ofHIV/AIDS, WHO Geneva, reported on the results from a recent academic investigation to detetmine the "Impact and Cost-Effectiveness of Two '100% Condom Use' Models in Dominican Republic". Investigating the impact of the programme using a voluntary "community-and solidarity-based" approach and a programme that used also a 100% CUP "policy", investigators concluded that there was a "more intense impact and better cost-effectiveness when government policy is added." Investigators also concluded that the 100% CUP policy had relevance in non-Asian countries. 2.3.2 Sex worker support groups
Representatives of sex worker support organizations from Thailand (Ms Chantawipa Apisuk, Ms Phenjan Khamkhanan and Ms Siriporn Sriphen from Empower Foundation) and Cambodia (Ms Mang Chrep from the Cambodian Women for Peace and Development with assistance from Ms Nith Sopha of Family Health International) presented their views and concerns about sex work in their national context. Both groups were concerned with the illegal status of sex work and the discrimination they often endure in the hands of governmental authorities. They look forward both to being recognized as a legitimate "entertainment professionals" and also to programmes that will give sex workers training to expand their vocational opportunities.
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2.3.3 POLICY Project Mr David Lowe, Senior Technical Adviser, POLICY Project, presented the results of a study this organization conducted on the Cambodian 100% CUP based on the perceptions of sex workers. While the POLICY Project was overall supportive of the programme's efforts to help sex workers to protect their own and the public health, they were concerned that the 100% CUP in Cambodia had both conceptual and implementation problems that handicapped its effectiveness and compromised the human rights of sex workers. 2.3.4 100% CUP partners
Participating agencies from UNFP A, UN AIDS, USAID, FHI, PSI, DKT, Policy Project, Empower and Futures Group shared their experiences, mid the possible support to the 100% CUP. 2.4 Group Work
At two junctures of the meeting, the plenary was divided into working groups. The first group work considered some cross-cutting problems in implementing the 100% CUP that were revealed in the country reports. The second group work brought counhy representatives together to elaborate on the next steps and resource needs for expanding the 100% CUP in their respective countries. The active plenary discussions that followed the group presentations contributed directly to the conclusions and recommendations.
3. CONCLUSIONS AND RECOMMENDATIONS
3.1
Conclusions
Participants at the meeting reached the following conclusions regarding the status and future of the 100% CUP in the Asian region: The meeting recognized that: (1) HIV transmission associated with sex work remains a great concern 'for countries in the Asian region that have both widespread as well as local concentrations of entertainment establishments and sex work; (2) the experience of countries that have been implementing the 100% Condom Use Programme ( 100% CUP) in the Asian region, supported also by a recent academic study in the Dominican Republic, continues to offer good and growing evidence that the 100% CUP is:
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(a) effective in increasing consistent condom use and decreasing the transmission of STI and HIV associated with establishment-based sex workers; (b) a prevention strategy that is feasible across a diverse spectrum of both localities and countries when tailored lo the local political, cultural and epidemiological needs; and (c) capable of expanding rapidly to a large scale; (3) the successful experience with the 100% CUP in Thailand and Cambodia has served as an effective model appropriate for use in other countries seeking to address HIV transmission associated with establishment-based sex work; the Asian experience with designing and implementing the 100% CUP has grown substantially in the last two years to include China, the Lao People's Democratic Republic, Mongolia, Myanmar, the Philippines and VietNam; (4) most countries implementing the 100% CUP have noteworthy achievements in condom promotion in sex establishments, and recognize the need for more intensive work to achieve the final policy goal of"No Condom- No Sex." (5) all countries with 100% CUP activities were encouraged by the results of efforts to date, and are exploring actively the potential to strengthen and expand their programmes while recognizing that: (a) strong commitments of political support from local, provincial and national leaders is critical for the success of programmes; and (b) additional human and financial resources will be required from local and national levels as well as from bilateral and international partners and NGOs; (6) in areas where there is establishment-based sex work, it is critical to assure that essential policy and strategic components of the 100% CUP is given priority , attention; (7) in the implementation of the 100% CUP, attention should be paid to assure that programme activities are directed only at public health objective and : (a) do not compromise the rights and safety of sex workers and clients; and (b) do not become misconstrued as efforts to legalize or promote prostitution or to encourage promiscuity; (8) the 100% CUP is focusing primarily at establishment-based sex work and there is a need to complement and support other strategies addressing the prevention of HIV/AIDS and STI; and, encourages what efforts governments and partners can undertake especially to: a. assure access of sex workers and clients to high quality STI care; b. promote condoms generally; and, c. reduce stigmatisation and discrimination of sex workers that serve to increase their vulnerability to HIV/AIDS and STI transmission and care.
