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  1. Section Editor(s): Kennedy, Maureen Shawn MA, RN

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Bulgarian nurses in jail-and in limbo-as trial is postponed again. Five Bulgarian nurses and a Palestinian physician (pictured at right in May) continue to await retrial in Libya, where they have been held since 1999 on charges of deliberately infecting 400 children with HIV at a hospital where they worked. Their original conviction and sentence-death by firing squad-was overturned by the Libyan Supreme Court in 2004, but their retrial in a lower court has been repeatedly postponed, despite calls from the European Union for their immediate release and insistence by defense lawyers that confessions were obtained under psychological torture. Medical experts claim that the Libyan children's HIV infection predated the arrival of the nurses and the physician at the hospital and was caused by such practices as the reuse of infected needles.

 

The ICN joins the call for a women's agency. Representing the world's 13 million nurses, the International Council of Nurses (ICN) is encouraging its members to support the formation of an international women's agency through the United Nations. According to Stephen Lewis, the UN Special Envoy for HIV/AIDS in Africa who led a UN Coherence Panel in July, such an agency should be a well-funded organization with a global vision. It would work with governments to develop public policy to help improve the lives of women, seek funding from donors, support nongovernmental organizations and other women's groups, and lobby for the equality of women in every aspect of life, from health care to politics. "That's exactly what UNICEF does for children," Lewis said in his presentation. "Why can't we have the same for more than half of humankind?" To see the report, "Gender Equality Now or Never: A New UN Agency for Women," go to http://www.icn.ch/UNwomen_agency_position_paper.pdf.

 

Killer environments. According to a recent report by the World Health Organization, about 23% of premature deaths worldwide can be attributed to unhealthful environments. Chief among the conditions with environmental causes are diarrhea, lower respiratory infections, injuries arising from radiation and workplace hazards, and malaria-all prevalent in developing countries. The report, "Preventing Disease through Healthy Environments," cites preventable environmental factors as causes in over 33% of diseases in children five years of age or younger, arguing that establishing access to clean water, improving sanitation, and educating people on basic hygiene could save millions of lives each year. Go to http://www.who.int/quantifying_ehimpacts/publications/preventingdisease/en/index.

 

Increasing the rate of male circumcision in sub-Saharan Africa. It might prevent millions of new cases of HIV and deaths from AIDS in the next 20 years, according to a report published in the July 2006 issue of PLoS Medicine. Researchers applied statistical projections to data from a prior randomized, controlled trial showing that male circumcision lowered rates of HIV transmission from women to men by 60%. The data from this trial were consistent with a lower prevalence of HIV infection in with a higher prevalence of male circumcision. Because estimates can be uncertain of the prevalence of male circumcision and HIV infection in Africa, and because projections are based on only one study, the authors call for a large-scale, community-based program to increase male circumcision, with results monitored carefully, to determine its effects over time.

  
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At the 16th International AIDS Conference held in Toronto in August, the World Health Organization and several UN agencies released a joint statement noting that they "do not currently recommend the promotion of male circumcision for HIV prevention." But while awaiting the results of trials scheduled to end next summer, agencies are developing guidelines for safe circumcision.