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Projected Uptake of New Antiretroviral (ARV) Medicines in Adults in Low- and Middle-Income Countries: A Forecast Analysis 2015-2025.
Gupta A; Juneja S; Vitoria M; Habiyambere V; Nguimfack BD; Doherty M; Low-Beer D
PloS One. 2016; 11(10):e0164619.
With anti-retroviral treatment (ART) scale-up set to continue over the next few years it is of key importance that manufacturers and planners in low- and middle-income countries (LMICs) hardest hit by the HIV/AIDS pandemic are able to anticipate and respond to future changes to treatment regimens, generics pipeline and demand, in order to secure continued access to all ARV medicines required. We did a forecast analysis, using secondary WHO and UNAIDS data sources, to estimate the number of people living with HIV (PLHIV) and the market share and demand for a range of new and existing ARV drugs in LMICs up to 2025. UNAIDS estimates 24.7 million person-years of ART in 2020 and 28.5 million person-years of ART in 2025 (24.3 million on first-line treatment, 3.5 million on second-line treatment, and 0.6 million on third-line treatment). Our analysis showed that TAF and DTG will be major players in the ART regimen by 2025, with 8 million and 15 million patients using these ARVs respectively. However, as safety and efficacy of dolutegravir (DTG) and tenofovir alafenamide (TAF) during pregnancy and among TB/HIV co-infected patients using rifampicin is still under debate, and ART scale-up is predicted to increase considerably, there also remains a clear need for continuous supplies of existing ARVs including TDF and EFV, which 16 million and 10 million patients-respectively-are predicted to be using in 2025. It will be important to ensure that the existing capacities of generics manufacturers, which are geared towards ARVs of higher doses (such as TDF 300mg and EFV 600mg), will not be adversely impacted due to the introduction of lower dose ARVs such as TAF 25mg and DTG 50mg. With increased access to viral load testing, more patients would be using protease inhibitors containing regimens in second-line, with 1 million patients on LPV/r and 2.3 million on ATV/r by 2025. However, it will remain important to continue monitoring the evolution of ARV market in LMICs to guarantee the availability of these medicines.
Use of network meta-analysis in clinical guidelines.
Kanters S; Ford N; Druyts E; Thorlund K; Mills EJ; Bansback N
Bulletin of the World Health Organization. 2016; 94:782-784.
In conclusion, WHO clinical guidelines have become increasingly evidence-based through the use of rigorous methods of synthesizing the evidence. Over the past decade, high-quality, pairwise meta-analyses have been widely used in this context, but network meta-analysis methods are increasingly important for the optimal evaluation of competing interventions. We expect that network meta-analysis will increasingly be used and adapted for developing other guidelines. (Excerpt)
Progress Toward Strengthening National Blood Transfusion Services - 14 Countries, 2011-2014.
Chevalier MS; Kuehnert M; Basavaraju SV; Bjork A; Pitman JP
MMWR. Morbidity and Mortality Weekly Report. 2016 Feb 12; 65(5):115-9.
Blood transfusion is a life-saving medical intervention; however, challenges to the recruitment of voluntary, unpaid or otherwise nonremunerated whole blood donors and insufficient funding of national blood services and programs have created obstacles to collecting adequate supplies of safe blood in developing countries (1). Since 2004, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provided approximately $437 million in bilateral financial support to strengthen national blood transfusion services in 14 countries in sub-Saharan Africa and the Caribbean* that have high prevalence rates of human immunodeficiency virus (HIV) infections. CDC analyzed routinely collected surveillance data on annual blood collections and HIV prevalence among donated blood units for 2011-2014. This report updates previous CDC reports (2,3) on progress made by these 14 PEPFAR-supported countries in blood safety, summarizes challenges facing countries as they strive to meet World Health Organization (WHO) targets, and documents progress toward achieving the WHO target of 100% voluntary, nonremunerated blood donors by 2020 (4). During 2011-2014, overall blood collections among the 14 countries increased by 19%; countries with 100% voluntary, nonremunerated blood donations remained stable at eight, and, despite high national HIV prevalence rates, 12 of 14 countries reported an overall decrease in donated blood units that tested positive for HIV. Achieving safe and adequate national blood supplies remains a public health priority for WHO and countries worldwide. Continued success in improving blood safety and achieving WHO targets for blood quality and adequacy will depend on national government commitments to national blood transfusion services or blood programs through increased public financing and diversified funding mechanisms for transfusion-related activities.
Adoption of national recommendations related to use of antiretroviral therapy before and shortly following the launch of the 2013 WHO consolidated guidelines.
Nelson LJ; Beusenberg M; Habiyambere V; Shaffer N; Vitoria MA; Montero RG; Easterbrook PJ; Doherty MC
AIDS. 2014 Mar; 28 Suppl 2:S217-24.
OBJECTIVE: To determine the status of key national policies on the use of antiretroviral therapy (ART) at the time of the launch of the 2013 WHO consolidated guidelines as well as to track early progress towards adoption of these recommendations following dissemination. DESIGN: Descriptive analysis of global data on baseline ART policies as of June 2013 and early intentions to adopt the 2013 WHO for use of antiretroviral drugs guidelines as of November 2013. METHODS: Compilation of existing global reports on key HIV policies, review of national guidelines, data collection through annual drug procurement surveys and through guidelines dissemination meetings in each of the six WHO regions. RESULTS: Data were available from 124 low- and middle-income countries, including 97% of the 57 high-priority countries that have been identified by WHO and the Joint United Nations Program on HIV/AIDS (UNAIDS). At baseline, only one country reported recommending antiretroviral therapy (ART) at a CD4 T-cell count 250 cells/mul or less for adults and adolescents in 2013, whereas nine countries already recommended using CD4 T-cell count 500 cells/mul or less. Recommendations for ART initiation regardless of CD4 T-cell count for HIV-infected patients with tuberculosis (86%), hepatitis B (75%), all HIV-infected women who were pregnant or breastfeeding (option B+: 40%) or HIV-infected persons in a serodiscordant relationship (26%) had been nationally adopted as of June 2013. Eight of 67 countries (12%) already recommended treating all children less than 5 years of age. The triple antiretroviral combination of tenofovir + lamivudine (or emtricitabine) + efavirenz was recommended as the preferred first-line option for adults and adolescents more frequently (51%) than for pregnant women (38%), or for both adults/adolescents and pregnant women (28%; P < 0.05). Fewer than half (37%) of all countries reported recommending lopinavir/ritonavir for all HIV-infected children less than 3 years of age; 54% of countries reported recommending routine viral load monitoring, whereas only 41% recommended nurse-initiated ART. CONCLUSIONS: A number of key WHO policy recommendations on antiretroviral drug use were adopted rapidly by countries in advance of or shortly following the launch of the 2013 guidelines. Efforts are needed to support and track ongoing policy adoption and ensure that it is accompanied by the scale-up of evidence-based interventions.
Contraception for women with medical disorders.
Ng CH; Fraser IS; Berbic M
Best Practice and Research. Clinical Obstetrics & Gynaecology. 2014 Aug; 28(6):917-30.
