On the occasion of World AIDS Day, Cambodian Alliance for Combating HIV/AIDS (CACHA) campaign and activities were carried out on 1st December 2006 nation wide. The major activities that took place were like, joint statement calls for greater accountability and a more effective approach that targets the basic needs of HIV-positive people such as access to affordable drugs, employment opportunities, education, healthcare, and housing services.

CACHA statement is submitted to Excellency Madam Hor Naun, Member of the Permanent Committee of the National Assembly Chairperson of Commission on Public Health, Social Work, Labor and Women Affairs. This statement is covered by international/local radio/TV and newspapers. More, people living with HIV/AIDS were interviewed by the different media for newspapers, radio and TV. On the very occasion CACHA also appealed to the government to take action on the following problems.




ARV TESTING :

The National ethic committee recently approved the implementation of a drug trial that will be conducted in Calmette hospital with Pasteur Institute. The trial corresponds to the phase 2 for the experiment of the Truvada which is supposed to be more effective than Nevirapine for the reduction of HIV/AIDS transmission from mother to child. The drug is also expected to have less side-effect and not to generate similar resistance as Nevirapine. Even if the present trial is mainly restricted to obtain the exact dosage of the drug (quantity of the product that is transmitted from the mother to the child after the delivery), we need to have written documents attesting the proper medical following up of the volunteers on a long term basis, and their access to insurance provision in case of health related problems.

More, we are concerned about the outcome of the third phase of the trial if implemented in Cambodia on a large scale. If the Truvada drug is proven to be effective, it will be patented by Gilead company in the USA. There are chances that the price of the brand drug may be expensive and thereby may not be available in poor resource settings including countries like Cambodia that accepted the trial to be made. We ask therefore for substantial guarantees of the availability of the drug in the future at an affordable price for the country.

"We need drugs but we also need a code of conduct."

• We appeal to the government to release all the details to the community about drug-testing agreements and consult with the public.

PHARMACEUTICALS :

Drug sales are not regulated in Cambodia. Fake and expired drugs are often dispensed by unqualified staff at private pharmacies. The result can be serious illness and even death.

We have reports about medical staff and other individuals in Phnom Penh and the province profiting from drugs which are meant for HIV-positive people. These practices can be lethal for HIV-positive people. These allegations are serious but difficult to provide evidence.

"Patients are afraid to speak out because they think they will lose their medical services."

• We appeal to the government to stop the sale of fake and expired drugs and fulfill the requirement of pharmacists to dispense drugs professionally.
  
  
• We appeal to the government, especially the Ministry of Health and NCHADS to monitor the system of procurement and distribution of ARVs.
  
  
• We appeal for the assurance of the quality ARVs that will reach the people who need.
  
  
• We appeal to the government to assure the distribution of drugs in hospitals is closely monitored.
  
  

TREATMENT :

Many people work hard to provide services to HIV/AIDS patients. However, some medical staffs do not behave professionally, and discriminate against HIV/AIDS patients. People cannot talk to the doctors about this problem. Hospitalization and other medical treatment are still too costly for HIV-positive people. The code of ethics is often not well respected among many medical professions.

"Access to quality medical care is a right, not a privilege."

• We appeal to the government to provide public medical facilities with medical staffs who treat patients professionally and with humanity.

EMPLOYMENT :

HIV-positive people suffer from stigma and discrimination even in HIV/AIDS projects. People lose their jobs and their customers in the factories, marketplace, civil service school and other places.

In the past, the government and NGOs agreed to the idea of "Greater Involvement of People Living with AIDS" (GIPA), especially in HIV/AIDS projects. Government guidelines state 2-3 positive people should be employed in each Home-based Care (HBC) Project, but they are not. Most HIV-positive people who do get jobs on HIV/AIDS projects are employed as volunteers.

"HIV-positive people have the same right as other people to get jobs"

• We appeal to the government to implement policies in HIV/AIDS programs that:
  
  
  1. Encourage HIV-positive people to apply for and give them priority;
     
     
  2. HIV-positive people should be paid wages equal to others;
     
     
  3. Provide a minimum salary of US50 per month (including HBC workers and "volunteers");
     
     
  4. Implement the policy of hiring 2-3 HIV-positive people for each HBC project.
     
     
• We appeal to the government to formulate and implement laws that protect and encourage people living with HIV/AIS (PLWHA) in the workplace everywhere and for that ILO guidelines could be useful to consider.

SOCIAL SERVICES :

People sell everything including land to pay for health related problems like HIV/AIDS. They are not able to provide education for their children. They cannot feed their families. Many of the children become orphans or vulnerable to all kinds of abuse.

"The families of HIV-positive people need food, jobs, shelter and training."
We appeal to the government

• To help the families with serious medical issues like HIV/AIDS who are being forced to leave their house and land.
  
  
• To help find shelter and land for homeless families of PLWHA.
  
  
• To provide services to the wives and families of military with HIV/AIDS.
  
  
• To provide family of PLWHA (including orphans and vulnerable children) with education and vocational training.
  
  
• To provide mental health services.
  
  
• To provide rehabilitation centers for drug abusers.
  
  
• To assure that police and the court protect the rights of orphans and vulnerable children.
  
  

On this World AIDS Day, the voices of HIV-positive people appealed to the government to take action to solve these problems in the interest of all Cambodian society.