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The forgotten: Living with HIV in war-ravaged Yemen

Patients’ names have been changed to protect their identity. Sanaa, Yemen – With each breath he took, the red rashes on Ahmad’s cheeks appeared to get brighter and brighter. The eight-year-old had just made his way up the stairs of the al-Jumhurriya hospital in the Yemeni capital Sanaa, one of the few health centres in the…

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The forgotten: Living with HIV in war-ravaged Yemen

Patients’ names have been changed to protect their identity.

Sanaa, Yemen – With each breath he took, the red rashes on Ahmad’s cheeks appeared to get brighter and brighter.

The eight-year-old had just made his way up the stairs of the al-Jumhurriya hospital in the Yemeni capital Sanaa, one of the few health centres in the war-ravaged country that provides free medical treatment to people living with HIV.

As he took his seat in the waiting room next to his ailing father, the sound of static from an old analogue TV appeared to startle the young boy, further heightening his anxiety as he waited for doctors to call him in for his latest blood test.

Three years ago, Ahmad was healthy and playful, his father Zakariyya told Al Jazeera.

“When he became sick, we took him to the hospital and doctors carried out tests and told us he had problems with his immune system,” he said.

“They later told us it was HIV. My wife and I also took the tests and we also tested positive.”

An acronym for the human immunodeficiency virus, HIV attacks important cells that help the body fight off infections, disease, and other viruses.

When the infection goes untreated, it causes AIDS. This typically causes fever, weight loss, recurrent diarrhoeal infections and other symptoms.

While both are seen as treatable, a cure has yet to be found.

The government has zero funds allocated for HIV and AIDS
Taha al-Mutawakel, Minister for Health in the Houthi-run administration

‘I take a red pill every day’

Zakariyya said his family moved to Sanaa sometime in 2016 for treatment when fighting engulfed his neighbourhood in the southwestern city of Taiz.

As Houthi fighters were being expelled from the city, air strikes and street clashes devastated the city with at least 37 of its 40 hospitals and medical institutions forced to close.

According to local authorities, Doctors without Borders (MSF) was one of the few aid agencies that that continued providing free antiretroviral (ARV) treatment to the 600 people living with HIV/AIDS in the capital.

The situation was so dire, that there were reports some patients were rationing their medicines because of the difficulty associated with reaching clinics and hospitals.

Citing the case of one woman, MSF said that she began taking half a tablet instead of a whole one and even began taking them on alternate days so she didn’t have to completely stop her treatment.

Zakariyya said he and his family were among the fortunate ones and received their intended doses. 

“The doctors have given us medicine,” he said. “I don’t know its name, but it’s a red pill. I take one every day.”

Yemen’s health system is on the brink of collapse with thousands of medical staff and facilities affected by the conflict [Al Jazeera]

Thrown out of their homes

According to the World Health Organization, the first HIV case appeared in Yemen in 1987, and the number of the people living with it was estimated to be around 9,900.

While prevalence was only 0.2 percent of the population, most Yemenis living with either of the viruses faced stigma and discrimination, even from their families.

According to the most recent report by Stigma Index, the world’s largest social research project implemented by people living with HIV, most HIV-positive Yemenis had been thrown out of their homes by family members due to fears of infection.

The research said that all the people they interviewed experienced some form of stigma because of their HIV status, with one third saying they had to “change their residence or could not rent a place” because of their condition.

Ibrahim al-Babli, a doctor at the HIV/AIDS laboratory at the al-Jumhurriya hospital, said those patients were not the only forgotten victims of this war.

A staggering 1.2 million civil servants living in Houthi-held areas had not received their salaries after the Yemeni government stopped paying them in late 2017 in an effort to start a popular uprising.

The effects were devastating, with health, education and sanitation services left without the people needed to run them.

Resources were stretched so thin, Babli said, that patients were lucky to enter a manned hospital.

“I haven’t received my salary in months, I get paid sporadically,” said Babli.

“If doctors aren’t cared for, then that means there’s no care for the patients.”