Many women in the reproductive years have chronic medical conditions that are affected by pregnancy or in which the fetus is placed at increased risk. In most of these women, ongoing medical management of their conditions is greatly improved, even compared with a decade or two ago. However, their condition may still be seriously exacerbated by the physiological changes of pregnancy, and close monitoring of a carefully planned pregnancy is optimal. This requires effective and safe contraceptive use until pregnancy is desired and the medical condition is stabilised. Many contraceptives will also have adverse effects on some medical conditions, and there is now a considerable awareness of the complexities of some of these interactions. For this reason the World Health Organization has developed an excellent, simple and pragmatic programme of guidelines on a four point scale (the WHO "Medical Eligibility Criteria": WHO-MEC), summarising risk of specific contraceptive methods in women with specified chronic medical conditions. The general approach to contraceptive management of many of these conditions is addressed in this article. Copyright (c) 2014. Published by Elsevier Ltd.
UNAIDS terminology guidelines. Revised version.
Joint United Nations Programme on HIV / AIDS [UNAIDS]
Geneva, Switzerland, UNAIDS, 2011 Oct. [40] p.
These guidelines to UNAIDS’ preferred terminology have been developed for use by staff members, colleagues in the Programme’s 10 Cosponsoring organisations, and other partners working in the global response to HIV. Language shapes beliefs and may influence behaviours. Considered use of appropriate language has the power to strengthen the global response to the epidemic. UNAIDS is pleased to make these guidelines to preferred terminology freely available. It is a living, evolving document that is reviewed on a regular basis. Comments and suggestions for additions, deletions, or modifications should be sent to terminology@unaids.org.
Prevention of mother-to-child transmission of HIV: antiretroviral strategies.
Read JS
Clinics In Perinatology. 2010 Dec; 37(4):765-76, viii.
The World Health Organization's Strategic Approaches to the Prevention of HIV Infection in Infants includes 4 components: primary prevention of HIV-1 infection; prevention of unintended pregnancies among HIV-1-infected women; prevention of transmission of HIV-1 infection from mothers to children; and provision of ongoing support, care, and treatment to HIV-1-infected women and their families. This review focuses on antiretrovirals for secondary prevention of HIV-1 infection-prevention of HIV-1 transmission from an HIV-1-infected woman to her child. Antiretroviral strategies to prevent the mother-to-child transmission of HIV-1 in nonbreastfeeding populations comprise antiretroviral treatment of HIV-1-infected pregnant women needing antiretrovirals for their own health, antiretroviral prophylaxis for HIV-1-infected pregnant women not yet meeting criteria for treatment, and antiretroviral prophylaxis for infants of HIV-1-infected mothers. The review primarily addresses antiretroviral strategies for nonbreastfeeding, HIV-1-infected women and their infants in resource-rich settings, such as the United States. Antiretroviral strategies to prevent antepartum, intrapartum, and early postnatal transmission in resource-poor settings are also addressed, albeit more briefly. Copyright (c) 2010 Elsevier Inc. All rights reserved.
HIV: the fight is far from over.
Lancet. 2010 Dec 4; 376(9756):1874.
This editorial argues that despite the report by UNAIDS that the trajectory of the HIV epidemic has been broken, a US Institute of Medicine (IOM) report paints a bleaker picture for the immediate future of HIV/AIDS in Africa. The IOM report states that sub-Saharan Africa bears 68% of the worldwide burden of HIV infection and the gap is growing between the number of people needing treatment and the availability of resources.
The Millennium Development Goals report 2007.
New York, New York, United Nations, Department of Economic and Social Affairs, 2007 Jun. 36 p.
Since their adoption by all United Nations Member States in 2000, the Millennium Declaration and the Millennium Development Goals have become a universal framework for development and a means for developing countries and their development partners to work together in pursuit of a shared future for all. The Millennium Declaration set 2015 as the target date for achieving most of the Goals. As we approach the midway point of this 15-year period, data are now becoming available that provide an indication of progress during the first third of this 15-year period. This report presents the most comprehensive global assessment of progress to date, based on a set of data prepared by a large number of international organizations within and outside the United Nations system. The results are, predictably, uneven. The years since 2000, when world leaders endorsed the Millennium Declaration, have seen some visible and widespread gains. Encouragingly, the report suggests that some progress is being made even inthose regions where the challenges are greatest. These accomplishments testify to the unprecedented degree of commitment by developing countries and their development partners to the Millennium Declaration and to some success in building the global partnership embodied in the Declaration. The results achieved in the more successful cases demonstrate that success is possible in most countries, but that the MDGs will be attained only if concerted additional action is taken immediately and sustained until 2015. All stakeholders need to fulfil, in their entirety, the commitments they made in the Millennium Declaration and subsequent pronouncements. (excerpt)
Population and HIV / AIDS 2007. [Wallchart].
United Nations. Department of Economic and Social Affairs. Population Division
New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2008 Mar. [2] p. (ST/ESA/SER.A/270)
The AIDS epidemic remains one of the greatest challenges confronting the international community. In countries with a large number of people living with HIV, all population and development indicators are affected by the epidemic. Governments often cite HIV/AIDS as their most significant demographic concern. For more than two decades, the rapidly expanding HIV/AIDS epidemic has triggered a wide array of responses at the national, regional and global levels. The goals established by the United Nations General Assembly in the 2000 Millennium Declaration and through the adoption of the 2001 Declaration of Commitment on HIV/AIDS reflect widely-held concerns about the impact of the epidemic on development and human well-being. More recently, at the 2006 High Level Meeting on AIDS, Member States adopted a Political Declaration focusing on how to attain universal access to comprehensive HIV/AIDS prevention programs, treatment, care and support by 2010. (excerpt)
Children and AIDS: Second stocktaking report. Actions and progress.
UNICEF; Joint United Nations Programme on HIV / AIDS [UNAIDS]; World Health Organization [WHO]
New York, New York, UNICEF, 2008 Apr. 48 p.
This report will focus on three major themes. First, strengthening communities and families is crucial to every aspect of a child-centred approach to AIDS. Support by governments, NGOs and other actors should therefore be complementary to and supportive of these family and community efforts, through, for example, ensuring access to basic services. Second, interventions to support children affected by HIV and AIDS are most effective when they form part of strong health, education and social welfare systems. Unfortunately, because maternal and child health programmes are weak in many countries, millions of children, HIV-positive and -negative alike, go without immunization, mosquito nets and other interventions that contribute to the overall goal of HIV-free child survival. A final theme of this report is the challenge of measurement. Documenting advances and shortfalls strengthens commitment and guides progress. A number of countries have data available on the 'Four Ps', and targeted studies are being developed to assess the situation of the marginalized young people who are most at risk but often missed in routine surveys. (excerpt)
International guidelines on HIV / AIDS and human rights. 2006 consolidated version. Second International Consultation on HIV / AIDS and Human Rights, Geneva, 23-25 September 1996. Third International Consultation on HIV / AIDS and Human Rights, Geneva, 25-26 July 2002. Organized jointly by the Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV / AIDS.
