"The success of women’s goals for gender equality and poverty alleviation lies in every nation’s willingness to tackle such sensitive issues as reproductive health and family planning objectively." This was the message to participants from the President of the Philippines, H.E. Gloria Macapagal-Arroyo, delivered on her behalf by Executive Secretary Mr. Alberto Romulo. The links between population size, carrying capacity of natural resources and families’ quality of life were highlighted and the importance of family planning in addressing population issues was stressed. In closing, the President made three points: ‘Firstly, all participants commit themselves to widespread information dissemination in their respective countries. Secondly, the success of efforts depends on convincing not only the women, but the men of Asia, and, finally, that all parliamentarians in Asia should unite to sustain the region’s fight for the protection of its women and children, and the fight against poverty.’

In his welcome address, Senator Biazon informed participants that the culture perpetuating conceptions of women as full-time homemakers subordinate to men, people against whom violence is a private matter, a reserve labour force and as sexual objects remains deeply embedded among Asians and other nationalities around the world. He said, "we must raise our voices in unison with other advocates of change to do all that we can so that disenfranchised women become empowered, attain a critical mass in political and legislative bodies and, for those already in positions of influence, to assert their leadership and address urgent social development issues confronting all nations today."

"The nagging issue of gender inequity and inequality is what the AFPPD Standing Committee on Status of Women has been tasked to address," Mrs. Kelly Hoare MP Australia stated. Empowerment of women must, therefore be social – where a woman is given space for herself; economic – where a woman has the ability to acquire capital and the strength to decide how she wants to use it; and political – whereby a woman can assert her basic right in decision-making.

Senator Malinee explained to participants how some countries such as Thailand, Vietnam, Indonesia and Cambodia are working hard on VAW legislation. "In Thailand, with AFPPD support, two bills on VAW have been processed and ready to be presented to the Parliament. For 2004, AFPPD has made plans to further extend empowerment of women activities for male and female parliamentarians across the region," she said. Senator Malinee felt the conference would provide an excellent opportunity to deepen parliamentarians’ knowledge of women’s issues and it would propagate innovative ideas to promote the status of women and reduce male domination, particularly in the political arena.

Parliamentarians and officials from global and regional parliamentary groups including FAAPPD; IAPG; IEPFPD; PGA; UNFPA; IPPF; EPWG; PNoWB; and the Council of Europe attended the meeting. AFPPD was represented by Senator Malinee Sukavejworakit MD, Secretary General, and Mr, Shiv Khare, Executive Director.

The meeting was organised by UNFPA in cooperation with the Inter-European Forum of Parliamentarians on Population and Development (IEPFPD) in order to discuss the agenda and directions for the upcoming IPCI 2004, which will focus greatly on 10th anniversary of the ICPD. The ICPD’s Plan of Action will reach its mid-point next year and it was decided to commemorate this and the ICPD through the pragmatic and constructive country-by-country analysis of achievements, constraints encountered and lessons learnt so far. The upcoming conference will also provide an opportunity for reflection on ICPD goals and demonstrations on how, with parliamentarians support, achieving these goals will contribute to the attainment of the Millennium Development Goals (MDGs).

First on the Steering Committee’s agenda was the review of the purpose and proposed outline of the IPCI conference delivered by Mr. Stirling Scruggs, UNFPA.

He spoke on the impacts the first IPCI had on parliamentarian programmes and achievements and Ms. Harumi Kodama gave the evaluation of and feedback on the 1st IPCI, which took place in Ottawa in 2002. Reports on follow-up activities undertaken as a result of the Ottawa Conference in 2002 were then presented by the executive directors of AFPPD, FAAPPD, IAPG, IEPFPD and PGA. Other points for discussion included an overview of plans for the ICPD+10, identification of priorities for the IPCI 2004 and ICPD+10 such as focus areas, issues and topics, specifications on the date, venue and programme of the conference and coordination and synergies of IPCI 2004 with other ICPD +10 related activities.

Overview of HIV/AIDS in Asia was the first topic of the workshop and resource person Mr. Paul Toh, Inter-country Programme Development Advisor for UNAIDS / SEAPICT gave the first presentation focusing on the AIDS situation in South and Southeast Asia and whether enough is being done to combat HIV/AIDS. The session was moderated by Representative Patricia Sarenas from the Philippines.