‘Zero funds for HIV/AIDS’

The UN has repeatedly described Yemen’s humanitarian situation as “catastrophic” and, on Wednesday, Mark Lowcock, the under-secretary-general for Humanitarian Affairs, said the situation had worsened in the past year with “more than 24 million people now needing humanitarian assistance”.

Taha al-Mutawakel, the Minister for Health in the Houthi-run administration, told Al Jazeera that the war had crippled the health system with “zero funds allocated for HIV and AIDS”.

“We’re currently operating with a grant of $800,000 provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria,” he said.

“Medicines are readily available and offered free of charge and distributed to each of the governorates … but the siege has had a major impact on patients seeking treatment.”

Saudi Arabia, which has been conducting an air campaign in Yemen since March 2015, intensified its embargo on the country in 2017, restricting both humanitarian aid and commercial goods from entering Houthi-held ports.

The kingdom said the blockade was a necessary precaution aimed at preventing weapons being smuggled into Yemen by Saudi Arabia’s regional rival, Iran.

The inadequacy of services … may increase the vulnerability to HIV/AIDS transmissions
Eltayeb Elamin, Regional Programme Adviser at UNAIDS Middle East

‘Race against time’

Eltayeb Elamin, the Regional Programme Adviser at UNAIDS Middle East said the blockade had greatly affected the movement of HIV and AIDS patients, with the “disruption to the supply system … leading to difficulties in the accessibility for available services”.

“The effect of the war on the health infrastructure is also greatly stressed with inadequate supplies hampering HIV/AIDS prevention efforts especially counselling and testing,” he said.

“The inadequacy of services … may increase the vulnerability to HIV/AIDS transmissions through lack of universal precautions and inadequacy of needed services.”

Zakariyya said while he was still in the dark about his son’s future, he was confident that with some treatment, he could go on to live a full life.

“My son nearly died. But now, all praise to God, he is doing much better,” he said. “We believe in God and have faith that our lives and our fate are in his, not our, hands.”

Meritxell Relano, UNICEF’s resident representative in Yemen, said that with the fighting showing no signs of abating, aid agencies were in a “race against time” to save children such as Ahmad.

“We urge for an end to the war on children, not tomorrow, but today,” she said. “Parties to the conflict must work to reach a negotiated political solution, prioritising and upholding the rights of the children.

“The longer this war continues, the more children are going to die on the world’s watch.”

Resources are stretched so thin, that according to Dr. Babli, patients are lucky to enter a manned hospital [Al Jazeera]

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Why the Women’s Tennis Association rallied for Peng Shuai

A prominent Chinese citizen associated with a major international organisation disappears, then a letter is sent stating all is well. The organisation appears to accept the letter at face value although questions remain before the citizen emerges months later under duress. The circumstances are different but there is a similar thread to the disappearance of…

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Why the Women’s Tennis Association rallied for Peng Shuai

