Subject: COMMENTS ABOUT UNAIDS: PLEASE RESPOND
From: [email-masked]
Date: Wed, 4 Mar 1998 21:43:43 -0600 (CST)

AN OPEN LETTER FROM TRIANGULO ROSA ABOUT UNAIDS
 AND ACTIVISM IN THE DEVELOPING WORLD

We are  herein forwarding the entire text of a rather surprising
communication that we  received on March 2nd   from UNAIDS, following a
letter sent by Richard Stern,  Health Coordinator  of  the gay/lesbian
association Triangulo Rosa in Costa Rica,   to David Patterson, UNAIDS human
rights Specialist based in Geneva.  

The correspondance is between  Patterson and Calle Almedal who is a  UNAIDS
NGO liason also based in Geneva.

We also include below the text of the letter to which David Patterson was
responding so that readers may have all the data involved in this
correspondance.

We think readers should draw their own conclusions about this matter, but we
personally think this correspondance  is inappropriate and unfortunately,
may reflect an attitude which would stifle rather than encourage responsible
activism in the developing world,  where the problems are far different
than those in North America and  Europe. One might conclude that Mr.
Patterson is more interested in appeasement and  tranquilization, than in
the issues at hand.  

 There are few voices to be heard advocating for what is needed in the
developing world. Remember that over 90 percent of people with AIDS in these
regions have never been to  a support group or  a  gathering of  AIDS
activists.  They don´t have medications  which they need  and medical
attention for them  is horribly deficient.  Their rights are constantly
abused  and as such they  are often  unable to develop a consciousness about
seeking what they need and defending themselves.

The very small minority of us in the developing world who have been able to
be  empowered enough to  be able to speak up and say the truth have a
responsibility to make our views known and we  will hopefully not be
intimidated by comments such as those made Mr. Patterson.  We here at
Triangulo Rosa and the Asociacion of PVVIH, are proud of being pioneers in
the area of human rights for people with AIDS in our region, and we  will
continue to speak out  about  UNAIDS, local governments,  and other entities
in positions of power and responsibility, regardless of whether UNAIDS human
rights specialists    view us  as "irrational."  

We would be interested in hearing feedback and of course that letters could
be also be forwarded to
Mr. Patterson (very important-with copies to Peter Piot)  if possible.
Please feel free to redistribute  this material to other NGO´s and to your
local medias of communication.

UNAIDS
e-mail:  David Patterson:  [email-masked]
               Peter Piot                [email-masked]
fax: 41-22-791-4165:  address faxes to Peter Piot, Director, UNAIDS

Sincerely,
(signed)

Francisco Madrigal
President 
Association Triangulo Rosa
506-258-0214
fax  506-258-0635
e-mail. [email-masked]
[email-masked]

Richard Stern
Health Coordinator
Triangulo Rosa
Tel: 506-234-2411

Guillermo Murillo
President, 
Asoc. of Persons Living with AIDS of Costa Rica
phone 506-433-8522
e-mail [email-masked]

