Executive Summary

The main feature of this quarter has been the official transition of the Center's management. A coherent management structure had to be devised so as to ensure the Center's ability to expand its scope of work and funding capacity, while sustaining its activities and commitments. This occurred during heavy teaching commitments of Center staff at the HSPH, stretching the Center to the upper limit of its implementation capacity. Critical to the Center's relations to its partners was to ensure that the image it projected internationally was one of dynamism and targeted expansion. Accordingly, activities were strengthened in policy and program development and in training. A review of the financial situation of the Center revealed critical issues that also needed to be addressed in order to implement the Center's workplan, while raising additional resources to ensure its expansion. Efforts have been made to raise funds for the Health and Human Rights journal. Fundraising for Operationalizing Cairo and Beijing: a Training Initiative in Gender and Reproductive Health has begun both through the School's Development Office and in direct contact with potential funders. A comprehensive umbrella grant application was submitted to UNAIDS which, during this quarter, had nominated the FXBC/HSPH as one of its first Collaborating Centers.

The Center devoted a great deal of attention to broadening the scope of its work as it relates to children and young people, particularly in the context of HIV/AIDS. This was done through a multifaceted approach which included working with UNAIDS on the background documents for the 1998 World AIDS Campaign, preparation of materials for training on HIV, health and the rights of the child, both within the School and outside, and the completion of publication of an article concerning the rights of children confronting HIV/AIDS. Published in one of the two special issues of the Health and Human Rights journal dedicated to HIV/AIDS, this article will also serve as a strategy document for combined action by UNAIDS and its cosponsors, in particular WHO and UNICEF. To further respond to the needs of children in a world with HIV, the Center has begun a collaborative project on assessing and responding to care and support gaps experienced by adults and children living with HIV/AIDS in developing countries. The project, which will begin in Brazil and Senegal, is a major step towards linking prevention strategies--which have been thus far the mainstay of the Center's work in HIV--to care issues.

Center's staff have also been elaborating projects submitted for funding to international agencies in order to bridge policy and strategic development on the one hand, and field based evaluation and program development on the other. This is necessary to ensure that further conceptual development remains firmly anchored on field realities.

The Center has been expanding its partnerships, in particular in conjunction with the 50th anniversary of the UDHR. Working in coalition with other groups, including international NGOs and academic and student groups has been challenging. However, the Center played a catalytic role in building a series of effective and engaging activities around the theme of the UDHR, particularly through the launching of a joint information campaign that will celebrate its 50th anniversary. The participation of the HSPH in ensuring that the 50th anniversary receive appropriate attention is helping to enhance the impact of the campaign, both inside the University and with the health and human rights community at large.

Following are activities which marked the first quarter of 1998.

Core Activities

Education and Training

At HSPH

Courses offered during this period at the Harvard School of Public Health were The Frontiers of Knowledge in HIV/AIDS Prevention, Care and Research (PIH 258b) and Health and Human Rights (PIH 218c:). The AIDS course offered guest sessions by experts in the various areas of HIV/AIDS research, prevention, care, and treatment, and received high marks from students again this year. Health and Human Rights, now in its 5th year, was restructured to optimize student involvement. The course included discussion and group case study work. Topics covered include children, reproductive health, HIV/AIDS, and landmines. Both courses were extremely well received by students and received highest mention on student evaluation forms.

Creation and curriculum development of Women, Gender and Health, a core course for the Interdepartmental Program on Women and Health, co-sponsored by PIH, MCH, HPM and HSB departments, has been completed. Currently syllabus and course materials are being prepared; the course is scheduled to be offered by Sofia and Nancy Krieger in the "b" period 1998-99.

Student Tutorials/Advising

Center staff supervised a number of students in individual and group work; areas of study included: the impact of policing on the health of intravenous drug users , HIV laws and privacy, and the health impacts of racial discrimination on health and access to health services in the U.S.A.

Elsewhere

Operationalizing Beijing: A Training Initiative in Gender and Reproductive Health

This multifaceted project, to be completed by the year 2000, was created in partnership with the World Health Organization and the Women’s Health Project, Witwatersrand University. The International Coordinating Committee met in late January in Geneva to finalize the workplan for the next several years. Contacts have been made with several foundations to explore funding options for core activities and the regional centers.The pilot course, which was held in South Africa in August 1997, is serving as the basis in the design of training modules. Additional regional training centers in Argentina, Australia, China, Egypt, and Kenya have been selected. Each training center will conduct the three-week course for government officials and adapt the training modules to country-specific needs.

Dissemination of Information

HHR Journal

Sofia Gruskin took over the editorship of the journal Health and Human Rights in January 1998. During the review period, work on special theme issues on HIV/AIDS and Human Rights was completed. Since the articles offer a wide range of information and of current thinking on the subject, it was decided to publish two companion issues of the journal. Part I (The Roots of Vulnerability) is published as Volume 2 No. 4, and Part II (Uprooting Vulnerability) will be published in Volume 3. No. 1 in April. The special two-issues set will be available in time for the 12th International Conference on HIV/AIDS in Geneva.

Books

Health and Human Rights: A Reader An up-to-date anthology of writing on health and human rights providing a broad spectrum of views and voices from around the world was completed in this period. It will be published in time for the 50th Anniversary of the Universal Declaration of Human Rights by Routledge Publishers New York. This book was co-edited by Jonathan Mann, Sofia Gruskin, and Michael Grodin and George Annas from Boston University, School of Public Health.

A text book entitled Cardiology and AIDS, edited by S. Lipshultz, was released. It contains a chapter by Daniel Tarantola on the global epidemiology of AIDS.