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3.2
Recommendations
3.2.1 All countries confronting a significant level of STI and/or HIV transmission associated with establishment-based sex work should consider the potentials for implementing a 100% CUP in the context of the local situation and needs. 3.2.2 Govermnents, with the support of national and international partners should: (1) recognize the need to accord a high level of political support for the 100% CUP that is vital to its implementation and expansion; assure a good balance of resources between prevention and care activities; assure the coordinated multi-sectoral involvement in the I 00% CUP; ensure that there is participation of all stakeholders, including sex workers, in the planning and implementation of the 100% CUP at all levels (local, provincial and national.); and seek out opportunities to encourage and support sound scientific research and evaluation with regard to: a. b. c. the changing dynamics of sex work; public he~lth interventions essential to preventing STI/HIV transmission through sex work; and, the perceptions and needs of sex workers and clients relating to the protection of health and prevention of disease transmission.
(2) (3) (4)
(5)
3.2.3 WHO should: (1) increase efforts to assist countries to identify and implement those components that are essential to the most efficient implementation of 100% CUP; work more broadly to assure that there is good understanding among some sectors that the 100% CUP is not an effort to promote or legalise prostitution or to encourage promiscuity; and continue to place a priority on HIV/AIDS and STI prevention programmes.
(2)
(3)
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ANNEX 1
WORLD
HEALTH
ORGANISATION MONDIALE DE LA SANTE
ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
MEETING ON 100% CONDOM USE PROGRAMME FOR THE PREVENTION OF HIV/AIDS AND STI Vientiane, Lao People's Democratic Republic 18-21 August 2003
WPR!ICP /HSI/3.5/001/HSI(3)/2003/IB/2 1 August 2003
ENGLISH ONLY
LIST OF PARTICIPANTS, TEMPORARY ADVISERS, OBSERVERS, REPRESENTATIVES AND SECRETARIAT 1. PARTICIPANTS CAMBODIA Dr Kilin Pisey Supervisor-! 00% Condom Use Programme Bantay Mean Chey Provincial Hospital Ministry of Health 151-153 Avenue Kampuchea Krom PlmomPenh Tel: (855 12) 868 571 Fax: (855 54) 958 923; 958 632 Dr Ly Penh Sun Deputy Chief of Technical Bureau National Center for HIVI AIDS, STD and Dennatology Ministry of Health No. 170 Preah Sihanouk Avenue Phnom Penh Tel: (855 12) 850053 Fax: (855 23) 216 515 E-mail: penhsun@online.com.kl1 Mr Kim Sitha HIV/AIDS Program Manager-AIDS/STD Office Sihanouk Ville Health Department Sangkat 4 Khan Metapheap Sihanoukville Tel: (85512)849001 Fax: (855-34) 933645
- 12Annex 1 CHINA Dr Wang Wenjie Deputy Director Division II Department of Disease Control Ministry of Health 1 Xiwai Nanlu Beijing 100044 Tel: (8610) 68792363 Fax: (8610) 68792514 E-mail: wangwj@moh.gov.cn Dr Wang Xiaochun Director Office of International Cooperation and Program Management National Center for AIDS/STD Prevention and Control No. 27 Nanwei Road Beijing 100050 Tel: (8610) 63039091 Fax: (8610) 63039074 E-mail: wangxc@ 163. net Mr Chen Xi Chief, AIDS/STI Prevention Division Hunan Provincial Center for Disease Prevention and Control 50 Furongzhong Road, Changsha Hunan 410005 Tel: (86731) 4305730 Fax: (86731) 2223945 E-mail: bsichan@hotmail.com
