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Two years ago, Kamiar Alaei, MD, and Arash Alaei, MD, were arrested in Iran, just as they were preparing to leave for Mexico to present on their innovative harm reduction work at the XVII International AIDS Conference.

On July 18, the world convenes again for the XVIII International AIDS Conference in Vienna, Austria — but will be short two shining stars. Arash and Kamiar remain in jail today. The Iranian government accused the brothers of using trips to AIDS and public health conferences around the world to “foment a velvet revolution” and sentenced them to years in prison. We say treating AIDS is not a crime.

Friends and colleagues of the Alaeis will be in Vienna spreading the word about their case and advocating for their release, and PHR will be supporting them all the way.

Will you be in Vienna at the AIDS conference? To volunteer with these efforts, email Clint Trout at clintworldwide [at] yahoo [dot] com.

Want to take action to support the Alaeis? Sign our new petition, calling on the government of Iran to free the Alaeis.

Throughout their careers, the Alaeis have promoted public health diplomacy and supported the quest for shared solutions to the world’s shared disease burden. It is an outrage to call this treason. Medical professionals should not be put in prison for doing their jobs. Take action today and stand in solidarity with the Alaeis.

See the Background page at IranFreeTheDocs.org for more information on their case.

Physicians for Human Rights joins numerous international NGOs, including Amnesty International, Human Rights Watch, and Reporters Without Borders, in supporting United4Iran’s Global Day of Action on June 12, 2010. June 12 events will be occurring in over 70 cities around the world. Go to 12June.org for more information.

June 12 marks the one year anniversary of Iran’s disputed election, which was followed by a government crackdown that saw an increase in arbitrary arrests, torture, and politically motivated use of the death penalty. The Global Day of Action calls attention to Prisoners of Conscience in Iran, and demands their unconditional release.

Since last year’s elections, the human rights situation in Iran has only grown worse. PHR continues to highlight the case of Drs. Kamiar and Arash Alaei, Iranian doctors who have been held by Iranian authorities since June 2008. After being imprisoned without charge for six months, the Doctors Alaei were convicted and sentenced for the charges of being in “communications with an enemy government” and “seeking to overthrow the Iranian government.” Kamiar was given a three year prison sentence, while Arash was sentenced to six years.

The Iranian government used the doctors’ travel to international AIDS conferences as a basis for the charge. Iran cannot continue to imprison medical professions for doing their job. By equating public health diplomacy with treason, the Iranian government poses a threat to all Iranians working for scientific knowledge.

Stand with PHR and the international community to tell the world that “Treating AIDS is not a crime.” Visit iranfreethedocs.org for more information on the Alaeis. And on June 12, please help us remember and defend those in Iran jailed for their humanitarian work.

The Obama Administration has initiated a comprehensive review of US landmines policy to decide whether or not the US will join the Mine Ban Treaty. President Obama needs to hear from you about how harmful landmines are to the health and human rights of people worldwide.

Email President Obama today and tell him to join the Mine Ban Treaty.

PHR shared the 1997 Nobel Peace Prize for our work to ban landmines. Since then, 156 countries have signed onto the treaty, which bans the use, trade, production and stockpiling of antipersonnel mines.

However, the US has refused to join. President Obama now has the opportunity to partner with every member of NATO—and every country in the Western Hemisphere, save Cuba—in supporting this critical treaty. Tell him to take action today.

Landmines kill thousands of people a year, with millions more affected by the agricultural, economic and psychological impact of the device. While landmines are a weapon of war, most casualties are civilians: indeed, UNICEF estimates that 30-40% of landmine victims are children. And landmines don’t just kill in conflict zones: there are millions of landmines and unexploded ordinances in more than 80 countries worldwide.

These indiscriminate weapons maim and kill, and destroy families and communities. The US has not used landmines since the 1991 Gulf War; it is time for us to promise never to use them again. Tell Obama to join the Mine Ban Treaty today.

68 Senators co-signed a letter to President Obama in May, showing their support for the Mine Ban Treaty. Now Obama needs to hear from you. Email him today, and ask 6 friends to do the same. PHR members have been advocating to ban landmines for more than 15 years. This is our best chance to join the Mine Ban Treaty in years, and we need your support.

Take action today!

Want to do more? We are asking major US health professional associations to sign a letter to the Administration against the use of landmines. If you have any contacts at health professional associations who might be able to help, please email Gina at gcoplon-newfield[at]phrusa[dot]org.