Office of the United Nations High Commissioner for Human Rights; Joint United Nations Programme on HIV / AIDS [UNAIDS]
Geneva, Switzerland, Office of the United Nations High Commissioner for Human Rights, 2006. 115 p. (HR/PUB/06/9)
The International Guidelines on HIV/AIDS and Human Rights arose because of various calls for their development in light of the need for guidance for Governments and others on how to best promote, protect and fulfill human rights in the context of the HIV epidemic. During the first International Consultation on AIDS and Human Rights, organized by the United Nations Centre for Human Rights, in cooperation with the World Health Organization, in Geneva, from 26 to 28 July 1989, participants discussed the possible elaboration of guidelines to assist policymakers and others in complying with international human rights standards regarding law, administrative practice and policy. Several years later, in his report to the Commission at its fifty-first session (E/CN.4/1995/45, para.135), the United Nations Secretary-General stated that "the development of such guidelines or principles could provide an international framework for discussion of human rights considerations at the national, regional and international levels in order to arrive at a more comprehensive understanding of the complex relationship between the public health rationale and the human rights rationale of HIV/AIDS. In particular, Governments could benefit from guidelines that outline clearly how human rights standards apply in the area of HIV/AIDS and indicate concrete and specific measures, both in terms of legislation and practice, that should be undertaken". (excerpt)
AIDS epidemic update, December 2007.
Joint United Nations Programme on HIV / AIDS [UNAIDS]; World Health Organization [WHO]
Geneva, Switzerland, UNAIDS, 2007 Dec. 50 p. (UNAIDS/07.27E; JC1322E)
Every day, over 6800 persons become infected with HIV and over 5700 persons die from AIDS, mostly because of inadequate access to HIV prevention and treatment services. The HIV pandemic remains the most serious of infectious disease challenges to public health. Nonetheless, the current epidemiologic assessment has encouraging elements since it suggests: the global prevalence of HIV infection (percentage of persons infected with HIV) is remaining at the same level, although the global number of persons living with HIV is increasing because of ongoing accumulation of new infections with longer survival times, measured over a continuously growing general population; there are localized reductions in prevalence in specific countries; a reduction in HIV-associated deaths, partly attributable to the recent scaling up of treatment access; and a reduction in the number of annual new HIV infections globally. Examination of global and regional trends suggests the pandemic has formed two broad patterns: generalized epidemics sustained in the general populations of many sub-Saharan African countries, especially in the southern part of the continent; and epidemics in the rest of the world that are primarily concentrated among populations most at risk, such as men who have sex with men, injecting drug users, sex workers and their sexual partners. (excerpt)
Global progress in PMTCT and paediatric HIV care and treatment in low- and middle-income countries in 2004 -- 2005.
Luo C; Akwara P; Ngongo N; Doughty P; Gass R
Reproductive Health Matters. 2007 Sep; 15(30):179-189.
A growing number of countries are moving to scale up interventions for prevention of mother-to-child transmission (PMTCT) of HIV in maternal and child health services. Similarly, many are working to improve access to paediatric HIV treatment. This paper reviews national programme data for 2004-2005 from low- and middle-income countries to track progress in these programmes. The attainment of the UNGASS target of reducing HIV infections by 50% by 2010 necessitates that 80% of all pregnant women accessing antenatal care receive PMTCT services. In 2005, only seven of the 71 countries were on track to meet this target. However PMTCT coverage increased from 7% in 2004 (58 countries) to 11% in 2005 (71 countries). In 2005, 8% of all infants born to HIV positive mothers received antiretroviral prophylaxis for PMTCT, up from 5% in 2004, though only 4% received cotrimoxazole. 11% of HIV positive children in need received antiretroviral treatment in 2005. In 31 countries that had data, 28% of women who received an antiretroviral for PMTCT also reported receiving antiretroviral treatment for their own health. Achieving the UNGASS target is possible but will require substantial investments and commitment to strengthen maternal and child health services, the health workforce and health systems to move from pilot projects to a decentralised, integrated approach. (author's)
[Molecular epidemiology of HIV infection]
Yin TM
Zhonghua Liu Xing Bing Xue Za Zhi / Chinese Journal of Epidemiology. 1997 Oct; 18(5):309-311.
Global HIV infection and AIDS: according to WHO estimates, by mid 1996 there were 7 million cumulative AIDS cases. Today the number of people infected with HIV is even more alarming: roughly 21.8 million, of those 42% are women. By the year 2000 there will be between 40 and 50 million cases. Each day about 8,500 additional people are infected with AIDS; one can say the situation is grim. Currently, the AIDS and HIV epidemic regions are shifting, they have gradually moved from the original sites of North America and West Europe toward the mass populations of developing countries in Asia, Africa, and Latin America. In the Asian region which contains about 60% of the world's population, beginning in 1988, with Thailand and India at the center, an exploding epidemic has taken shape. Recent materials indicate, those infected with HIV in Thailand exceed 700,000, over 2 million in India, and the HIV epidemic has already spread to the near neighbors Burma, southern China, Cambodia, Malaysia and Vietnam. With the accumulation of molecular epidemiology research materials, the complete picture of the causes and characteristics of this massive epidemic happening in the Asian region is gradually becoming clear. (excerpt)
Wanted: a just, humane world.
Bekele F
Africa Recovery. 1999 Dec; 13(4):[3] p..
Within a generation, the world could -- and should -- become a place where every infant is properly nurtured and cared for, where every child receives a quality basic education, and where every adolescent is given the support and guidance he or she needs in the difficult transition to adulthood, says the State of the World's Children 2000, published in December by the UN Children's Fund (UNICEF). Acknowledging the progress made in protecting children over the course of this century and in the decade since the 1989 adoption of the Convention on the Rights of the Child, UNICEF says much more remains to be done. It draws particular attention to three tragedies of which children and women are currently the main victims, largely in the developing world: armed conflict, HIV/AIDS and poverty. And the report adds that women are victims of these ills in disproportionate numbers due to gender discrimination. (excerpt)
Strategic guidance on HIV prevention.
New York, New York, UNFPA, 2001. 32 p. (Preventing HIV / Promoting Reproductive Health)
UNFPA has worked in the field of population and development for more than three decades and has addressed the issue of HIV/AIDS for the last decade. However, no organization by itself has the capacity or the resources needed to address and halt the pandemic. An effective response requires careful collaboration and coordination among organizations, with each bringing to the partnership a distinct set of capabilities, strengths and comparative advantages. As one of the eight cosponsors of UNAIDS (the other cosponsors being UNICEF, UNDP, UNDCP, UNESCO, ILO, WHO and World Bank), UNFPA chairs Theme Groups in many countries and supports HIV-prevention interventions in almost all of its country programmes. To maximize its response and to strengthen coordinated activities with other partners, it is critical for staff at every level to have a common understanding of the Fund’s policies and strategic priorities. The aim of this document is to provide such guidance to staff, delineating the niche in which UNFPA as an organization has a definite comparative advantage in addressing the HIV/AIDS epidemic, especially at the country level. (excerpt)
Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: guidelines on care, treatment and support for women living with HIV / AIDS and their children in resource-constrained settings.