LAO, PDR
Dr Chansy Phimphachanh Director National Committee for the Control of AIDS Bureau Ministry of Health Vientiane Tel: (856-21) 315500; Mobile: (856-20) 518282 Fax: (856-21) 315500 or 315127 E-mail: ncca@laotel.com Dr Panom Phongmany Deputy Director of Health Department Savannillchet Province Tel: (856-41) 212021; Mobile: (856-20) 540943 Fax: (856-41) 214095 E-mail: pphongmany@yahoo.com Dr Phengphet Phetvixay Head ofiEC Unit National Committee for the Control of AIDS Bureau Ministry of Health Vientiane Tel: (856-21) 315500; Mobile: (856-20) 2202498 Fax: (856-21) 315500 E-mail: phetvixay@hotmail. com
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Annex 1 MONGOLIA Dr Bavuu Enkhjin Officer in Charge of HIVI AIDS and STI Ministry of Health 2 Olympic Street Room 212 Ulaanbaatar-48 Tel: (976) 1132-6155 Fax: (976) 9191-0982 E-mail: ebavuu@aids.nm; ebavuu@huuhed.com Dr Khalzan Davaajav Head Department of AIDS/STI National Centre for Communicable Diseases Ulaanbaatar-48 Tel: (976) 11 458787 Fax: (976) 11 458787 Dr Lkhagvajav Zolboot Head, Department of Health Darkhan uul 165 Tel: (976) 01 23165 Fax: (976) 01 372 34303 PHILIPPINES Dr Roderick Poblete Medical Specialist II Philippine National AIDS Council 3'd Floor Building 12 Department of Health Manila Tel. No.: (63 2) 7430512 Fax No.: (63 2) 743 0512 or 3386439 E-mail: pnacsec@yahoo.com Dr Urrninico Baronda Jr. City Health Officer 11 City Heallh Office Ortiz St Iloilo City Tel. No.: (63 33) 3377505 Fax No.: (63 33) 3375284 Ms Gloria Peralta City Administrator City Hall Laoag City Tel. No.: (63 77) 771 4264 Fax No.: (63 77) 771 3168 or 772 1100 E-mail: lapeso@laoag.net
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VIETNAM
Dr Nguyen Van Kinh Program Officer Administration for Preventive Medicine and HIVI AIDS Control Ministry of Health 138 A Giang Vo Street Ba dinh District HaNoi Tel: (844) 8461 591 Fax: (844) 8465732 E-mail: kinhbyt@hotmail.com Dr Hoang Due Hanh Director Ratay Preventive Medicine Center No 23 Nguyen viet xuan street Ha Dong Town Ha Tay Province Tel. No.: 84 34 825901 Fax: 84 34 824490 E-mail: hoangduchanh@hotmail.com Dr Nguyen Van Huan Director Dennatology and Venereology Center Quang Ninh Province Tel: 84 033 835747 Fax: 84 033 835747
3. TEMPORARY ADVISERS Ms Chantawipa Apisuk, Noi Foundation Director Empower Foundation 57/60 Tivanond Road Nonthaburi Thailand Tel. No. (662) 526 8311 Fax No: (662) 526 3294 E-mail: badqirls@empowerfoundation.org Capisuk@access.inet.co.th
Dr Anupong Chitwarakom Senior Expert in Preventive Medicine Depa1tment of Disease Control Ministry of Public Health Nonthaburi 11000 Thailand Tel. No.: (662) 590 3225 Fax No.: (662) 965 9573 E-mail: anupongc@health.moph.go.th
