From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which – in their view – remains woefully underused.

Marketed in the United States as Truvada, and sometimes available abroad in generic versions, the pill has been shown to reduce the risk of getting HIV from sex by more than 90 percent if taken daily. Yet worldwide, only about a dozen countries have aggressive, government-backed programs to promote the pill. In the U.S., there are problems related to Truvada’s high cost, lingering skepticism among some doctors and low usage rates among black gays and bisexuals who have the highest rates of HIV infection.

“Truvada works,” said James Krellenstein, a New York-based activist. “We have to start thinking of it not as a luxury but as an essential public health component of this nation’s response to HIV.”

A few large U.S. cities are promoting Truvada, often with sexually charged ads. In New York, “Bare It All” was among the slogans urging gay men to consult their doctors. The Los Angeles LGBT Center – using what it called “raw, real language” – launched a campaign to increase use among young Latino and black gay men and transgender women.

“We’ve got the tools to not only end the fear of HIV, but to end it as an epidemic,” said the center’s chief of staff, Darrel Cummings. “Those at risk have to know about the tools, though, and they need honest information about them.”

Truvada in the U.S.

In New York, roughly 30 percent of gay and bisexual men are using Truvada now, up dramatically from a few years ago, according to Dr. Demetre Daskalakis, a deputy commissioner of the city’s health department.

However, Daskalakis said use among young black and Hispanic men – who account for a majority of new HIV diagnoses – lags behind. To address that, the city is making Truvada readily available in some clinics in or near heavily black and Hispanic neighborhoods.

“We like to go to the root of the problem,” said Daskalakis, who personally posed for the “Bare It All” campaign.

According to the U.S. Centers for Disease Control and Prevention , Truvada would be appropriate for about 1.2 million people in the U.S. – including sex workers and roughly 25 percent of gay men. Gilead Scientific, Truvada’s California-based manufacturer, says there are only about 145,000 active prescriptions for HIV prevention use.

Under federal guidelines, prime candidates for preventive use of Truvada include some gay and bisexual men with multiple sexual partners, and anyone who does not have HIV but has an ongoing sexual relationship with someone who has the virus.

An international approach 

Abroad, a few government health agencies – including those in France, Norway, Belgium, Kenya, South Africa, Brazil and some Canadian provinces – have launched major efforts to promote preventive use of Truvada or generic alternatives, providing it for free or a nominal charge. In Britain, health officials in Scotland and England recently took steps to provide the medication directly through government-funded programs, though in England it’s in the form of a trial limited to 10,000 people.

Truvada was launched in 2004, initially used in combination with other drugs as the basic treatment for people who have HIV, the virus that causes AIDS. It is primarily spread through sex.

Controversy arose in 2012 when the U.S. Food and Drug Administration approved Truvada to reduce the risk of getting HIV in the first place, for what’s called pre-exposure prophylaxis, or PrEP. It blocks the virus from making copies and taking hold. Critics warned that many gay men wouldn’t heed Truvada’s once-a-day schedule and complained of its high cost – roughly $1,500 a month.

Gilead offers a payment assistance plan to people without insurance that covers the full cost. Some cities and a few states – including Illinois, Massachusetts and Washington – also help cover costs. Activists have pressed Gilead to make its copay program more generous in light of its profits from Truvada.

“There’s no reason it has to cost so much,” said Krellenstein.

Gilead spokesman Ryan McKeel, in an email, said the company is reviewing the copay program.

“Like those in the advocacy community, we are committed to expanding access to Truvada for PrEP to as many people as possible,” he wrote.

In June, the FDA approved a generic version of Truvada, which is likely to push the price down, but it won’t be available in the U.S. for a few years.

The Truvada debate has taken many twists, as exemplified by the varying stances of the Los Angeles-based AIDS Healthcare Foundation – a leading HIV/AIDS service provider. In 2012, the group unsuccessfully petitioned the FDA to delay or deny approval of Truvada for preventive use. The foundation’s president, Michael Weinstein, belittled Truvada as “a party drug” and warned it would increase the spread of sexually transmitted infections by encouraging men to engage in sex without condoms.

But last year, the foundation, while still skeptical about some Truvada-related policies, urged Gilead to cut its price to make it more available.

“We have no dispute about its ability to prevent HIV transmission,” said spokesman Ged Kenslea. He noted that the organization’s 40 pharmacies across the U.S. handle many Truvada prescriptions.
…

From: MeNeedIt

One person was killed Monday during clashes between security forces and protesters in a Tunisian town, a security official and residents said, as demonstrations over rising prices and tax increases spread in the North African country.