As you read in our previous landmines blog post, the Obama Administration is reviewing current US landmine policy right now, and will soon decide whether or not the US will join the Mine Ban Treaty. Why should the US join? Check out these compelling facts and see why this is a critical health and human rights issue:

Injury and Death:

• The International Campaign to Ban Landmines (ICBL) estimates that 15,000-20,000 people are maimed or killed by landmines yearly, with millions more affected by the agricultural, economic and psychological impact of the weapon.
• UNICEF estimates that 30-40% of mine victims are children under 15 years old.
• Landmines are responsible for the injury and death of thousands of US and allied troops in all US-fought conflicts since World War II, including dozens in Iraq and Afghanistan. In the 1991 Gulf War, landmines caused 34% of US casualties.
• At the beginning of the 20th century, nearly 80% of landmine victims were military personnel. Today, 90% of landmine victims are civilians.

The Economic and Social Cost:

• The ICBL estimates that there are millions of landmines and other unexploded ordnance in the ground in over 80 countries.
• Landmines cost as little as $3 to produce and up to $1,000 per mine to clear.
• Most kinds of landmines last forever. Mines laid during WWII are still killing and maiming civilians.
• It costs $100 to $3,000 to provide an artificial limb to a landmine survivor. Adults require a prosthesis replacement every two to three years and a child must have a new one every six months to a year.
• Landmines cause environmental damage in the forms of soil degradation, deforestation, and the pollution of water resources with heavy metals. Subsistence farmers are unable to work the land in mined areas.
• Landmines affect all aspects of human life, including the ability of refugees to return home. A report from the United Nations High Commissioner for Refugees (UNHCR) published in 1997 stated that 13.2 million refugees, 4.9 million internally displaced people and 3.3 million returnees were at risk from landmines.

The US and Landmines:

• The United States is one of only 39 countries that have not yet joined the Mine Ban Treaty; in the Western Hemisphere, only the U.S and Cuba are non-signatories.
• The US has the third largest mine arsenal in the world—a stockpile of 11 million Anti-Personnel Landmines (APLs)—despite not using landmines since 1991 or producing them since 1997. Enormous amounts of taxpayer money are used to maintain these weapons.
• The United States is one of only 13 countries that refuse to halt production of APLs.
• The Bush Administration’s landmine policy, announced in February 2004, represented a major rollback of US progress on the landmine issue. The policy increased funding for mines, permitted indefinite US use of self-destructing mines, and refused to phase out long-lived mines until 2010. The Obama Administration has yet to revise the Bush policy.

These indiscriminate weapons maim and kill, and destroy families and communities. President Obama is currently reviewing US landmine policy. We need your voice to tell the President to ban mines now! The US has not used landmines since the 1991 Gulf War. It is time for us to promise never to use them again.

Take action today: email Obama and tell him to join the Mine Ban Treaty!

The Obama Administration has initiated a comprehensive review of the US landmines policy to decide whether or not the US will join the Mine Ban Treaty. PHR has re-engaged in this campaign at the request of The US Campaign to Ban Landmines (USCBL) and members of the Administration, and we are hopeful that this will be an opportunity to show the world that the US respects health and human rights.

Over the next few months, we’ll be updating you on the treaty via a new blog series (this is blog #1) and asking for your help to urge President Obama to join the Mine Ban Treaty.

One immediate action item: We are asking the presidents of major US health professional associations to sign a letter to the Administration showing the unity of the medical, public health and nursing community against the use of landmines. If you have any contacts at major health professional associations who might be able to help, please email Gina Coplon-Newfield at gcoplon-newfield[at]phrusa[dot]org as soon as possible.

As you may know, PHR is a founding member of the International Campaign to Ban Landmines (ICBL), a grassroots movement that brought the international community together to form the 1997 Mine Ban Treaty, which bans the use, trade, production, and stockpiling of antipersonnel mines. PHR and the other ICBL founding groups were awarded the Nobel Peace Prize for their work toward achieving the treaty, which 156 countries have signed.

As with many international human rights treaties, the US has refused to sign, arguing that US soldiers are exposed to risk if the country can’t use landmines as a deterrent weapon. The United States’ position sets us apart from most other countries: Indeed, all other member countries of NATO are signatories to the treaty (Poland plans to ratify the treaty in 2012). By refusing to sign, the US joins China, Russia, Cuba, India and Pakistan among the countries that have not committed to stop using landmines. The US has not used landmines since the 1991 Gulf War, yet previous administrations have chosen to keep the weapon available, just in case.

Early in his tenure, it appeared President Obama had made the same decision. In November 2009, a White House spokesman stated that after reviewing the matter, the Obama Administration had decided not to sign the Mine Ban Treaty. The announcement prompted public outcry among human rights groups, and the following day, the White House insisted the issue was still under review. The current review is headed by Samantha Power and Barry Pavel at the National Security Council.