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Annex 1 Ms Mang Chrep Peer Educator Cambodian Women for Peace and Development #11 302 Snakat Beoeng Keng Kang I Phnom Penh Cambodia Tel. No.: (855) 23 360 192 Fax No.: (855) 23 3960 192 Ms Phenjan Khamkhanan Office Manager Empower Foundation 57/60 Tivanond Road Nonthaburi Thailand Tel. No. (662) 526 8311 Fax No: (662) 526 3294 E-mail: badgirls@empowerfoundation.org Dr Tun Myint Assistant Director (AIDS/STD) Director-Disease Control Department of Health 91 Upper Pansodan Street Mingalartaungnyunt township Yangoon Myanmar Tel. No.: 95-1-246704 Fax No.: 95-l-251973 E-mail: hhlwin@cybertech.net.mm Dr Tia Phalla Secretary General National AIDS Authority #33 R 360 Boeing KengKang Phnom Penh Cambodia Tel: (855-23) 214873 Fax: E-mail: naa02@bigpond.com.kh Ms Siripom Sriphen Project Coordinator Empower Foundation 57/60 Tivanond Road Nonthaburi Thailand Tel. No. (662) 526 8311 Fax No: (662) 526 3294 E-mail: badgirls@empowerfoundation.org
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3. OBSERVERS/REPRESEN TATIVES Australian Agency for International Development Rakounna Sisaleumsak AusAID Australian Embassy Rue J. Nehru, Quartier Phone Xay Vientiane Lao People's Democratic Republic Tel. No. (856 21) 413600 Fax No.: (856 21) 413613 E-mail: rakouna.sisaleumsak@dfat.gov.au
DKT International
Mr Larry Holzman Country Director DKT International-VietNam 111 Unit 504, 5 Floor 30 Nguyen Du, Hai Ba Trung HaNoi VietNam Tel. No.: (844) 9437363 (Ext 102) Fax No.: (844) 9437370 Mobile: 0903 456088 Email: HolzmanLC@aol.com larrv@dktintemational.org Mrs Nith Sopha Women's Health Officer FHI/IMPACT- Cambodia #11, St. 302 Sangkat Boen Keng Kang 1, Chamcarmom Phnom Penh Cambodia Tel: (855) 23 211 914 Fax: (855) 23 211 913 E-mail: sopha@fl1i.org.kh Mr Wang Zhenxiu Deputy Program Manager Futures Group Europe-Beijing Office C12 Guanghua Road, Chaoyang District Beijing China Tel. No.: (86 10) 6586 1298 Fax No.: (86 10) 6586 3701 Mobile: 139-1170 4101 E-mail: Wangzx@51condom.com
Family Health International
Futut·es Group
- 17-
Annex 1
Ministry of Health, Labour and Welfare, Japan
Dr Ichiro Kamoshita Senior Vice Minister of Health Labour and Welfare Ministry of Health, Labour and Welfare lntemationa l Affairs Division Minister's Secretariat Governmen t of Japan 1-2-2, Kasumigase ki, Chiyoda-ku Tokyo 100-8916 Japan Tel. No.: (81-3) 3595 2403 Fax No.: (81-3) 3501 2532 Mr Stephen Croll Cambodia Country Program Leader PATH-Cam bodia 22 Street 184 Sangkat Phsar Khan Daun Penh PnomPenh Cambodia Tel: (855 23) 215 005 Fax: (622 23) 720 172 E-mail: Mr David Lowe Senior Technical Advisor POLICY Project Sripat Court Apartment 9A 7 Phaholyothi n Soi 4, Samsen-Nai Phyathai Bangkok 10400 Thailand Tel: (66 0) 2 615 0538 Mobile: (66 0) 1 720 8191 Fax: (66 0) 2 615 0533 E-mail: davidbkkth@ yahoo.com Sihamano Bannavong Communica tions Manager PSI-Lao P.O. Box 8723 Vientiane L1l:o People's Democratic Republic Tel: (856-21) 350740-1 Fax: (856-21) 315334 E-mail: bsihamano@ hotmail.com Khamlay Manivong Country Programme Adviser UNAIDS - Lao PDR P.O. Box 345 Vientiane Lao People's Democratic Republic Tel: (856-21) 213395-97 Fax: (856-21) 241742 E-mail: khamlay.ma nivong@un dp.org
Programme for Appropriate Technology
Policy Project