World Health Organization [WHO]
Geneva, Switzerland, WHO, 2004. v, 49 p.
Mother-to-child transmission (MTCT) is the most important source of HIV infection in children. In 2001, the United Nations General Assembly Special Session on HIV/AIDS committed countries to reduce the proportion of infants infected with HIV by 20% by 2005 and by 50% by 2010. Achieving this urgently requires an increase in access to integrated and comprehensive programmes to prevent HIV infection in infants and young children. Such programmes consist of interventions focusing on primary prevention of HIV infection among women and their partners; prevention of unintended pregnancies among HIV-infected women; prevention of HIV transmission from HIV-infected women to their children; and the provision of treatment, care and support for women living with HIV/AIDS, their children and families. WHO convened a Technical Consultation on Antiretroviral Drugs and the Prevention of Mother-to-child Transmission of HIV Infection in Resource-limited Settings in Geneva, Switzerland on 5–6 February 2004. Scientists, policymakers, programme managers and community representatives reviewed the most recent experience with programmes and evidence on the safety and efficacy of various antiretroviral (ARV) regimens for preventing HIV infection in infants. This information was reviewed in the context of the rapid expansion of ARV treatment in resource-constrained settings using standardized and simplified drug regimens. Prior to the Technical Consultation, a draft set of recommendations had been issued for public comment. (excerpt)
At the crossroads: accelerating youth access to HIV / AIDS interventions.
Joint United Nations Programme on HIV / AIDS [UNAIDS]. Inter-Agency Task Team on Young People
New York, New York, United Nations Population Fund [UNFPA], HIV / AIDS Branch, UNAIDS Inter-Agency Task Team on Young People, 2004. 8 p.
Young people remain at the centre of the epidemic in terms of transmission, vulnerability, impact, and potential for change. Today’s young generation, the largest in history, has not known a world without AIDS. Of the over 1 billion young people worldwide, 10 million are currently living with HIV. If we are to reach the global targets set forth in international agreements, urgent action and increased investment must be made in HIV prevention, treatment and care programmes specifically for young people. (excerpt)
Sport for development and peace: towards achieving the Millennium Development Goals. Report from the United Nations Inter-Agency Task Force on Sport for Development and Peace.
United Nations. Inter-Agency Task Force on Sport for Development and Peace
New York, New York, United Nations, 2003. vi, 36 p.
This report analyses in detail the potential contribution that sport can make towards achieving the United Nations Millennium Development Goals (MDGs). It provides an overview of the growing role that sports activities are playing in many United Nations programmes and crystallizes the lessons learned. It also includes recommendations aimed at maximizing and mainstreaming the use of sport. (excerpt)
Technical advisory meeting on implications of the newly identified HIV-1 subtype O viruses for HIV diagnosis. Press release.
World Health Organization [WHO]. Office of Information
Geneva, Switzerland, WHO, 1994 Jun 24. 2 p. (Press Release WHO/50)
HIV is characterized by an high level of genetic diversity. HIV types HIV-1 and HIV-2 have been identified, and HIV-1 variants have been grouped by their gag and env sequences into at least eight subtypes, subtypes A-H. Divergent HIV-1 subtypes also have recently been identified which cannot be classified in any of the existing HIV-1 subtypes and are thus designated as subtype O for "genetic outliers". Limited available sequence data from HIV-1 subtype O viruses suggest that diversity within the subtype O group may be as great as that which exists between HIV-1 subtypes A-H. The majority of virus strains classified as HIV-1 subtype O have been isolated from patients of Cameroonian origin or their sexual contacts although recent preliminary studies in Cameroon suggest that less than 10% of HIV-1 infections there are caused by subtype O strains. A few subtype O infections have also been reported in Gabon and France, but limited studies have found no evidence of the presence of HIV-1 subtype O in Belgium, Cote d'Ivoire, Kenya, Togo, and Zaire. The ability of currently available anti-HIV assays to identify individuals infected with subtype O has not been extensively studied. An informal consultation of 22 international experts on the implications of this newly identified subtype for HIV diagnosis took place June 9-10, 1994, at World Health Organization headquarters. In general, one is more likely to fail in detecting HIV infection because of the absence of antibody in the seroconversion window phase than from infection with an highly divergent HIV subtype. The existence of these subtype O viruses is therefore likely to have little, if any, impact upon HIV diagnosis and blood safety outside of the area where they are prevalent. The expert group recommended that diagnostic tests and strategies for HIV antibody testing be urgently reevaluated in the region where subtype O virus has been found, a panel of sera be collected from asymptomatic and symptomatic individuals to use in assessing the sensitivity of available HIV antibody assays for antibodies against HIV-1 subtype O, envelope genes of subtype O isolates be sequenced to provide information useful in the production of HIV antibody assays and the determination of the relatedness of HIV strains, expanding the global surveillance of newly recognized HIV subtypes, and developing and evaluating algorithms for the detection and further characterization of variant HIV strains.
Estimated global distribution and regional spread of HIV-1 genetic subtypes in the year 2000.
Osmanov S; Pattou C; Walker N; Schwardlander B; Esparza J
Journal of Acquired Immune Deficiency Syndromes. 2002 Feb 1; 29(2):184-90.
The objective of this study was to estimate the global distribution and regional spread of different HIV-1 genetic subtypes and circulating recombinant forms (CRFs) in the year 2000. These estimates were made based on data derived from global HIV/AIDS surveillance and molecular virology studies. HIV-1 incidence during the year 2000 was estimated in defined geographic regions, using a country-specific model developed by WHO-Joint UN Programmes on HIV/AIDS (UNAIDS). The proportion of new infections caused by different HIV-1 subtypes in the same geographic regions was estimated by experts from the WHO-UNAIDS Network for HIV Isolation and Characterization, based on results generated by HIV molecular epidemiology studies in 1998-2000. The absolute numbers and relative proportions of new infections due to different genetic subtypes of HIV- 1 by different geographic regions were calculated using these two sets of estimated data. The results of the study demonstrated that the epidemiology of HIV-1 subtypes and CRFs is characterized by their differential distribution and varying significance as a driving cause of the pandemic on regional and global basis. The largest proportion of HIV-1 infections in the year 2000 was due to subtype C strains (47.2%). Subtype A/+CRF02_AG was estimated to be the second leading cause of the pandemic (27%), followed by subtype B strains (12.3%). The same analysis confirmed an increasing role of HIV-1 CRFs in the pandemic. The authors conclude that combined analysis of data based on the global HIV/AIDS surveillance and molecular virology studies provides for a useful model to monitor the dynamics of the global spread of HIV-1 subtypes and CRFs on regional and country levels--the information of potential importance for diagnosis and treatment of HIV/AIDS, as well as for the development globally effective HIV vaccines. (author's)
Networking of laboratories for isolation and characterization of HIV-1 in different countries.