Political Courage in Thailand – Mr. Paul Toh, UNAIDS

"Asian AIDS epidemics spread through specific, identifiable behaviours and pop-ulations, and these epidemics are vulnerable to focused efforts," Mr. Toh explained. "Prevention efforts can reap immense benefits in Asia; a good example of this would be the case of Thailand, which was able to avert over five million new infections." "However," Mr. Toh continued, "it takes political courage to ‘do the right thing’ and the way forward is through effective as opposed to easy prevention programmes, ensuring resources are focused on the right populations, to take a pragmatic rather than dogmatic approach and to be more open about the extent of risk as HIV ‘thrives in the dark.’" In conclusion, Mr. Toh said that the lessons still have not been learned as awareness and condom use are low in many countries, coverage of prevention programmes is limited, and effective responses are rare. He felt that if prevention efforts were focused and paid specific attention to adolescents, the opportunity to significantly decrease the number of HIV infections would be tremendous.

Broken down into two parts, ‘Introduction to Vaccine Research, Development and the Clinical Trial Process’ was the topic for discussion in session two. Prof. Emeritus Prasert Thongcharoen gave a presentation during the first segment with Ms. Patricia de Lille MP South Africa moderating.

Prevention is Better Than Cure - Prof. Emeritus Prasert Thongharoen, MOPH

Prof. Prasert, Chair of the Subcommittee on HIV/AIDS Vaccine Development, Ministry of Public Health, Thailand, listed various methods for effective HIV/AIDS prevention, including education and behaviour modification, drug abuse treatment, condoms, topical microbicides, and vaccines.

Prof. Prasert was optimistic that an AIDS vaccine would be developed in the not too distant future as there are sound scientific and strategic reasons that support the extensive efforts in HIV vaccine discovery and development. He then went on to describe in detail the steps taken in vaccine process and the types of experiments that are undertaken during the vaccine development process. Finally he provided insights into the ongoing Phase III efficacy trials in Thailand.

In part two of session two, Dr. Jean-Louis Excler, Scientific Director of IAVI India and Dr. Pannee Pitisuttitham, Associate Professor, Faculty of Tropical Medicine, Mahidol University, gave presentations. Ms. Kate Bourne, Vice-President of IAVI New York moderated.

"The global scale and entrenchment of the HIV/AIDS epidemic mandates a multi-sectoral response that is dynamic and inclusive, and takes into account diverse behaviours, values and social structures," commenced Dr. Excler. "Broad public involvement in AIDS vaccine development is therefore needed to support the development of new technologies for public health, while also promoting other fundamental human rights related to biomedical research, such as the right to individual freedom and security, and the right to individual, voluntary, and informed consent to participate in the research." He then explained that the different vaccine concepts developed by IAVI come from various sources including academic institutions, biotechnology companies, and pharmaceutical industries while manufacturing and quality control are performed through contract manufacturers and laboratories or by biotechnology and pharmaceutical companies.

In conclusion, Dr. Excler told participants it would be prudent to consider HIV vaccines within a reasonable timeframe of availability in order to manage expectations and avoid creating false hopes. Overall, Dr. Excler felt that ten to twenty years may be needed from now before there is any tangible impact on the HIV epidemic.

Dr. Pannee Pitisuttitham, Associate Professor, Faculty of Tropical Medicine, Mahidol University Thailand went into specifics regarding HIV trials and the development process or a vaccine in her presentation. She revealed that the first HIV vaccine trial enrolled volunteers in 1988 and that, so far, forty-nine trials of twenty-six vaccine candidates have been studied through NIAID’s AIDS Vaccine Evaluation Group. She explained that good clinical practice is to have regulations governing the conduct of clinical studies and that good laboratory practice is to have regulations governing the conduct of non-clinical safety studies and in vitro practices.

Reasons to Remain Optimistic

Dr. Pannee said that there are many reasons to remain optimistic for the development of a successful and effective AIDS vaccine. She divulged that passive transfer of anti-HIV or anti-SIV antibodies to chimps and monkeys has prevented infection under certain conditions, several HIV vaccine candidates in early human trials have proven to be ‘safe’ and immunogenic, and biostatistical modelling suggest that even a partially effective preventive intervention may have a powerful effect on the AIDS epidemics.

Site Visits to BVEG

’Experiences and Key Priorities of Parliamentarians’ was the title of session three. Dr. David Apuuli, Director General of the Uganda AIDS Commission, moderated.

The session focused specifically on recapturing the experiences of the site visit and previous discussions on the role of parliamentarians in creating a facilitating environment for vaccine development and use. Participants spoke on country-by-country issues and exchanged views, and key priorities. Action points parliamentarians should focus on were identified.