PSI
Joint United Nations Programme for HIV/AIDS
- 18Annex 1 Ms Geeta Sethi Country Programme Advisor UNAIDS,P.O. Box 877 Phnom Penh Cambodia Tel: 855 23 219 340 Fax: 855 23 721 153 E-mail: unaidscmb@bigpond.com.kh United Nations Populatio n Fund Dr Chaiyos Kunanusont CST Adviser on HIV/AIDS and STI UNFPA-CST Bangkok 14th Floor, U.N. Building Raj damn ern Avenue Bangkok 10200 Thailand Tel: 66-2-2881476 Fax: 66-2-2802715 E-mail: kunanusont. unescap@un.org Dr Chantha Chak Development Assistance Specialist for HIVI AIDS/ID Office of Public Health US Agency for International Development-Cambodia No. 18 Mongkul Earn Street #288 Phnom Penh Cambodia Tel: (855) 23 216 436 ext. 324 Fax: (855) 23 217 638 Mobile: (855) 12-810 213 E-mail: cchak@usaid.gov Dr Jamie Uhrig World Health Organization, Myanmar 71h Floor , 330 Ahlone Road Yangon Myanmar Tel: (951) 212 608 Fax: (951) 212 605 E-mail: uhrigj.whomm@undp.org
United States Agency for Internatio nal Developm ent
WHO, Myanma r
3. CONSUL TANTS
Dr Robert Darrell Fischer Consultant 9000 New Delhi Pl. Dulles, VA 20189-9000 USA Tel: (503) 246 1984 Fax: (503) 262 9547 E-mail: fischer@ie-eg.com; fischer@internetegypt.com
- 19-
Annex 1 Ms Mangai Balasegaram Media Consultant-Freelance Journalist No. 30 Jalan 5/40 Petaling Jaya Selangor, 46000 Malaysia Tel: (6) 012 313 0703 Fax: (603) 7955 1052 E-mail: mangai@wi ldmail.com
4. SECRETA RIAT Dr Bernard Fabre-Teste Regional Adviser, Sexually Transmitted Infections, including HIV/AIDS World Health Organization Regional Office for the Western Pacific United Nations Avenue 1000 Manila Philippines Tel. No.: (632) 528 9714 Fax No.: (632) 521 1036 E-mail: fabretesteb@wpro.who.int
WHO/WP RO
WHO/HQ
Dr Gilles Poumerol Department ofHIV/AID S World Health Organization CH 12111 Geneva 27 Switzerland Tel. No .: (41) 22 791 3539 Fax No.: (41) 22 791 4220 E-mail : poumerolg@ who.int
Ms Gaik Gui Ong Technical Officer Sexually Transmitted Infections, including HIV/AIDS World Health Organization Regional Office for the Western Pacific United Nations Avenue 1000 Manila Philippines · Tel. No.: (632) 528 9718 Fax No.: (632) 521 1036 E-mail: ongg@wpro .who.int
-20-
Annex 1
WHO/China
Dr Zhao Pengfei Project Coordinator, HSI WHO, China 401, Dongwai Diplomatic Office Building 23, Dongzhimenwai Dajie Chaoyang District Beijing 1000600 China Tel: (8610) 6532 7189 to 92 Fax: (8610) 6532 2359 Email: zhaopf@chn.wpro.who.int Dr Wiwat Rojanapithayakorn WHO, Mongolia Ministry of Health Building Ulaanbaatar Mongolia Tel: (976) 11-32 7870 Fax: (976) 11-32 4683 E-mail: Wiwatr@mog. wpro. who.int
WHO/Mongolia
- 21 -
ANNEX2
Meeting on 100% condom use programme for prevention ofHIV/AID S and STis Monday 18 August 2003 ~_e_~~iol\ I
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08 :00 08:30-09:00
Registration Opening remarks (WHO/MoH)
Dr Deodato Giovanni, WR Dr Ponmek, MOH Photo session
Lao Office Dr Bounly
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09:00-09:10 09: 10-09:25 Introduction of participants and selection of daily Chairs Meeting objectives and expected outcomes Overview ofHIV/STI epidemic status
MsG.G.Ong
Dr Bemard F.T.