Osmanov S
In: International Symposium on Biomedical Research Issues of HIV Infection in Thailand. Bangkok, Thailand, January 31 - February 2, 1994. Sponsors: Thailand Health Research Institute, Harvard AIDS Institute, Ministry of Public Health of Thailand, Center for Vaccine Development, Mahidol University. Cambridge, Massachusetts, Harvard AIDS Institute, 1994. 4-6.
HIV-1 is a complex retrovirus characterized by extensive genetic variation due to numerous errors in reverse transcription and involving different geneses of the mutations. At least six nearly equidistant genetic clades, or subtypes, can be identified based upon the phylogenetic analysis of the env coding sequences. HIV-1 variability may make it difficult to develop vaccines which are effective against the various HIV-1 strains prevalent in different geographic locations. With the goal of establishing a mechanism for monitoring HIV-1 variability on a global basis, the Global Program on AIDS of the World Health Organization (WHO) established the WHO Network for HIV-1 Isolation and Characterization. The network constitutes an integral part of the WHO Strategy for HIV-1 Vaccine Development. It is formed by primary laboratories in Brazil, Rwanda, Thailand, and Uganda, the WHO-sponsored sites for the development and field evaluation of HIV-1 vaccines; 15 secondary/expert laboratories in France, Germany, Spain, Sweden, the Netherlands, the UK, and the US which conduct detailed characterization of HIV-1 strains; centralized facilities in Germany and the UK for the isolation of HIV-1 strains following standard procedures; repositories for the storage and distribution of viral isolates and other reagents in the UK and the US; and data management facilities in collaboration with the Los Alamos HIV-1 Database in the US. Five of the six known HIV-1 genetic subtypes were found through genetic screening of HIV-1 strains collected from the four sites. In most cases, more than one subtype was present in the same country. Biologic characterization of the HIV-1 isolates determined that most of the viral strains collected in Brazil, Rwanda, and Thailand can be defined as slow/low phenotypes and were non-syncytia inducing. The Ugandan isolates belonging to subtype D, but not to subtype A, were characterized by the highest replicative capacities and were syncytia-inducing viruses. There is as yet no explanation for this latter finding.
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400 Communications Ltd
57 Hatton Garden, London
EC1N 8HP (Map)
design@400.co.uk
jobs@400.co.uk
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Museum of Brands
The Museum of Brands hosts exhibitions that explore the social impact of good design, and is a great addition to your list of places to visit in 2019.
Last year Time Out magazine celebrated their 50th birthday with a series of events across London. One of the things that caught our eye was their ‘50 Years, 50 Covers’ exhibition at the Museum of Brands. Not only did this explore the way in which Time Out has grown as a brand since its birth, but it made for a stunning visual representation of the changing face of London: a timeline of how the city, the consumer and our society has developed over the past 50 years.
With contributions from a huge number of designers, the exhibition offered a diverse exploration of aspects of design including typography, photography, illustration and collages. It exposed how each contributor has been influenced by the decade, year, month, even week in which they were working. These designs act as a social narrative, telling us something of the time in which they were created.
Exhibition: Time Out: 50 years, 50 covers
The museum is a great place to go to discover how society informs the way we think about design. The current exhibition, ‘Can Marketing Save Lives?’ looks at how advertising has been used over the past century to influence the British public in terms of motivating and educating them on issues of public health. It highlights how visual cues have been used in the media to influence behaviour over the years, and asks how advertising can be used going forward to engage the public and act as a support tool for the prevention and handling of public health concerns.
Exhibition: Can Marketing Save Lives?
With exhibitions running alongside each other that address such varied subjects, the museum explores how good design connects politics, modern culture, social issues and technology. Taking this on board, and working with clients such as UNICEF and the World Health Organisation, we are keen to further explore the social impact of design.
Looking towards the year ahead we will be considering human-led design in more detail and looking to translate our ideas and briefs into visually effective work that both illustrates and informs. Watch this space!
Museum of Brands has one permanent exhibition, ‘Time Tunnel’, which showcases the history of advertising over the last 150 years, as well as a rolling series of different exhibitions, talks and events throughout the year.
‘Can Marketing Save Lives?’ is on until 26 May.


Arthur Meredith Walters
Arthur Meredith Walters (1918 - 2010) was a social services administrator who is most recognized for his role as the Louisville Urban League executive director from 1970 to 1987. Known as a “bridgebuilder” and one of Louisville, Kentucky’s most effective leaders for justice and opportunity, he was among the inaugural inductees of the Kentucky Human Rights Commission Hall of Fame in 2000. Walters was born Nov. 6, 1918, in Magnolia, Ky. He graduated as valedictorian of his class from Bond-Washington High School. He was attending Kentucky State College when he entered the U.S. Army in 1945. A veteran of World War II and the Korean War, he was one of the first African American officers to lead integrated troops. Walters earned the U.S. Army Bronze Star for valor and the Soldier’s Medal. He retired as a lieutenant colonel after serving 20 years. He later earned his Master’s of Education degree from the University of Louisville. He joined the Louisville Urban League, an affiliate of the National Urban League, in 1963, as its industrial relations secretary, and from 1963 to 1987, he worked tirelessly in creating employment, housing, and educational opportunities previously denied minorities. He wrote the nationally recognized on-the-job training program for the League to assist the under-skilled in finding employment and to help persuade Kentucky and area companies to hire, train, and recruit black workers. In 1969, for example, he led efforts to place 345 workers in jobs, which paid them a combined paycheck of more than $2 million, according to Urban League statistics. He told The Louisville Times in 1970, “We have convinced the ‘doubting Thomases’ that disadvantaged people can be good employees, and the only way to determine if they can perform is to put them on jobs.” Arthur Walters’ hard work gained him the respect of many, statewide and nationally. His achievements earned him an impressive list of honors, including Adult Black Achiever of the Year, Freedom Award, and Doctor of Humane Letters from Bellarmine University, where there is a scholarship named for him. The annual Louisville Urban League Arthur M. Walters Champion of Diversity Award is also named in his honor. He died Oct. 16, 2010, at the age of 91.


Hot Topic #10
Here is our list of examples dealing with asbestos:
Please note that this is only a random selection of examples of good practice and this list is not supposed to and cannot be complete.
To learn more, you can go to our TOOLBOX and search for the title of the example (please note that the database search takes some time), go to the GOOD PRACTICE area (if the example is presented there) or follow the link to the project or partner web site.
Asbestos in schools (UK)
This website by HSE offers a variety of information and material related to abestos – guidelines, regulations, information on inspection initiatives and a checklist.
Asbestos was extensively used as a building material in the UK from the 1950s through to the mid-1980s. It was used for a variety of purposes, typically fireproofing and insulation. Any building built before 2000 (houses, factories, offices, schools, hospitals etc) can contain asbestos.
System buildings (for example CLASP, SCOLA, SEAC, MACE, ONWARD) constructed during the period 1945 -1980 were widely used for the construction of school premises. These buildings can have structural columns fire proofed with asbestos containing materials (ACMs).
The Impact of Asbestos (Canada)
This video describes the history of asbestos, from its origins as a "miracle" material to its threat to worker health and safety. It includes personal stories from those who've been directly affected and urges those at risk of exposure to test for the presence of asbestos and only remove it if trained and qualified.