Articles

Children Confronting HIV/AIDS: Charting the Confluence of Rights and Health

Sofia and Daniel put together an article summarizes the three situations--children infected, affected and vulnerable -- and three levels of governmental obligations to respect, protect and fulfill rights -- which should be considered when identifying children’s specific needs and rights in the context of HIV/AIDS. A method is proposed to analyze systematically the confluence between HIV/AIDS and children’s rights. It will be published in the AIDS issue of the journal Health and Human Rights, this approach will serve as the basis for a broad analysis/application to be used by UNAIDS.

Reports

Monitoring the AIDS Pandemic (MAP) Network

Data collection and analysis has begun for the compilation of the regional report on the Status and Trends of the HIV/AIDS Epidemic in Eastern Europe. Both the report on Eastern Europe and the MAP World Report on the Status and Trends of the HIV/AIDS Pandemic will be released in Geneva just prior to the opening of the 12th International Conference on HIV/AIDS. MAP’s regional reports on the HIV/AIDS epidemics in Asia and the Pacific, Africa, and Latin America and the Caribbean are being widely referenced. Some delays have occurred in finalizing the reports and putting them on-line. However, it is expected to have all reports on-line shortly. The MAP secretariat was transferred from Washington-based AIDSCAP to the FXB Center with Daniel continuing to serve as the co-chair.

Multimedia

50th Anniversary of the Universal Declaration of Human Rights

The Health and Human Rights Consortium, of which the FXB Center is a founding member, has been very active in this period. The Consortium meets monthly and in addition to a number of activities connected with the 50th anniversary of the UDHR has created a website, and produced and printed a statement on the 50th anniversary of the UDHR which, with a reprint of the UDHR, is being sent to all schools of medicine, public health, and nursing to encourage observance of the anniversary. A revised version of the Consortium’s statement has also been accepted by JAMA for publication this August.

The Center is also working with the Health and Human Rights Student Group at HSPH to promote the UDHR50 campaign school-wide. Students have held signing sessions in support of the anniversary; these signature pages will be included in Amnesty International’s Biggest Book of the World to be presented to the United Nations on December 10. Additional activities will be held throughout the academic year.

FXB Center Seminar Series

Three seminars were offered for students, staff and faculty at HSPH in this period. Dr. Zieba Shorish-Shamley, chairperson of the Washington-based Women’s Alliance for Peace and Human Rights in Afghanistan, discussed the health status of Afghan women under the Taliban rule. Professor Henry Steiner, Director of the Human Rights Program at Harvard Law School, talked about the relevance of economic and social rights in relationship to human development. Susannah Sirkin, Deputy Director of Physicians for Human Rights, gave a presention on the 1998 Nobel Prize winning International Campaign to Ban Landmines.

Research

The Right to Privacy/Confidentiality and HIV

A research project exploring privacy issues relating to HIV such issues as employment, education, prison settings and partner notification, including comparative jurisprudencial analysis of laws and court cases around the world will be completed by early April.

Enhancing HIV/AIDS Care

Multicenter 5-year study in 5 countries (Brazil, Mexico, Thailand, South Africa, Botswana) in partnership with the Harvard AIDS Institute supported by a grant (1 million per year) from the Merck Corporate Foundation. The study explores various models of HIV/AIDS care, assess their impact and economic implications, and guide countries in the development of their own standards of care. The project has begun in Brazil and project coordinators have been hired.

The initiative will officially be launched at the 12 International Conference on HIV/AIDS in Geneva with a special session held on the opening day.

Assessing national and international financing of AIDS programs

A 80-country study of funds allocation on AIDS prevention and care/treatment campaigns supported by a grant from UNAIDS. This study will define the patterns and use of financing, and suggest mechanisms for sustainable monitoring of resources in responding to HIV/AIDS worldwide. A comprehensive report will be submitted to the Program Committee Board of UNAIDS in May.

Confronting the Clash of Women’s and Children’s Interests in Public Discourse

This study to develop a coherent and pragmatic public agenda integrating the health needs and rights of women with the health and rights needs of children is continuing. In partnership with Dr. Paul Wise (Boston Medical Center) and supported by a grant from the Children’s Studies project of the Harvard Project on Schooling and Children. Research leading to several products including publications and conference is underway.

Policies and Programs

World AIDS Campaign/UNAIDS

The FXB Center was invited to act as the special advisor for the 1998 World AIDS Campaign which focuses on youth.

UN Commission on the Status of Women

The FXB Center prepared several position papers in conjunction with the Commission’s secretariat, governments and other nongovernmental organizations relevant to review of the Platform for Action for the 4th World UN Conference on Women in Beijing. The focus for this year was the girl-child, violence and human rights.

Linkages and Partnership

UNAIDS

The FXB Center has been invited to become a UNAIDS Collaborating Center. For 1998, a comprehensive project has been proposed for a human rights strategy which will include work on policy analysis and monitoring (best practice quality assurance, human rights treaty bodies and financing of AIDS response), capacity building (AIDS service organizations, human rights and HIV, data needs and use, country program advisors and theme groups training, children, health and rights), and ad-hoc technical cooperation towards the expansion of the global response to HIV/AIDS.

WHO

The FXB Center continues to consult with several programs at the World Health Organization on reproductive health, indicators, law, gender and development, and HIV/AIDS care.

White House Global AIDS & Rights

Ms. Sandra Thurman, the Director of the Office of National AIDS Policy in Washington requested a meeting with Center staff to discuss areas of mutual concern and possible future activities. Center staff met with her and the deputy director, and agreed on information exchange and collaboration on projects of mutual interest, starting with international advocacy.