>From: [email-masked]
>Date: Mon, 02 Mar 98 17:02:27 +0100
>To: <[email-masked]>, <[email-masked]>
>Cc: <[email-masked]>, <[email-masked]>
>Subject: Re[4]: Reply   
>
>
>     David,
>     Thanks for your note.
>     I opted off talking to him - i want this on "paper". No offense but I 
>     rather know what I have said or written.
>     Calle
>
>
>______________________________ Reply Separator
_________________________________
>Subject: Re[3]: Reply   
>Author:  D. PATTERSON at whohq4
>Date:    3/2/98 4:54 PM
>
>
>     
>Calle
>     
>Not bad, however I note I advised you to speak to him ( Richard Stern)
personally on the 
>telephone, to let him vent his anger and frustration, and then to follow up as 
>below. I don't think he is particularly rational at present and therefore I 
>don't know if your 'rational' response will achieve its ends. We will see. I 
>hope I am wrong.
>     
>David
>     
>______________________________ Reply Separator
_________________________________
>Subject: Re[2]: Reply   
>Author:  C. ALMEDAL at whohq4
>Date:    3/2/98 4:05 PM
>     
>     
>     Dear Richard,
>     
>     Thank you for your frank communication with me, I rather like it.
>     
>     I have read the e-mails that I have saved (I have not saved all of 
>     them) between me and you in order to better understand what you expect 
>     UNAIDS to do. As far as I can see, but please correct me if I am 
>     wrong, there are five main issues:
>     
>     1. UNAIDS general lack of response in the Region. 
>     2. Your project proposal
>     3. Access to treatment & drugs for PLHA in the Region. 
>     4. UNAIDS general responsibilities.
>     5. WHO's work with churches in the Region.
>     
>     In order to be able to answer you correctly, I have discussed the 
>     issues both with David Patterson, whom you know, and Luiz Loures who 
>     is the Head of the Latin American Desk here. As you can see I copy 
>     this mail to them.
>     
>     1. UNAIDS general lack of response in the Region.
>     Luiz Loures informed me that UNAIDS soon will hire two news staff to 
>     work in Central America. One will be based in Honduras and the other 
>     one in Guatemala. Dr. Fulladolsa is leaving us.
>     It is clear that the fact that UNAIDS doubles its effective in the 
>     Region is a response to perceived needs. We all hope that the two new 
>     persons there will be able to work effectively and that they will 
>     include collaboration with both community groups and NGOs in their 
>     work plans. I will make sure that I brief them before they leave from 
>     here. But it will take some time before they are in place.
>     
>     2. Your project proposal.
>     I have discussed it with both David Patterson and with Gunilla Ernberg 
>     here. Both advised me to answer you as I did; it needs to come from a 
>     Theme Group if we are to process it in any way here. I also told you 
>     that I personally like it and I suggested you to contact LACCASO, 
>     ILPES and PASCA in order to try to get funds for it. Furthermore, I 
>     remember that I also said that it was a bit problematic that the 
>     project is not initiated by an NGO or a community group, but by you as 
>     an individual consultant.
>     I am sorry that I can not fund you project, but I have to abide to 
>     certain rules and regulations. You are not the only person who submits 
>     projects to us and you are not the only one I have to tell that I am 
>     sorry not being able to fund you. UNAIDS is not a funding agency and 
>     there is nothing I can do about it.
>     
>     3. Access to treatment and drugs in the Region.
>     UNAIDS has promoted the right for People living with HIV and AIDS to 
>     have access to treatment, including retrovirals. This has caused much 
>     concern and criticism as not everybody agrees with us. For your 
>     information I would like to point out that The UK NGO Consortium on 
>     AIDS as well as ACTUP Paris are highly critical of UNAIDS stand point. 
>     UNAIDS now has decides to try a system out in four countries in order 
>     to pilot a project on access to drugs for PLHA.
>     UNAIDS can not force Governments in Central America or anywhere else 
>     to change their Health Policies or Strategies. Governments listens to 
>     UNAIDS when they want to and ignore UNAIDS when it fits them, as with 
>     the rest of the UN system. We all hope that with the two new staff 
>     member in place in Central America a dialogue with the Governments on 
>     amongst other issues the one about access to drugs will come up. 
>     UNAIDS is not at all content with the way drugs, includingretrovirals, 
>     are smuggled into many countries and used rather haphazardly, and we 
>     are trying to correct that with our pilot project.
>     
>     4. UNAIDS general responsibilities.
>     From the meeting I had in London last week, with the major development 
>     NGOs, I have gained a better understanding of how difficult it is to 
>     understand what UNAIDS is. We will try to elaborate a concise document 
>     explaining what NGOs and community groups can, and can not, expect of 
>     UNAIDS. My personal feeling is that there are too high expectations, 
>     and often, as in the case with the major Development NGOs, 
>     expectations on UNAIDS that are far outside of both the mandate UNAIDS 
>     has and the capacity we have here.
>     As soon as the document is elaborated I will send you copies.
>     
>     5. Who's work with Churches in the Region.
>     I seem to have misunderstood you when you brought up the use of 
>     1.000.000 USD on seminars with churches in the Region. I was under the 
>     impression that you intended to investigate in the Region what 
>     happened and what the out come was. I did not understand that you 
>     asked me about it. I can try to find out what it all was about, but I 
>     suppose that PAHO has the answers and that it might be faster for you 
>     to find out in Costa Rica. If you want me to look into this, please 
>     let me know.
>     
>     If I have misunderstood you and your expectations on me or UNAIDS 
>     completely, please tell me exactly what it is you want UNAIDS and me 