A prominent Chinese citizen associated with a major international organisation disappears, then a letter is sent stating all is well. The organisation appears to accept the letter at face value although questions remain before the citizen emerges months later under duress.
The circumstances are different but there is a similar thread to the disappearance of Chinese tennis player Peng Shuai, who last month accused former Vice Premier Zhang Gaoli of sexual misconduct, and Meng Hongwei, the former head of Interpol, who disappeared on a trip to China in 2018 and 18 months later pleaded guilty to corruption. He was sentenced to 13 years in prison.
Following Meng’s disappearance, Interpol largely appeared to accept his resignation letter and Secretary-General Jurgen Stock told the Associated Press news agency that the international police body was forbidden by internal rules to investigate.
Things could have turned out the same for Peng, a world-class athlete and Olympian, after a social media post about her ordeal with Zhang was deleted, except that the Women’s Tennis Association (WTA) immediately began to push back. Prominent tennis players also followed suit, including Naomi Osaka and Serena Williams.
The WTA has also continued to raise questions even after Chinese state broadcaster CGTN shared an email on Twitter – purportedly from Peng – saying that she was “not missing” or “unsafe” and that reports of her allegations were “not true”. She reemerged in public a few days later and spoke to the International Olympic Committee over a now heavily-criticised video call.
“[It] remains unclear if she is free and able to make decisions and take actions on her own, without coercion or external interference,” WTA Chairman and CEO Steve Simon said afterwards, stressing that the organisation remained concerned about her wellbeing.
The alleged email from Peng Shuai to Steve Simon that was aired on state broadcaster CGTN last month [CGTN/Twitter via Reuters]After the WTA’s repeated expressions of concern about Peng Shuai’s wellbeing, the IOC said it had held a video call with the player and released a still photo from the call [IOC via EPA]Late on Wednesday, the WTA announced the “immediate suspension” of all tournaments in China and Hong Kong. China hosted nine WTA events in 2019 and a year earlier signed a 10-year deal to host the WTA finals in Shenzhen, according to Reuters news agency.
“It’s really crazy that the Women’s Tennis Association has more credibility right now than Interpol in pushing back on China’s gross human rights abuses, abduction of members of its organisation, and poking holes in what is just thinly-veiled coercive statements and propaganda,” said Michael Caster, co-founder of the human rights watchdog Safeguard Defenders, which monitors disappearances in China.
‘Not acceptable’
China’s foreign ministry has accused critics and media of “malicious hyping” and politicising Peng’s disappearance from public view.
Meanwhile, Zhang, the high-ranking party member at the centre of Peng’s allegations, has not been seen in public in several weeks, according to Caster.
He described Peng’s situation as part of the same “playbook” used by the Chinese government when concerns are raised about the wellbeing of a citizen or foreigner living in China – from human rights lawyer Wang Yu to Swedish human rights activist Peter Dahlin who went on to become one of the founders of Safeguard Defenders.
“These farcical public presentations from Peng Shuai are clearly scripted as part of a propaganda effort and we say that because we’ve seen this movie before,” Caster told Al Jazeera.
In announcing the suspension of tournaments, the WTA’s Simon stressed that China’s handling of Peng’s case was not acceptable and should not be allowed to become acceptable.
“If powerful people can suppress the voices of women and sweep sexual assault under the rug then the basis on which the WTA was founded – equality for women – would suffer an immense setback,” Simon said in a statement. “I will not and cannot let that happen to the WTA and its players.”

Game, set, and match to the @WTA in the grand slam for sports and human rights in #China! Steve Simon announces WTA’s decision to suspend tournaments in China… via @WTA https://t.co/LlZ7yW86BQ @hrw @MinkysHighjinks @hrw
— Sophie Richardson (@SophieHRW) December 1, 2021