Video (on YouTube)
Information modules for the safer handling of asbestos (Europe)
Nine information modules have been produced by the European Federation of Building and Woodworkers (EFBWW), each dealing with a specific family of products. The nine modules are presented in a folder which gives basic information on asbestos and on how to work with it. Additionally, it covers some details on the project partners. Additionally a leporello/leaflet has been produced, also giving some basic information on asbestos and showing parts of the nine information modules. This leaflet is directed to workers especially. All products are available in the following languages. English, French, German, Hungarian, Italian, Lithuanian, Polish and Spanish. They are available as a printed version and on the project partners webpages as electronic versions.
Håndbogen (Denmark)
This manual is a work of reference for the working environment in the building and construction industry. The manual provides guidelines on good working environment practice and on how the rules of the Working Environment Act can be followed within enterprises and on building sites.
The manual has been published by Branchearbejdsmiljørådet for Bygge & Anlæg, with specialist assistance from Working Environment Authority experts in the field of building and construction.
ABClean Project (Europe)
In many Member States, asbestos related training requirements are often limited to workers in companies specialized in asbestos removal. This leaves out many workers who are at risk of exposure to asbestos, who receive no training on asbestos awareness at all.
For this reason, ABClean distinguishes between two types of workers when it comes to asbestos. The first group consists of workers in companies that are specialized in asbestos removal, who receive the appropriate training to perform this task and the second group consists of workers in other professions who are not specialized in asbestos removal, but who may encounter asbestos containing products in the course of e.g. maintenance, demolition or renovation. While some Member States have legislation in place to train this second group of workers on asbestos awareness, other Member States do not. In order to help address this discrepancy, the e-learning course is being offered together with training providers and institutes for occupational medicine.
Introduction to asbestos learning package (UK)
This 45 minute interactive lesson with supporting activities and materials is aimed primarily at trades apprentices in the 16 - 19 age group, for delivery by college lecturers and other vocational education providers. It is also relevant to, and capable of being delivered by, industry professionals, eg as part of workplace training.
Research shows that although tradespeople know that asbestos is harmful to health, they believe that it is a historical problem, and so do not take action to protect themselves. This package is designed to raise awareness of apprentices about the risks they face when working with asbestos, providing them with basic guidance about what they need to do.
The package is free to download and consists of: Introduction and Lesson Plan for lecturers, 'Asbestos The Hidden Killer' power point presentation (Including notes for lecturers), Task sheets „The hunt for asbestos“, Pocket card
, Film poster, Comic poster, Asbestos building poster
Asbestos – the hidden killer (UK)
Special website run by HSE providing information on asbestos and asbestos- related risks and dangers. The website contains information, brochures, videos and more.
Whats is asbestos? Where can it be found? What is the danger? How should I handle it? What are the facts? These are the questions asked and answered on the website.
Asbestos guidelines (Austria)
These guidelines offers hands-on information about asbestos, risks and dangers related to asbestos and methods for minimizing and avoiding dangers and risks at work related to asbestos.
Asbestos in Kyrgyzstan (Kyrgyzstan)
Asbestos and asbestos waste are hazardous to human health and the environment. Kyrgyzstan is one of world's biggest consumers of asbestos. Currently asbestos containing materials are used without restriction in public buildings like hospitals, schools and kindergartens, and in many other consumer products such as brakes and building materials. To raise awareness, provide information, build networks, strengthen citizen's capacities and develop solution strategies to present to state authorities, this project will help to reduce the use of asbestos and clean up contaminated waste sites. People now and future generations will highly benefit from these activities.
WECF in cooperation with BIOM, Kyrgyzstan, will convene a High-Level Conference on Asbestos in Bishkek and conduct trainings in several cities of Kyrgyzstan with different multpliers, including NGOs.
asbestos.com
This website by The Mesothelioma Center, USA, provides various information and help on Asbestos-related health problems. Information on Mesothelioma and its causes, resources to find help, legal options and lots of other resources are available.
Videos of people with asbestos-related health problems, the „Mesothelioma Packet“, an informational packet with detailed and comprehensive resources about this disease and the information on the website about possible Asbestos exposure at work can be used for prevention and educational purposes to raise awareness for the risks and dangers of Asbestos.
www.asbestos.com
OSH Reps
This website from Australia offers information on many different hazards at work, training courses on various topics, frequently asked questions and the possibility to ask questions.
www.ohsrep.org.au
Mesothelioma + Asbestos Awareness Center
The Mesothelioma + Asbestos Awareness Center brings attention to the dangers of asbestos and the deadly form of cancer it causes: mesothelioma. MAA center is an independent group working to help mesothelioma patients, caregivers, advocates and others looking to learn more about the disease.
The website offers information about mesothelioma diagnosis, treatment, and other aspects of the disease, as well as the substance that causes it (asbestos), a regularly updated blog that provides the latest news about mesothelioma treatment research, advocacy efforts, and legal issues, a comprehensive directory of doctors and cancer centers that treat mesothelioma, complete with contact information, a well as access to free case reviews for mesothelioma patients and family members who want to learn more about legal compensation.
MAA Center
Mesothelioma Justice Network at asbestos.net
The Mesothelioma Justice Network was established to be the leading online resource for victims of asbestos exposure. The network tries to help people suffering from Mesothelioma by learning exactly how asbestos has affected them, understand and cope with the disease and take legal action against those responsible for the diagnosis.
It’s been well-established that mesothelioma patients and those with asbestos-related diseases are legally entitled to compensation for their diagnosis. The complicated part is proving the exposure and linking it directly to one or more negligent companies.
The Mesothelioma Justice Network longs to help prove the case. Comprehensive informational, legal and supportive resources have been established to help patients navigate the intricacies of this situation. The Mesothelioma Justice Network is the resource that not only helps to understand the legal rights, but actually fights for the victims on their behalf.
www.asbestos.net
Mesothelioma Guide
Mesothelioma is a rare but serious cancer caused by exposure to asbestos. It takes 20-50 years to develop and occurs in the lining of the lungs, chest, abdomen and heart. Mesothelioma Guide is a website providing lots of resources for people suffering with this asbestos-related type of cancer. The website helps to learn about the disease, find doctors, treatment, financial help and advice. It offers an interactive live chat and maps to find a doctor in your region, a link to a community of patients, as well as reports of patients who survived mesothelioma.
The Free Mesothelioma Guide can be ordered on the website.
www.mesotheliomaguide.com
Mesothelioma Group
Mesothelioma is a type of cancer that affects the mesothelium, a thin membrane protecting the lungs, abdomen and heart. Where the cancer originated in the mesothelium determines the mesothelioma type. There are three types of Mesothelioma: Pleural Mesothelioma, Peritoneal Mesothelioma and Pericardial Mesothelioma.
The Mesothelioma Group is a small team of healthcare professionals, patient advocates, and communication specialists who have one goal: to lead the way in supporting and encouraging mesothelioma patients and their families. The group provides step-by-step guidance, caregiving support, and invaluable resources and information.
www.mesotheliomagroup.com
Mesothelioma Help
The mission of Mesothelioma Help is to spread awareness and provide information to individuals who might have experienced Asbestos exposure, which leads to the deadly cancer of Mesothelioma.