A man was killed during a demonstration against government austerity measures in Tebourba, 40 km (25 miles) west of Tunis, the security official said, without giving details.

The protest had turned violent when security forces tried stopping some youths from burning down a government building, witnesses said. Five people were wounded and taken to a hospital, state news agency TAP said.

Tunisia, widely seen in the West as the only democratic success among nations where Arab Spring revolts took place in 2011, is suffering increasing economic hardship.

Anger has been building up since the government said that from Jan. 1, it would increase the price of gasoil, some goods and taxes on cars, phone calls, the internet, hotel accommodations and other items, part of austerity measures agreed with its foreign lenders.

The 2018 budget also raises customs taxes on some products imported from abroad, such as cosmetics, and some agricultural products.

The economy has been in crisis since a 2011 uprising unseated the government and two major militant attacks in 2015 damaged tourism, which comprises 8 percent of GDP. Tunisia is under pressure from the International Monetary Fund to speed up policy changes and help the economy recover from the attacks.

Violent protests spread in the evening to at least 10 towns with police and crowds clashing in Fernaneh, Bouhajla, Ouslatia, Moulouche, Sabitla, Gtar and Kef.

There was also a protest turning violent in Ettadamen district in the capital, residents said. Security forces had already dispersed small protests in Tunis late Sunday.

On Monday, about 300 people also took to the streets in the central Tunisian town of Sidi Bouzid, cradle of the country’s Arab Spring revolution, carrying banners aloft with slogans denouncing high prices.

A lack of tourists and new foreign investors pushed the trade deficit up by 23.5 percent year-on-year in the first 11 months of 2017 to a record high $5.8 billion, official data showed at the end of December.

Weakened dinar

Concerns about the rising deficit have hurt the dinar, sending it to 3.011 versus the euro Monday, breaking the psychologically important 3 dinar mark for the first time, traders said.

The currency is likely to weaken further, said Tunisian financial risk expert Mourad Hattab.

“The sharp decline of the dinar threatens to deepen the trade deficit and make debt service payments tighter, which will increase Tunisia’s financial difficulties,” he said.

Hattab said the dinar may fall to 3.3 versus the euro in the coming months because of high demand for foreign currency and little expectation of intervention from the authorities.

Last year, former Finance Minister Lamia Zribi said the central bank would reduce its interventions so that the dinar steadily declined in value, but it would prevent any dramatic slide.

The central bank has denied any plans to liberalize the currency, but Hattab said Monday’s decline showed there was an “undeclared float” of the dinar.

A weaker currency could further drive up the cost of imported food after the annual inflation rate rose to 6.4 percent in December, its highest rate since July 2014, from 6.3 percent in November, data showed Monday.
…

From: MeNeedIt

Oprah Winfrey’s moving speech at the Golden Globes has some fans and fellow celebrities calling for her presidential run.

The actress accepted the Cecil B. DeMille lifetime achievement award at Sunday’s ceremony, and it didn’t take long for Twitter to start lighting up with the hashtag #Oprah2020.

Comedian Sarah Silverman tweeted  “Oprah/Michelle 2020.” 

Leslie Odom, Jr., who played Aaron Burr in the Broadway musical “Hamilton” tweeted “She’s running. A new day is on the way.”

Winfrey brought the typically rowdy crowd to silence and tears with her speech.

She spoke of seeing Sidney Poitier win an Academy Award when she was a girl, and weaved it into the #MeToo movement.

She says “speaking your truth is the most powerful tool you all have.”

 
…

From: MeNeedIt

What president?

A year after politics – and the newly elected occupant of the White House – dominated the conversation and tone of the Golden Globes, there was barely a mention of such things at Sunday’s ceremony. This year, it was all gender politics, and of course the (hash)MeToo movement that has engulfed Hollywood and spread into the culture at large with astonishing speed. From the sea of glittering black gowns worn in solidarity on the usually multi-colored red carpet, to sly references to unequal pay and recognition for women, to Frances McDormand’s salute to “a tectonic shift” in the Hollywood power structure, it was a night for reckoning – crowned by Oprah Winfrey’s barn-raiser of a speech proclaiming “Their time is UP!”

Some key moments:

Serious carpet talk:

Usually, red carpet interviews focus on the provenance of designer gowns and jewelry. This year, there was talk of working conditions for farmers and janitors, and demands for equal pay across society. Several actresses, including Meryl Streep, Michelle Williams and Emma Watson, brought social activists with them, to focus on real-life solutions to gritty problems far from Hollywood. “We feel emboldened in this particular moment,” Streep said, “to stand together in a thick black line dividing then from now.”