We expect the Obama Administration to make a decision in the next few months, making it critically important that the President hear from health professionals and human rights activists about how harmful landmines are to humanity. We will soon send out an action alert, which will give you the chance to email Obama and urge him to sign onto the Mine Ban Treaty. Please take action, and urge friends and family to do the same.

Congress is joining in the advocacy too. On May 22, Senator Patrick Leahy of Vermont sent a letter co-signed by 68 senators (including 10 Republicans) to President Obama, encouraging him to develop a plan to overcome any obstacles to joining the Convention. 68 is a magic number: international treaties must be approved by a 2/3 majority in the Senate, so if Obama decides to sign onto the treaty, 68 Senators would be enough to accede to it (of course, though this letter is a good indication of potential votes, it’s not a guarantee).

PHR members have been advocating to ban landmines for more than 15 years, and we need your help again at this critical juncture. Keep an eye out for more actions alerts and blogs. And spread the word—this is our best chance to join the Mine Ban Treaty in years, and we need your voice!

On May 10th, The New York Times published a heartrending story on the faltering fight against AIDS in Uganda — a story that has sparked a firestorm of controversy and criticism of the Obama Administration’s global AIDS strategy.

The Times identified a deep funding gap for combating AIDS in Uganda, including a freeze on new funds from the United States and a lack of commitment to AIDS spending by the Ugandan government (which evidently has no problem finding $300 million to spend on Russian fighter jets). The Times also outlined the devastating human toll this funding gap is taking on people living with — and dying of — AIDS.

Sadly, this news is not new. In March 2009, PHR invited Dr. Peter Myugenyi, Founder and Director of the PEPFAR-supported Joint Clinical Research Centre in Uganda, to Washington, DC to talk about the emerging funding gap for AIDS in Uganda. Said Dr. Mugyenyi:

After urging people to get tested and enter care, we now have to tell them there is no treatment available when they need it. We created hope and now we are returning to the days when one member of a family can get treatment and the others cannot.

It is a recipe for chaos as patients start to share doses or skip treatment altogether. I fear that we will soon start to see more drug-resistant strains of HIV and rising death rates.

As The Times notes, one year later, Dr. Myugenyi remains fearful:

Dr. Peter Mugyenyi, the hospital’s founder, helped the Bush administration form its AIDS plan and sat beside Laura Bush during the State of the Union address as it was announced.

The loss of donor interest “makes me frantic with worry,” Dr. Mugyenyi said.

He offers copies of e-mail messages he exchanged with American aid officials. One reminds him that he has been instructed to stop enrolling new patients and asks for an explanation of reports that he is treating 37,000 when only 32,000 are authorized. Another asks him not to announce publicly that his funds have been frozen.

He admits slipping pregnant women and young mothers like Ms. Kamukama into treatment slots “contrary to instructions.”

“Morally, I can’t turn them away,” he said.

This story gained traction worldwide, and was followed by a New York Times editorial, The Wavering War on AIDS, which outlined a $13 billion deficit in AIDS spending, and a series of letters to the editor, including one by PHR Global Health Action Campaign advisor Pat Daoust.

Dr. Mugyenyi won’t turn away patients. And we won’t turn away from this issue.

PHR, in conjuction with other global health groups, sent a letter to Secretary of State Clinton last week, urging her to end the AIDS funding freeze and ensure Ugandans have access to life-saving AIDS treatment.

PHR members have spent years advocating for more global AIDS funding and health programming based on science and human rights. We will continue to fight for greater global health funding, a strong US global health strategy, and to ensure people living with AIDS worldwide have access to drugs and quality care.

Want to help? Encourage your Representative to co-sponsor the Global HEALTH Act, which will provide $2 billion for health system strengthening and support a comprehensive US global health strategy, both of which will help in the fight against AIDS.

Today, as we celebrate International Nurses Day, the health workforce crisis remains one of the greatest hurdles to realizing the right to health for all in developing countries.

The Global HEALTH Act can help. The GHA, introduced in Congress by Representative Barbara Lee on March 24, would provide $2 billion over five years to increase the number of doctors, nurses, pharmacists and other health workers in developing countries, and to improve primary health care for all. The bill not only authorizes new resources, it also calls for the creation of a US Global Health Strategy that will complement the goals of developing countries and ensure our aid money is effectively used to save the lives of hundreds of thousands of people.

That is why PHR is uniting with more than 15 other US organizations to hold a national Call-in Day TODAY to support the Global HEALTH Act. Be part of the movement. Tell your Representative to support Global Health by co-sponsoring this bill.