The primary victims of Asbestos exposure and Mesothelioma include veterans, emergency personnel, firemen, mechanics, and even homeowners. By providing a live chat option (the only mesothelioma/asbestos website that offers a live chat 24/7), Q & A sessions, survivor blog posts, and an annual $10,000 scholarship, the website strives to have an impact on the community. Mesothelioma Help has fostered relationships with organizations all across the globe.
www.mesotheliomahelp.org
Mesothelioma HelpNow
Mesothelioma HelpNow wants to educate and support mesothelioma patients and their families. Research has shown the more they know about a disease, the better prepared they'll be to cope with everything that comes their way.
The website offers a wide range of information material for patients and friend or family members, a blog and lots of resources to find information and help.
www.mesotheliomahelpnow.com
mesothelioma.net
Another resource for help in case of Mesothelioma is mesothelioma.net. This website offers lots of information, contact details for doctors, trusts, veterans, a live chat and facts on Mesothelioma, treatments, benefits and free resources.
Mesothelioma Fund
Mesotheliomafund.com provides support and assistance for mesothelioma victims. Th mission is to help patients and their families get compensation through asbestos and mesothelioma trust funds. Trust funds were formed in the 1970's as irresponsible companies were forced to reveal the true dangers of the mineral. Since then, hundreds of thousands of victims have filed claims against companies that were responsible for asbestos exposure.
www.mesotheliomafund.com
treatmesothelioma.org
treatmesothelioma.org is a website containing information on Asbestos, Mesothelioma, treatments, medical help and further information on the topic. The site offers videos, a handbook, a community, and more.
www.treatmesothelioma.org
BYGGESIKKERHED (Construction Safety) (Denmark)
BYGGESIKKERHED.DK is a multimedia website dealing with construction safety. The website is available in four languages: Danish, English, Polish and German. It contains 15 different areas, each of them covering one profession at the construction site: bricklayer, scaffold builder, glazier, floor fitter, construction builder, mason paviour, building builder, electrician, painter, demolition worker, roofer, carpenter, plumber, asphalt worker and safety representative.
For every profession, a humorous video clip starring "Bent E" puts a focus on the special safety requirements. In addition, a collection of facts is available, as well as "Tasks", a kind of quiz to show what the user has learned so far.
This example can be found in detail in our GOOD PRACTICE area
Dealing safely with asbestos (Greece)
Greek Ministry of Labour and Social Affairs
Materials containing asbestos are a risk factor for those who come into contact with them, especially employees carrying out dismantling and demolition work. The hazards attached to asbestos will have not disappeared with the adoption of the proposed Community directive (amending Directive No 83/477/EEC) prohibiting the production and use of asbestos.
Protocol for a safe building renovation (Italy)
Renovation of a historic 14th century country house and its buildings in its grounds (lemon-house, cellar, storerooms) in order to create a large, luxury hotel complex and the creation of a business centre for the farm’s production activities. There is generally a high accident rate in building work. This particular project was difficult because of the need to preserve the historic features of the building and renovate to modern standards. The age of the buildings meant that there could be additional and unknown safety and health risks to the building workers present, for example due to weaknesses in the building structure.
Database (Tool Box)
Education Online


Fifth Quarter
Sports related news stories
Kentucky AD to succeed Duke AD as next to lead NCAA D1 men’s hoops...
Associated Press - July 12, 2019 3:16 PM
Kentucky athletic director Mitch Barnhart has been selected to lead the NCAA Division I Men's Basketball Committee.
WWAY News - July 10, 2019 5:50 PM
N.C. State fans are one step closer to drinking alcohol at Carter-Finley Stadium this fall after the Board of Trustees updated the school’s alcohol policy on Wednesday.
Tanner Barth - July 10, 2019 3:32 PM
Cori "Coco" Gauff took the tennis world by storm at Wimbledon and it began by beating her idol Venus Williams. There's a similar story right here in our own backyard.
WILMINGTON, NC (WWAY) — This weeks episode of Tanner’ Tee-Off Tuesday sent us to the Beau Rivage Golf and Resort in Wilmington.
The Burgaw Dixie Youth Sweetees are pint-sized sluggers who have something big to celebrate.
Fans cheer World Cup champs as leaders on and off the field
Associated Press - July 10, 2019 11:28 AM
The U.S. women's national soccer team will reign supreme once again Wednesday in New York City's Canyon of Heroes.
Tanner Barth - July 9, 2019 11:42 PM
The Los Angeles Lakers announced on Tuesday night that they have signed former UNCW men's basketball standout Devontae Cacok to deal.
The All-Star baseball season will continue for the Supper Optimist 10 & Under team out of Wilmington. They won the 10 & Under State Championship over the weekend in Ayden, NC.
Coco Gauff ends run at Wimbledon after loss in 4th round
Coco Gauff’s unexpected but remarkable run at Wimbledon is over. The 15-year-old American, who became the youngest player to qualify for Wimbledon’s main draw in the professional era, lost to former No. 1 Simona Halep 6-3, 6-3 in the fourth round on Monday.


20 Secrets Behind Yukon Men
by Doug Wintemute
Since it premiered on August 24th, 2012, Discovery Channel's Yukon Men has gained a large following of fans, who enjoy the show for its unscripted feel and its look at the lives of hunters and trappers in the wild north. Set in and around the Alaskan town of Tanana, a small village with about 300 residents, the name Yukon Men might seem misplaced. That being said, Tanana's location on the Yukon River might give you some insight into the choice.
The show follows a few specific hunters, trappers, and their families as they try to survive among the difficult conditions of the middle of nowhere. With few resources readily available, the men on the show must hunt and fish to survive and thrive. Each episode provides viewers with an closer look at the personal lives of these men -- we hear stories and watch as they try to overcome Mother Nature.
Fans aren't told everything. By scouring behind-the-scenes, we've found information that even the most voracious of fans might have missed. We'll reveal the information that is missing from many episodes and the secrets that the producers may not want viewers to know.
From untold dangers to the hidden and harsh realities of the show, here are 20 Secrets Behind Yukon Men.
20 Stan Zuray Fights
One of the stars of Yukon Men, Stan Zuray, has been living in the wilderness for more than 40 years. In that time, he's experienced many close calls -- times when he's almost been bested by nature. He's discussed some of this on the show and has even encountered a few close calls on air, but when he visited Reddit to hold an AMA, he delved into his most dangerous moments in more detail.
When a fan asked Zuray to talk about his scariest moment, the survivalist had two that came to mind.
He detailed an episode of Yukon Men, in which he nearly drowned in freezing water because his arms and legs were so cold he could barely move.
Luckily, the current had enough mojo to help him to shore.