>     to do. I will then try to reply again. I hope you will understand that 
>     I might have missed out something completely in our communication.
>     
>     I can really not comment on your plans to have an e-mail campaign. I 
>     note that you would like to have a personal response from Peter Piot 
>     before you carry out the campaign, and I would like to invite you to 
>     send him a letter or a fax, or even an e-mail, outlining what 
>     questions you need an answer to and which areas you think UNAIDS 
>     should have covered in the Region, but has not. If you send me a copy 
>     I will make sure that you get an answer as soon as it is physically 
>     possible. I suggest you to write directly to Dr Piot than rather 
>     having confidence in that I rely the correct questions to him, as I 
>     seem to have misunderstood some of your points.
>     
>     I hope this answers some of the issues you raise. 
>     
>     All the best
>     
>     Calle
>     
>     
>______________________________ Reply Separator
_________________________________
>Subject: Re: Reply   
>Author:  <[email-masked] > at unaids 
>Date:    2/28/98 11:48 AM
>     BELOW  ARE LETTERS SENT FROM RICHARD  STERN TO CALLE ALMEDAL AND DAVID
PATTERSON LAST WEEK  WHICH APPARENTLY STIMULATED MR. PATTERSON´S RESPONSE
>     
>Dear Calle
>     
>I am sure you will not be pleased with what I am forwarding here, but it 
>certainly represents my most honest opinion.  
>     
>There is so little activism in this region and so few people can advocate 
>for what they really need, that we feel that those of us who are a bit more 
>empowered have to begin  to act and react. This is what we did here in Costa 
>Rica, with astonishingly good results and this is what we will do on a 
>region wide basis when it is appropriate.
>     
>After rereading all of my correspondance with you and my attempt to 
>articulate what I perceived is going on,  I can say that I have seen no 
>concrete result or change, and this is not something that we are prepared to 
>wait on, when people are dying absolutely unnecessarily, given the economic 
>possibilities and realities of access to treatment in this region.  
>     
>What do you think?
>     
>Richard
>     
>     
>     
>     
>     
>>Date: Fri, 27 Feb 1998 10:34:04
>>To: [email-masked]
>>From: [email-masked]
>>Subject: Re: Reply  
>>
>>
>>
>>David 
>>
>>The article dated September 29,  entitled "Costa Rican Supreme Court.." is 
>practically but not quite up to date.... I could make some further updates 
>of   it by Monday and e-mail on the same date. My main problem is that I am 
>going away on the weekend but will be back Sunday afternoon with time to 
>work on it.
>>
>>So if that is good enough for you let me know, if you need it even sooner, 
>than just do whatever you can.
>>
>>
>>After conversing with you and exchanging endless e-mails 
>with Calle allmedal, myself and Guillermo Murillo have decided  that we will 
>begin a major letter writing campaign at a Central American and 
>International level to call attention the the dramatic and inhumane lack of 
>reponsiveness on the part of UNAIDS in this region.  We have also talked to 
>people in  Guatemala and Panama who are  in agreement with this strategy.
>>
>>We would plan to ask people to send e-mail letters to you Calle Almedal and 
>Peter Piot and we will send out a plea on  Internet and through all of our 
>international contacts to try to draw attention to the dramatic lack of 
>response of ONUSIDA (as well as lack of information about your programs and 
>what we can expect from ONUSIDA in many aspects). 
>>
>>We will be as persistent and determined in this action as we have been in 
>our other actions to achieve what is fair for persons living  with AIDS.
>>
>>I would hope that you would really read the correspondance between myself 
>and Calle Almedal and also study what your  rep here is really accomplishing
>and the level of communication that he maintains with ONG's that work in SIDA. 
>>
>>We would welcome an personal response from Peter Piot before carrying out 
>this action, but we intend to do it.  We also  have a report detailing how 
>UNAIDS, at the time OMS,  spent  over $1,000,000 on workshops with the 
>religious sector 3 years ago in Central America, but no one that we can find 
>has ever seen any concrete results from the money that was spent---although 
>we don't deny the possibility that benefits occurred.
>>
>>Anyway, we hope to hear more from UNAIDS as we continue to develop this 
>project.
>>
>>Many  of the objections and concerns that we have, are included in the 
>correspondance with ALMEDAL so I strongly suggest that you try to get  with 
>him and review it.  The problem with his responses as you can see if you 
>read them very carefully  is that they are almost but not quite patronizing, 
>and  there is no evidence that any change or even significant investigation 
>of the situation is contemplated as a result of them.  He seems to agree 
>with a lot of what I  have written.  And then what???  What he is going to 
>do??? Or ask someone else to do??  
>>
>>I hope you understand that activism of this type is bound to create some 
>adverserial situations at this time, but people are dying, by the hundreds 
>in Central America and so much more could be done  to prevent this, and 
>ironically at the same time visibilize the epidemic and  contribution to 
>efforts at prevention.
>>
>>Sorry to put you in the middle of this  but  this is a human rights issue, 
>totally, and the issue is lack of direction, leadership and even 
>participation by UNAIDS on the issues, so  I think it belongs with you.
>>In North America and Europe there are as many activists  and as much 
>ability to protest as there are people living with AIDS. In our countries, 
>the majority of people with AIDS cannot articulate, nor do they even 
>understand or know what they are entitled to,  so  we take the same position 
>that we took here in Costa Rica with the medication issues, to follow our 
>consciences and try to articulate what we think is important, even though 
>there are relatively few of  us who are empowered enough to do so.
>>
>>
>>Thanks, 
>>
>>Richard
>