Moderated by Mr. Andy Quan, Representative of the Australian Federation of AIDS Organisations, session four sought to identify actions and find ways to minimise existing hurdles in order to maximise future access to all HIV-related services. Dr. Praphan Phanupak, Director of the Thai Red Cross AIDS Research Center and Dr. Surya Chandra MP Indonesia both gave presentations.

Dr. Phanupak provided some insightful directions and food for thought for parliamentarians with regards to HIV/AIDS. He said first and foremost all parliamentarians must be aware of how to prevent either themselves or their family members becoming infected by the virus. They should know the raw, updated HIV infection statistics in their own countries – and, in order to keep the data ‘fresh,’ continuing surveillance is pivotal. Finally, all parliamentarians must be well informed on the controversies and accepted international norms that surround HIV/AIDS. At the governmental level, parliamentarians need to know how to get things done with budget allocations, in their own constituencies, with inter-country collaboration, and with bilateral, regional, and international collaboration.

Dr. Chandra MP, speaking for a comprehens-ive approach towards ending the epidemic, noted the difference in challenges between industrialised and developing countries when conducting preventive HIV vaccine efficacy trials. Developing countries are particularly concerned with exploitation and unequal partnerships, lack of funds and infrastructure and training needs such as good clinical practice. Industrialised countries exhibit mistrust of researchers and governments and this exacerbates misunderstanding and mistrust of vaccines in general. He then went on to say as HIV is a relatively new disease, many drugs are also new and, consequently, are marketed at very high prices, but if the HIV/AIDS epidemic is to be controlled, then it is imperative these drugs are made available to those who need them and efforts to improve access must be increased.

The role of media in supporting HIV/AIDS vaccine development was presented by Mr. Dillip Cherian, India, and Mr. Tawee Jantrapromlin Thailand. The session was moderated by Mr. Ajoy Bose, IAVI, Advisor for Public Affairs.

Media is an Important Advocacy Tool

Mr. Cherian and Mr. Jantrapromlin explained to parliamentarians how they could use the media as an advocacy tool and how best to interact with journalists. They also provided some useful tips on how to get key messages across and how to deal with misquoting and misreporting.

Identifying key resources – financial, policy and social – that are needed to promote continued research in vaccine development, Ms. Kate Bourne, IAVI Vice-President spoke in session five. Dr. Li Honggui MP China was moderator.

In her introduction, Ms. Bourne cited IAVI’s mission statement: ‘IAVI’s mission is to ensure the development of safe, effective, accessible, preventive HIV vaccines for use throughout the world. She clearly outlined the four elements to developing country focus: Advocacy – build worldwide support and demand for AIDS vaccines; Science – accelerate promising vaccines into development and human trials; Industry – create markets and incentives to encourage private sector investment and involvement in AIDS vaccines; and Access – Assure policies and infrastructure for global access to AIDS vaccines. She told participants to imagine a world without AIDS and then challenged them to address HIV/AIDS issues at the local, national, regional and global level.

After Ms. Bourne’s presentation, participants were divided into two working groups to come up with recommendations. The first group worked on accelerating research and development while the second focused on accelerating access. Each group then presented its findings and recommendations during a facilitated discussion.

What type of services are available to HIV-infected persons in Japan?

The number of HIV-infected persons in Japan is relatively small as is the number of persons requesting HIV tests, but certain hospitals have been assigned to conduct HIV testing. Every precaution is taken to ensure total confidentiality and not disclose the patient’s name as sadly there is still a great deal of social stigma attached to HIV/AIDS. Important information on HIV/AIDS can also be obtained at these facilities.

What type of programmes are there in Japan to assist elderly people?

There are many programmes in Japan specifically catering to the elderly. For example, we have a day care scheme, which enables old people who are disabled or suffering from illnesses to obtain help to enhance their social adaptability as well as receive adequate health care. My mother, who is nearly one hundred years old, receives assistance from this welfare service and has someone who visits her and helps her with shopping, housework and other activities that she may have difficulty with.

With regards to health care, the elderly can go to the hospital and see special consultants who only charge for their first visit. Any further visits are free of charge.

In addition, we also have what is known as the ‘Silver Employment Human Resources Center’- a unique establishment that provides people over sixty years old an opportunity to obtain paid work on a daily basis. This has proven to be a great success as it not only enables the elderly to earn some money, it is also an excellent way of ensuring they remain active for as long as possible. Frequently, elderly persons have specialised skills and an extensive knowledge in unconventional fields, which can be put to very good use. I think it is important to keep the elderly actively involved in the community as it promotes a positive mind frame and ensures they don’t lead a dull life just sitting at home.