Laura Dern’s North star:

It was a night of unusually powerful speeches, whether long or short, that touched eloquently on the (hash)MeToo moment. One came from Laura Dern, who won supporting actress for “Big Little Lies,” a TV series that, aptly, depicts not only sexual abuse, but a group of women who only fully discover their power when they unite. Using her character to describe a past culture in which people were afraid to speak out, Dern urged Hollywood to support and employ survivors brave enough to come forward. And she went further: “May we teach our children,” she said, “that speaking out without the fear of retribution is our culture’s new North Star.”

A sly nod to a glaring omission:

One of the most glaring snubs in this year’s movie nominations came in the best director category, where Greta Gerwig was passed over for her much-loved “Lady Bird.” Natalie Portman, presenting the director prize, was not about to let that go unnoticed. “And here are the all MALE nominees,” she quipped, to knowing laughter. (Guillermo del Toro won for “The Shape of Water.”) Barbra Streisand also took a jab at the Globes, noting that she’d been the only woman to have won best director – in 1984. “That was 34 years ago, folks. Time’s up!” she said.

A ‘tectonic’ shift:

A big winner was “Three Billboards Outside Ebbing, Missouri,” in which Frances McDormand plays a mother taunting police to solve the rape and murder of her daughter. Winning for best actress, McDormand noted to the crowd that “I keep my politics private. But it was really great to be in this room and to be part of a tectonic shift in our industry power structure.” And she added: “Trust me: The women in this room tonight are not here for the food. We’re here for the work.”

Oprah rules the room:

But with all the eloquent speeches, none roused the room like Winfrey’s, who had the crowd giving her repeated ovations as she issued a warning – not once, but three times – to powerful men who abuse women: “Their time is up!” She ended her barn-storming speech, in which she accepted the Cecil B. DeMille lifetime achievement award, with a call to young girls. “I want all the girls watching here and now to know that a new day is on the horizon!” she said. “And when that new day finally dawns, it will be because of a lot of magnificent women … and some pretty phenomenal men, fighting hard to make sure that they become the leaders who take us to the time when nobody ever has to say, ‘Me too,’ again.” Director Ava DuVernay later wrote on Twitter that the room was “still vibrating like electricity from that speech.”

Sterling K. Brown makes history:

While most of the talk was about progress in the sphere of gender, actor Sterling K. Brown of TV’s “This Is Us” addressed progress of a different kind: he was the first black actor to win the Globe for best actor in a TV drama. He thanked the show’s creator, Dan Fogelman, for writing a role “for a black man that can only be played by a black man.” What he was grateful for, Brown said, is that “I’m being seen for who I am and being appreciated for who I am, and it makes it that much more difficult to dismiss me or dismiss anybody who looks like me.”

Calling out a network, on equal pay:

There’s been much talk about equal pay lately, but Debra Messing and Eva Longoria got very specific, calling out E! Entertainment Television on the issue while doing interviews with them on the red carpet.

Messing referenced the recent departure from E! of host Catt Sadler, who has said she was making about half the pay of her male counterpart, Jason Kennedy.

“I was so shocked to hear that E! doesn’t believe in paying their female co-hosts the same as their male co-hosts,” she said. “I miss Catt Sadler.”

Longoria also made the point, to Ryan Seacrest. “We support gender equity and equal pay and we hope that E! follows that lead with Catt as well,” she said.

Thelma and Louise return:

On an evening recognizing women in Hollywood, it was certainly apt to have Thelma and Louise, aka Geena Davis and Susan Sarandon, present an award. Davis – who is a longtime advocate for gender equality in film – joked cynically that the two had already “fixed everything.” She also noted that the men in the category they were presenting had agreed to give half their salary back “so the women can make more than them.”

She was joking there, too.
…

From: MeNeedIt

A group of disabled Egyptians is not letting the lack of having lost a leg get in the way of playing football. They have formed a team they hope will be a part of a soccer league for people with special needs. Faith Lapidus reports.
…

From: MeNeedIt

A US entrepreneur is taking advantage of a demand for American goods in Africa — creating an online portal for cross border trade between the two countries. As VOA’s Mariama Diallo reports.
…

From: MeNeedIt

The unpredictable and aggressive nature of wolf-dog hybrids makes them difficult to keep as household pets. But the founders of the Lockwood Animal Rescue Center in California say the dual nature of these animals makes them ideal therapists for combat veterans who suffer from PTSD. VOA’s Genia Dulot has more on the “Wolves and Warriors” program.
…

From: MeNeedIt

A remote island volcano in Papua New Guinea has begun spewing ash into the air, forcing the evacuation of more than 500 residents, media and nonprofit groups said.