It’s easy. Call the Congressional Switchboard at (202) 224-3121 and ask to be connected to your Representative’s office (if you don’t know who your Rep. is, find out). Then, make your case. Use the script below, and/or bring your own experiences into the call:

Hi, my name is XXX and I live in Town, State. I am calling to encourage Representative XXX to co-sponsor HR 4933, The Global HEALTH Act, which will help fix broken health systems in developing countries. The Global HEALTH Act calls for the development of a US Global Health Strategy to harmonize aid, and provides $2 billion over 5 years to help countries in Africa hire, train and retain more doctors, nurses and other health workers. The Global HEALTH Act will save lives: I hope Rep. XXX will consider co-sponsoring this bill today.

As of today, the global health community has secured nine co-sponsors: Reps. John Conyers (MI), Lynn Woolsey (CA), Raul Grijalva (AZ), Keith Ellison (MN), John Garamendi (CA), Fortney Pete Stark (CA), Diane Watson (CA), Jesse Jackson, Jr. (IL) and Eleanor Holmes Norton (DC). Help us secure more. Commemorate International Nurses Day by taking action. Join thousands around the country today who are making a difference. Call your Representative and encourage them to co-sponsor the Global HEALTH Act today.

UPDATE, May 17: The Global HEALTH Act has garnered six new co-sponsors: Jesse Jackson, Jr. (IL), Eleanor Holmes Norton (DC), Sam Farr (CA), Maxine Waters (CA), Bobby Rush (IL) and James McGovern (MA).

As of today, the global health community has secured seven co-sponsors for the Global HEALTH Act: Reps. John Conyers (MI), Lynn Woolsey (CA), Raul Grijalva (AZ), Keith Ellison (MN), John Garamendi (CA), Fortney Pete Stark (CA) and Diane Watson (CA).

PHR wants to double this number — and double it again. To gain more support for the GHA, PHR is organizing a Global HEALTH Act National Call-in Day on May 12th, International Nurses Day.

So far, more than 15 organizations have pledged to participate. We’d love more. If your organization/school/workplace is interested in taking part, contact us at ghacallinday[at]phrusa[dot]org.

And checkout the Call-in Day toolkit (doc), which contains all the information you’ll need to organize a great call-in day.

GHA National Call-in Day Toolkit (122.5 KiB, 4 hits)

UPDATE, May 11: The Global HEALTH Act has garnered two new co-sponsors: Reps. Jesse Jackson, Jr. (IL) and Eleanor Holmes Norton (DC).

UPDATE, May 17: Four more co-sponsors have been added: Sam Farr (CA), Maxine Waters (CA), Bobby Rush (IL), and James McGovern (MA).

You are not the only one encouraging your Congressperson to co-sponsor the Global HEALTH Act. Representative Barbara Lee sent a letter to all her Congressional colleagues last week, urging them to support the bill. Check out her letter below. It outlines the four ways that the Global HEALTH Act will assist with the development and implementation of Obama’s landmark Global Health Initiative. The Act will provide strategy, consistency and a greater emphasis on health workforce and health systems — all key to making foreign health policy that supports the right to health.

Her letter includes a list of organizations from across the globe that support the Global HEALTH Act — including PHR. Organizations are continually being added to this list, and we encourage you all to contact your Congressperson and urge them to co-sponsor this bill, which will revolutionize foreign health aid and save lives.

The health workforce crisis in Uganda is immense. Uganda is reportedly losing at least 1,400 skilled professionals each year, and there are only 29,000 medical personnel in a country of 31 million people. Consequently, the health system is suffering, and most often the blame falls on health workers, as they are on the frontline and seemingly represent the health sector. In the past eight months, since I’ve been in Uganda, media coverage of the health system has almost always focused on the negative aspects of health workers, further demonizing a field that is made up largely of hard working people.

Recent Ugandan headlines include:

Rioters attack Mityana hospital” (New Vision, Aug 21, 2009)

12 Health workers held over drug theft” (New Vision, Jan 11, 2010)

Health officials remanded over theft of government drugs” (Daily Monitor, Mar 11, 2010)

These news stories reflect the public’s negative perception of health workers, who are almost always associated with being unqualified, incompetent, rude, corrupt, and thieves. Furthermore, personal stories shared with me about using the health system are most often about being ignored and mistreated — not about receiving good care by caring health workers.