09:25-09:30
Chairperson
09:30-09:45
Dr Bernard Fabre-Teste
Chairperson
09:45-10:00 10:00-10:30 Principles of the 100% CUP Speech
Coffee/tea break Dr Wiwat Rojanapithayakorn H.E. Dr Ichiro Kamoshita, Vice Minister, Japan Chairperson Chairperson
I 0:30-12:00
10:30 11:00 11 :30 12:00-13 :30
Country presentations and discussions on implementation of 100% CUP -Thailand -Cambodia -Myanmar
Chairperson
Dr Anupong Chitwarakorn Dr Ly Penh Sun Dr Tun Myint Lunch break (Payment ofperdiem)
13 :30-15:00 13 :30 14:00 14:30 15 :00-15:30 15:30 16:00 16:30-17:00
Continuation of country presentations and discussions -China -VietNam -Mongolia Coffee/tea break -Lao PDR - Philippines Experience from Dominican Republic
Chairperson Dr Wang Wenjie Dr Nguyen Van Kinh Dr Bavuu Enkhjin
Dr Chansy Phimphachanh • Dr .Roderick Poblete Dr Gilles Poumerol
Chairperson
• •
Output of day 1: Update ofHIV/STI epidemic in Asia Understanding the principles of the 100% condom use programme • Experience sharing including lessons learned from all countries implementing the 100% CUP
-22-
Annex 2
Meeting on 100% condom use programme for prevention ofHIV/AIDS and STis Tuesday 19 August 2003
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Tim~
·. r, ' · Session
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08:15-08:30
Summary of presentation from Day 1 followed by introduction to group work Group work Coffee/tea break Continuation of group work Lunch break Presentation and discussion of group work Coffee/tea break Continuation of group presentation and discussion How to effectively involve sex workers in the planning and implementation of programmes - EMPOWER/Peer educator (Thailand) - Peer educator (Cambodia)
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08:30-10:00 10:00-10:30 10:30-12:00 12:00-13:30 13:30-15:00
-
Secretariat
Rapporteur
Secretariat
Chairperson
15:00-15:30 15:30
Rapporteur
Chairperson
Chairperson
16:20
16:40
Ms C. Apisuk I P. Khamkhanan/ S. Sriphen Ms Chin Srey Mao/ Mrs Nith Sopha
• •
Output of day 2: Report of discussions with suggested options Strategies to effectively involve sex workers in planning and implementation of programmes
-23-
Annex 2
Meeting onlOO% condom use programme for prevention ofHIV/AIDS and STis Wednesday 20 August 2003
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Summary of Day 2
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08:30-09:15
Case study on assessment and evaluation of the 100% CUP - Thailand - Myanmar - Cambodia Experience from POLICY PROJECT Dr Anupong Chitwarakom DrTunMyint Dr Tia Phalla Mr David Lowe
Chairperson
08:30 08:45 09:00 09: 15-09:30
Chairperson
09:30-10:00 10:00-12:00 Questions and answers and discussions on future challenges
Coffee/tea break
Lunch break
Dr Tia Phalla
12:00-13:30 ~
13:30-15:00
Group work on next steps for implementation and expansion of the 100% CUP in the countries
-
Chairperson
15:00-15:30 15:30-17:00 Presentation of group work
Coffee/tea break Rapporteur Chairperson
Outputs of day 3: • Report on future challenges • Country work-plan on implementation and expansion of the 100% CUP with identification of support needed
-24-
Annex 2
Meeting on 100% condom use programme for prevention of HIV/AIDS and STis Thursday 21 August 2003
Tim 08: I 5-08:30 08:30-09:30
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Summary of Day 3 Experience sharing from Participating agencies
Dr Robert Fischer Representative from Participatil1g agencies
Chairperson Chairperson
09:30- I 0:15
Future development and next steps
Coffee/tea break
Dr Robert Fischer
I 0:15-10:30 I0:30-12:00 Discussions on conclusion and recommendations
Dr Robert Fischer
Chairperson
12:00-13:30 13:30-14:45 Consensus on conclusions and recommendations Closing ~
Lunch break Dr Bemard FabreTeste Chairperson
!4:45-15:00 I5:00-15:30
NCCAB Coffee/tea break
Outputs of day 4:
•
•
Activities for future development and next steps Conclusion and recommendation of the meeting