Kadovar Island, a 365-meter (1,197 feet) tall volcano on the north coast of PNG, was thought to be dormant until it began erupting Jan. 5.

“It’s just a continuous emission of volcanic ash at the moment,” Cheyne O’Brien, a forecaster at the Darwin Volcanic Ash Advisory Centre, told Reuters by telephone Sunday.

The ash clouds have been thrown up steadily to a height of 2,133 meters (7,000 feet), forming a plume that is traveling west-northwest, he added.

The plume does not yet pose a hazard to aviation, but a change in wind direction could hit operations at PNG’s Wewak airport, O’Brien said.

All the residents of the island have been evacuated with no loss of life, U.S.-based charity Samaritan Aviation, which operates seaplanes to remote areas of PNG, said on Facebook.

The eruption may become explosive, bringing a risk of tsunamis and landslides, domestic online media Loop PNG quoted the Rabaul Volcanological Observatory as saying.

There are no confirmed records of a previous eruption of Kadovar, said Chris Firth, a volcanologist at Macquarie University, but scientists speculate it could have been one of two “burning islands” mentioned in the journals of a 17th-century English pirate and maritime adventurer, William Dampier.

Dampier may have recorded the last eruption of Kadovar during a voyage in search of “Terra Australis,” the southern continent once thought to be mythical, Firth said.

Volcanologists are interested to observe its behavior now, Firth added. 

“It’s hard to predict what might happen, as there’s nothing to compare it to,” he said.
…

From: MeNeedIt

The World Health Organization classifies alcohol as a “group 1 carcinogen.” That means there is convincing evidence it can cause cancer in humans. But new research shows how alcohol can damage the body on a genetic level. VOA’s Kevin Enochs reports.
…

From: MeNeedIt

Dogs are often used in airports to sniff out explosives or illegal drugs. But a high-tech machine has been developed that can “sniff” the air, so baggage handlers and bomb experts can check luggage and containers without touching them. VOA’s Deborah Block has more.
…

From: MeNeedIt

Eritrea has temporarily shut down nearly 450 private businesses, the latest in a series of moves that has sent shockwaves through the economy of the Red Sea nation.

The closures were a response to companies hoarding cash and “failing to do business through checks and other banking systems,” according to a Dec. 29 editorial published by Eritrea’s Ministry of Information on the state-run website Shabait.com.

Most of the affected businesses operate in the hospitality sector, according to the announcement, and they will remain closed for up to eight months, depending on the severity of the violations.

About 58,000 private businesses operate across the country, according to the government; less than 1 percent was affected by the recent closures.

Replacing the currency

The government has taken other steps in recent years to reassert control over the economy.

In 2015, Eritrea mandated that citizens exchange all notes of the currency, the nakfa, for new notes. The government also imposed financial restrictions, including limits on the amount of cash that could be withdrawn from bank accounts or kept in private hands, according to multiple reports.

Business owners complained about the restrictions, and reports from inside the country indicate the rules have altered Eritrea’s black market exchange rate, which affects the price of many goods.

State control

Tesfa Mehari, a professor of economics in England, said the Eritrean government wants a state-owned economy. That’s a trap many other countries have fallen into that generally leads to economic failure, Mehari said.

“The government cannot develop the economy. Only the people can do that,” Mehari told VOA’s Tigrigna service. “The government can only be a facilitator. There hasn’t been a country in the world that developed because of government control.”

He also said that the closures harm people’s trust in the government and in banking institutions. 

“At the end of the day, if the people of Eritrea want to develop the economy of the country, they can only work based on trust, especially with banks. What you have with banks is a matter of oath,” Mehari said.

Compounding this mistrust, he added, is that the government’s actions aren’t backed by a specific law or decree that is publicly available for all to read.

In a statement, the government also acknowledged shortcomings in modernizing its banking sector with up-to-date technology and relevant expertise, another potential impediment to confidence in the system.

In contrast, Ibrahim Ibrahim, an Eritrean-born accountant who supports the government, said the actions are needed to fight inflation and stabilize the currency.

“I don’t think the Eritrean government is trying to control the economy, and I don’t think that’s the current environment,” said Ibrahim, who is based in Washington, D.C. “However, there might be a situation where the government is taking measures to adjust things that are not normal and turn it into normalcy as per usual.”

He said any government has the right to regulate its currency and the businesses operating within its borders.