For those of us advocating for health workforce development, the negative image of health workers makes it more difficult to garner support and foster dialogue. We should honor the truth of people’s experiences with health workers and the health system, but the problem is complex and there are many underlying factors that need to be addressed. Health workers are overworked, underpaid, and lack proper resources and equipment. Yet the majority of health workers still show up to work and perform their duties. If they didn’t, the health system would completely collapse. At the same time, we should expect and demand a standard of care from our health workers.

Ugandan nurse Mitterand Kiirya (Physicians for Human Rights)

Given the complexity of the issue and the lack of easy answers, I wanted to highlight one health worker who I feel exemplifies the notion of a dedicated and ethical health worker. Mitterand Kiirya is a research nurse for the Antiretrovirals for Kaposi’s Sarcoma (ARKS) study at the Infectious Disease Institute (IDI) at Mulago Hospital, the largest national referral hospital in Kampala, Uganda. For the past 2½ years, he has been working with HIV-positive patients who have Kaposi’s Sarcoma. Previously, Mitterand worked at Uganda Cares, an antiretroviral access initiative in Masaka.

I first heard about Mitterand through my roommate, a U.S. medical student working with him at IDI. She would often talk about his dedication, and how he would invite her to join him on visits to the countryside 6–7 hours away from Kampala to check in on his patients in their homes. This was not part of his duties, but something he did on his own time. But most of all, she would always talk about how he inspired her to be a good doctor, because he always put the patient first. And, despite all the challenges he faced, he always remained positive and managed to smile and make people laugh everyday.

Here are some highlights from a recent conversation I had with Mitterand:

Why did you want to become a nurse?

It was from watching my mother. She is a mid-wife in my village, Namugong, Kaliro [in the Eastern part of Uganda]. I watched her passion for her patients. How she cared for them, wanting to alleviate their pain. What I saw was that she tried to understand the patient, and I wanted to do the same thing.

What does it mean to understand your patient?

Well…before seeing the doctor, the patient has a lot of anxiety, especially when they are referred from place to place. So I try to sit and talk to them before they see the doctor, prepare them to receive what the doctor will tell them.

What do you see as the role of the nurse?

As a nurse, I try to reverse what was impossible, and make it possible. I try to bring a message of hope and new life, especially with my patients who are HIV-positive. If you haven’t even given the message of assurance, then it’s the equivalent of not having come to work that day.

People have encouraged me to further my studies, and become a doctor. I have thought about it a lot, but I don’t want to lose the contact with my patients, which I think happens sometimes with doctors. So, right now, I’m staying a nurse, staying with my patients.

You often see that nurses, or health workers in general, get discouraged by their work environment. What do you think about this?

Yes, I do see some of my colleagues who are not working. But what I try to do is motivate them. Remind them about the ethical requirements of our profession, but also try to serve as an example for them too. But, I tell them that “ we are here to serve our profession, give the service and think about the quality of your services, the quality of your service should determine your cost”. But you must work hard.

I know the system is broken. Infrastructure is inadequate, and the environment is making it difficult. We are losing the confidentiality of the patient, because we are sharing spaces with only curtains to divide, and sometimes not even that. I am always trying to improvise to keep the patients alive.

How do you stay motivated?

I have love for the patients. That is what motivates me. Be their friend, we need to be there first for the patients.

Tell me about the award you received from Alicia Keys.

When I was working at Uganda Cares in Masaka, she contributed ARVs and general support for HIV-positive children. She found me at Masaka, working as a nurse, she was told through my director, my medical director, Dr. Bernard Okongo. He introduced me as a hardworking nurse, who was dedicated with total love for his profession. I received an award and took a picture with her. It was a big ceremony held in Masaka.

I felt very…actually felt humbled really, for the public to appreciate my contribution and my profession, I felt humbled. I felt so humbled. In this country, what de-motivates people, you can serve, but failure to appreciate your service is another big issue. If the services we are offering are appreciated, the level of our service would be so high.

Thanks Mitterand for speaking with me.

No, I say ‘thank you’ to you, because you are listening to me. Everyday, I am here for others, listening to them, and having to hold back my pain. But it’s nice that I can talk and you listen to me.

Speaking with Mitterand is always inspiring, and I know he is not the exception. From my experience in Uganda, I have witnessed the dedication of health workers throughout the country, ranging from district health officials to field doctors and nurses and community health workers. Further, I have seen administrators, Ministry of Health officials and policymakers who are also working tirelessly to improve the health of the population. I think it’s important for us in advocacy to re-frame the issue of health workers, by highlighting the positive aspects of their work and recognizing them for it, so that the media and general public can better understand them and the complexities of the Human Resources for Health issue. And we need health workers to also speak out and show their commitment and concern for the health of the population, because in the end, we are all working towards a collective goal to ensure the right to health for all.