I applaud Steve Simon & the @WTA leadership for taking a strong stand on defending human rights in China & around the world. The WTA is on the right side of history in supporting our players.
This is another reason why women’s tennis is the leader in women’s sports. https://t.co/PHiU0S7Prw
— Billie Jean King (@BillieJeanKing) December 1, 2021
Other international sporting bodies have already been targeted by Beijing over positions taken by their players and officials.
China briefly stopped airing NBA games after Houston Rockets manager Daryl Morey tweeted his support for Hong Kong’s 2019 democracy protests and erased Premier League football player Mesut Ozil from the Chinese internet after he spoke out against China’s treatment of Muslim Uighurs.
More recently, games involving the NBA’s Boston Celtics have been pulled from broadcast in China as Enes Kanter, their centre, continues to make criticisms about President Xi Jinping and China’s treatment of Xinjiang, Hong Kong, and Tibet while also voicing support for Taiwan.
Moment of reckoning
The WTA, however, had political momentum and timing on its side allowing the organisation to take a calculated risk, says Simon Chadwick, a professor of international sports business at Emlyon Business School in France.
Peng’s case and allegations of sexual misconduct also come at a moment of reckoning in the sports world over #MeToo allegations and mental health following the public struggles of athletes like Osaka and American gymnast Simone Biles.
“Number one for the WTA is that women and girls are their core business. It’s what the organisation is founded upon and to not be seen as supporting someone who apparently has gone missing would undermine what the WTA does,” Chadwick said.
“My feeling is that the WTA probably made a calculation and decided that it stood to lose more globally by not saying anything, then it stood to lose by essentially standing up to China.”
Chadwick says that despite considerable investments in the Chinese tennis industry, women’s tennis has not taken off there as quickly as the WTA initially anticipated.
Its deal with China has also struggled as a result of the pandemic. So far, Shenzhen has hosted only one WTA finals event in 2019. The 2020 final was cancelled as a result of the coronavirus, and the 2021 event was moved to Mexico following another Covid-19 outbreak in China.
The NBA came under pressure in China after Houston Rockets manager Daryl Morey tweeted his support for the Hong Kong protesters in 2019 [File: Xihao Jiang/Reuters]That may give the WTA the kind of latitude unavailable to groups like the IOC, which is due to host the 2022 Winter Olympic Games in Beijing in February. That organisation has also suffered as a result of the pandemic with the Tokyo Olympics, pushed back a year and not attended by the usual number of spectators.
Following Peng’s disappearance, the IOC has said it would “continue our open dialogue on all levels with the Olympic movement in China” following questions about Peng, according to the Associated Press.
Emma Terho, the IOC Athletes Commission Chair, said on Twitter that the organisation prefers a policy of “quiet diplomacy”.
Based in the Republican state of Florida, the WTA may have also felt some political pressure beyond Beijing.
Washington is mulling a boycott of the Winter Games protest against human rights abuses in places like Xinjiang and Hong Kong, notes Chadwick.
“I wonder to what extent there may have been some political pressure from within the United States put on the WTA to respond in the way that it did. I think from the perspective of the WTA, they reacted very, very quickly… unusually quickly, within a matter of two or three days, he said. “And that is extremely unusual.”
On Wednesday, Simon expressed regret at having to suspend events in China, but he said he was “greatly concerned” at the risks players and staff could face if events were held in the country in 2022.
He once again urged Beijing to prove Peng was free, and able to speak “without interference or intimidation” and to fully investigate the allegations of assault.
“I remain hopeful that our pleas will be heard and the Chinese authorities will take steps to legitimately address this issue.”

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Mexico and US to launch plan to stem Central American migration

The vast majority of people heading to the US-Mexico border are from Honduras, Guatemala and El Salvador.Mexico’s foreign ministry has said the Mexican and US foreign development agencies will work together on a project to address the root causes of migration from Guatemala, Honduras and El Salvador. The “Planting Opportunities” project announced on Wednesday will…

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Mexico and US to launch plan to stem Central American migration

The vast majority of people heading to the US-Mexico border are from Honduras, Guatemala and El Salvador.Mexico’s foreign ministry has said the Mexican and US foreign development agencies will work together on a project to address the root causes of migration from Guatemala, Honduras and El Salvador.
The “Planting Opportunities” project announced on Wednesday will bring together the Mexican Agency for International Development Cooperation (Amexcid) and the United States Agency for International Development (USAID) and target the three so-called Northern Triangle countries.
Migration from Guatemala, Honduras and El Salvador has fuelled record numbers of people being apprehended at the US-Mexico border, as asylum seekers have tried to enter the United States after fleeing poverty, violence and political instability.
The surge in arrivals has piled political pressure on the administration of US President Joe Biden, whose Republican rivals have accused him of causing “chaos” at the border.
Mexico’s National Guard has been dispatched along the country’s southern border with Guatemala and along main roads to stem the flow of migrants [File: Daniel Becerril/Reuters]During the last fiscal year, US authorities detained some 1.7 million people along the border.
The US has been increasingly reliant on Mexico to stem the flow of migrants, as it returns to Mexico the majority of people who arrive at the border under a Trump-era border restriction enacted due to the coronavirus pandemic.
The US is also in talks with the Mexican government to restart a programme that would force asylum seekers to wait in Mexico for their US immigration court hearings.
Both Biden and Mexico’s leftist President Andres Manuel Lopez Obrador have vowed to tackle what they call the “root causes” of migration.
They have pointed to poverty, lack of education and job opportunities, gang violence, political instability and corruption as some of the leading causes of migration, especially of young people.
The new US-Mexico collaboration will begin in Honduras, with an effort to teach job skills to more than 500,000 at-risk youth, the Mexican foreign ministry said on Wednesday.
The department did not provide details about the programme or how much funding would be allocated for the scheme.
The project will bring together the Mexican Agency for International Development Cooperation and the United States Agency for International Development [File: Jose Torres/Reuters]As a presidential candidate, Lopez Obrador had touted social programmes aimed at creating better lives for people in Central American countries, which he said would discourage people from leaving.
But those plans were shelved after former US President Donald Trump took office and made hardline, anti-immigration measures the main focus of his government.
In recent years, Mexico has blocked several caravans of people seeking to reach the US. It also has dispatched its National Guard to the country’s southern and northern borders to try to keep people away.