“When these businesses are given permission to work, that means they’re entering a contract,” he said. “At the core of entering into such agreements is that the businesses work within the legalities and the laws in place. If these businesses are not working according to the law, the government is going to take appropriate measures.”
…

From: MeNeedIt

Jerry Van Dyke, the younger brother of actor Dick Van Dyke who struggled for decades to achieve his own stardom before clicking as the dimwitted sidekick in television’s Coach, has died at age 86, his manager said.

John Castonia said Van Dyke died Friday at his ranch in Hot Spring County, Arkansas. His wife, Shirley Ann Jones, was by his side. No cause was immediately known.

Van Dyke had an affable, goofy appeal, but he spent much of his career toiling in failed sitcoms and in the shadow of his older brother, even playing the star’s brother in The Dick Van Dyke Show.

Until Coach came along in 1989, Van Dyke was best known to critics as the guy who had starred in one of television’s more improbable sitcoms, 1965’s My Mother the Car. Its premise: A small-town lawyer talks to his deceased mother (voiced by actress Ann Sothern), who speaks from the radio of an antique automobile.

Other bombs included 1967’s Accidental Family, in which he was a nightclub comedian; 1970’s The Headmaster, in which he was a gym teacher; and 1963’s Picture This, a game show that lasted only three months. He also joined The Judy Garland Show in 1963, to provide comic relief, but was fired at the end of the season.

‘Awful stuff’

“The show’s writers wrote awful, awful, awful stuff,” he recalled in a 1994 interview with The Associated Press, “and I was forced to do it. For instance, I had to come out and say to Judy Garland, ‘What’s a nice little old lady like you doing on television?’ ” He added: “And that was just the first week!”

In Coach, he finally made it, playing assistant football coach Luther Van Dam, comic foil to Craig T. Nelson’s coach Hayden Fox. The show aired from 1989 to 1997, and Van Dyke was nominated four times for an Emmy.

“I never knew what success was like, or having a hit series, or even doing something GOOD,” Van Dyke told the AP. “Finally I got a job that I enjoy doing, that’s not hard to do — and I get paid a lot of money.”

Nelson, his co-star on the show, paid homage to his former onscreen partner Saturday: “I am incredibly sad to hear of Jerry’s passing. He was such a brilliant comedian and we had a great time working together on Coach. It is just devastating news.”

Over the years, Van Dyke made guest appearances on numerous programs, among them The Mary Tyler Moore Show, whose star had played his sister-in-law on The Dick Van Dyke Show.

He also appeared on The Andy Griffith Show and Perry Mason and in such films as The Courtship of Eddie’s Father, Palm Springs Weekend, Angel in My Pocket and McLintock! 

His decision to take the My Mother the Car role wasn’t the only unfortunate career move he made in the mid-1960s. He also passed on a chance to play the title role on Gilligan’s Island and to replace the departing Don Knotts as the deputy on The Andy Griffith Show.

My Mother the Car lasted one season. (A New York Times critic cracked, “Last night’s premiere made a strong case for not fastening your seat belts.”) But Gilligan’s Island turned its star, Bob Denver, into a television icon and is still airing endlessly in reruns. Van Dyke said in 1990 that his brother told him My Mother the Car sounded good. (At the time, a show about a talking horse, Mister Ed, and other fantasy sitcoms were doing well.) 

“I never asked him for advice after that,” Jerry Van Dyke said.

Newhart role

He also rued the loss of a role in 1982 when he was up for a supporting gig in a series to star Bob Newhart, which would run for eight celebrated seasons. But Tom Poston got his role as George the handyman on Newhart. In recent years, Van Dyke made recurring appearances on The Middle and Yes, Dear.

He was born in Danville, Illinois, in 1931, six years after his brother. He said he knew from childhood that he wanted to be a comedian, and grew up listening to the radio shows of Bob Hope, Red Skelton and others. By age 8 he had earned a reputation as class clown.

He had his first brush with acting in a guest role on The Dick Van Dyke Show as Rob Petrie’s banjo-playing brother. “I came away thinking, ‘TV is a piece of cake; I want more of this,’ ” he told the AP.

Van Dyke entered Eastern Illinois University, but his education was interrupted by service in the Air Force during the Korean War. He spent much of that time entertaining colleagues at military shows with jokes and banjo playing.

When he got out of the service, he took that act on the road, with little success. Eventually he followed his brother to Hollywood.

Van Dyke is survived by his wife, two children from his previous marriage to Carol Johnson — Jerri and Ronald — and his brother. 
…

From: MeNeedIt