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Displaced Syrians face brutal winter exacerbated by economic collapse, charity warns

PARIS: French President Emmanuel Macron called on his Iranian counterpart, Ebrahim Raisi, to return to fulfilling Tehran’s obligations under the 2015 nuclear deal “without delay,” Macron’s office said, as negotiators seek to revive the accord through talks in Vienna.During telephone conversations on Monday, Macron urged Raisi to engage in a “constructive manner” with the talks,…

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Displaced Syrians face brutal winter exacerbated by economic collapse, charity warns

PARIS: French President Emmanuel Macron called on his Iranian counterpart, Ebrahim Raisi, to return to fulfilling Tehran’s obligations under the 2015 nuclear deal “without delay,” Macron’s office said, as negotiators seek to revive the accord through talks in Vienna.During telephone conversations on Monday, Macron urged Raisi to engage in a “constructive manner” with the talks, which resumed this week after a suspension of almost half a year following the election of the hardliner to the Iranian presidency.European powers are seeking to revive the nuclear deal, more formally known as the Joint Comprehensive Plan of Action. It has been moribund since the US withdrew from the agreement in 2018, prompting Tehran to ramp up nuclear activities as Washington reimposed sanctions.France’s objective is “to see Iran return to full respect for all of its commitments under the JCPOA and that the United States returns to the agreement,” the French presidency said.Macron also “underscored the need for Iran to engage constructively in this direction so that the exchanges allow a swift return to the agreement,” it added.“Iran must return without delay to compliance with all its commitments and obligations … and quickly resume cooperation that allows the (UN atomic energy) agency to fully carry out its mission,” it said.Iran’s top nuclear negotiator, Ali Bagheri, adopted a hard-line approach after just one day of the resumed talks, suggesting that everything discussed during previous rounds of diplomacy could be renegotiated.Speaking to Iranian state television, he described all that has been discussed so far as merely a “draft.”He added: “Drafts are subject to negotiation. Therefore nothing is agreed on unless everything has been agreed on.“On that basis, all discussions that took place in the (previous) six rounds (of talks) are summarized and are subject to negotiations. This was admitted by all parties in today’s meeting as well.”Bagheri’s remarks directly contradicted comments on Monday by EU diplomat Enrique Mora, who is leading the talks.“The Iranian delegation represents a new administration in Tehran with new, understandable political sensibilities, but they have accepted that the work done over the six first rounds is a good basis to build our work ahead, so no point in going back,” he said.Another state TV report highlighted Bagheri in Vienna saying that Iran demands a “guarantee by America not to impose new sanctions” or reimpose previously lifted sanctions.Mohammed Eslami, Iran’s civilian nuclear chief, reiterated this demand in comments to Iran’s official IRNA news agency.“The talks (in Vienna) are about the return of the US to the deal and they have to lift all sanctions and this should be in practice and verifiable,” he said.Raisi’s office said that he urged Macron “to strive with other parties in Vienna to conclude the negotiations and lift the sanctions against Iran.”Raisi said: “Sending a full team to the talks shows Iran’s serious will in these talks.”Referring to the US, he added: “Those who have started to violate the nuclear deal must gain the confidence of the other party for the negotiations to proceed in a real and fruitful manner.”

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