The other, according to Zuray, was what he called, "the scariest short moment." He described how "A bear came up a tree to grab ahold of my leg and rip me out of the tree. I had gotten too close to a mother with two cubs. I could tell from their agitation that that was the case. I casually climbed up a tree, not expecting the bear to come after me. The momma decided differently. I got about 10 feet up and the bear charged at the tree and ripped me out of the tree."
19 The Real Yukon Men Challenge Discovery's Yukon Men
Picking the name Yukon Men for a show that takes place in Alaska is a bit confusing. As mentioned above, however, the men in the show hunt and fish along the Yukon River, which is where they stake a claim to the name. That didn't stop some members of the Legislative Assembly (MLAs) from issuing complaints to the network for the name. Some, like MLA Darius Elias, say the show's hunting and trapping methods are vastly different from Yukoners. In fact, many of the activities in the show are illegal in Canada.
"Yukon hunters and trappers consider this program's name as an outright case of identity theft," claimed Elias. "Yukoners have worked so hard to ensure our territory is recognized around the world as a beautiful land filled with wonderful people." Currie Dixon, Yukon's Environment Minister, agreed with Elias. "I have to say that I do agree with him that some of the portrayals of trapping in the television show in question and the presentation of that as being in the Yukon is unfortunate.”
Discovery Channel's president and general manager, Paul Lewis, acknowledged the differences, but insisted that the setting is made quite clear. "With regard to the hunting and trapping activities featured in the series," he said. "We understand and recognize that there are important legal and cultural differences on this issue between Canada and many other countries around the world… As a channel that brings international stories to Canadians, diverse perspectives are an important feature of our programming.”
18 Questionable Hunting Methods
One of the huge controversies surrounding Yukon Men is the type of hunting methods used on the show. An article on the topic from The Guardian called the show "bloodthirsty" because of their tactics. According to the piece, many of the weapons used on the show seem excessive, overly violent, and brutish.
One of the most common guns seen, for instance, is an AR-15, a semi-automatic assault rifle, in other cases, one of the hunters uses a small tree to "stun" a trapped animal, and then there's the particularly troubling scene in which a man uses a wire noose for hunting. From the outside looking in, the hunters methods seem inhumane.
It is these methods on Yukon Men that has given rise to most of the criticism of the show.
Viewer discretion disclaimers and numerous warnings aside, there is an argument to be made that some of these hunting tactics are more for shock value than practicality.
According to the Yukon MLAs, the extreme hunting methods are a big reason why they want the show to change its name. Darius Elias suggests that the barbarity of the hunters on Yukon Men is alien to true Yukon hunters. "The few citizens who still maintain traplines take pride in their responsible approach to harvesting their fur," he said.
17 Dramatic Renactments
While it's expected from almost every reality show nowadays, fans still get a little disappointed to hear that their favorite "real" show involves a some falsehoods. For Yukon Men, the fakery might not be as extreme as most shows, but not everything shown on screen is happening exactly as viewers see it.
On Stan Zuray's Reddit AMA, he said that most of the film work simply made disjointed lifestyles seem coherent and story-based. "All reality shows have to produce an understandable story for its audience," he said. "But all the animals are real, all the hunting is real, all the fishing is real. Everything you've seen has been done. Sometimes it just gets edited to make it understandable."
Now the key here is the phrase "has been done." This is because Yukon Men, like many reality shows, use dramatic reenactments. In an interview with the Anchorage Daily News, Zuray admitted to this small manipulation. "The shows are like ours. They dramatize them, but it's also reenactments of what they really do. The drama is absolutely needed to hold the audience who has a remote ready to click at the slightest lack of excitement but you can get a good idea of the day-to-day life of these people on these shows -- it's hard work and can be dangerous."
16 Being Judged In Tanana
One of the most common questions that fans ask the cast of Yukon Men is about how the townsfolk of Tanana view them. Knowing that some of the scenes add in more drama than necessary and how much attention the show brings to the trapping and hunting methods, do people in Tanana like the show?
According to Stan Zuray, most of the reception is quite good. "By far, most of the people love the show and support it," he said on his Reddit AMA.
"It brings in a little bit of an economy to the village so it helps everyone out too. Kids absolutely love the show too - they run around the town sometimes trying to act like they're Courtney [Agnes], or Charlie [Wright], or me. We're always getting ribbed about being movie stars, but it's always in good fun."
Not everyone in the town is exactly thrilled with the show and the representation of Tanana's hunters and trappers. In an interview with the Anchorage Daily News, Zuray explained that "There are a few who do not like the show, did not like it when it was an idea and do not like it now." While he doesn't get into the reasons for the divide, it's possible that, in trying to "let people not from Alaska see it for what it is and not all the misconceptions of us as poachers and cruel trappers," Zuray and the rest of the cast actually worsened those accusations.
15 Are These Really Subsistence Lifestyles?
The stars of Yukon Men all live what they call a "subsistence lifestyle." They work for enough food and money to keep them alive and well, but they also live without many of the comforts that most people enjoy. It seems very dramatic, but is it manufactured drama?
When Charlie Wright, one of the stars, is asked if he could live without a gun, he says, " No, not for very long; something would eat you. You could live in the middle of the town with no gun, but if you want to live a subsistence life, there’s no way you could survive.”
According to some viewers who live in the area, however, this claim is mostly fiction. "I live in Alaska 125 miles from Tanana on the Tanana river," one viewer wrote. "[I] know the store owner in Tanana so, when they are saying they only have a few days of food left, all they would have to do is walk down the street to get a cheese burger at the cafe store. There is an airport in town that has flights every day in and out with mail, food, cargo, fuel, and people. The town has cell service, internet service, satellite TV, electricity, and all the other things the rest of the world has."
14 In Memory Of Seth Fairbanks
During the season finale of season four, "Breaking Point", viewers met Seth Fairbanks, a pilot from the area. Sadly, at the end of the episode, a note popped up: "In Memory Of Seth Fairbanks, 1985-2015". When the episode avoided any details about Fairbanks' passing, fans were sent scrambling for information.
Stan Zuray then posted a statement:
“People have been asking about Seth the pilot in the last episode of the Yukon Men season last Tuesday. He was a good friend of Charlie and became a good friend of the cast and crew of the show and many in Tanana. The plan was for him to continue being in the show and we were all looking forward to it as he was such a great guy and very capable young man. This fall, 500 miles to the south near the city of Anchorage, he and another person passed away in a plane crash (they survived the crash, but rescuers were unable to reach them before the tide came in). May he rest in peace and his family take some comfort in knowing what a nice person he was to us here.”
Reports came out about his passing, stating that Fairbanks called 9-1-1 after his plane crashed.
He and his passenger were forced to stand on the plane's wing, as the tide quickly came in, and awaited rescuers. Tragically, the rescue efforts were too late.
13 Close Encounters Of The Cold Kind
In a setting like Tanana, Alaska, we expect there to be dangerous situations, but just how dangerous is it to film a show like Yukon Men? According to the cast and crew, there have been a number of close calls when making the show.
In a behind-the-scenes special on the Discovery Channel website, Stan Zuray relates an occasion when his sled flipped over and he got stuck upside-down in a dangerous spot on a frozen channel. Thinking he needed help, a cameraman bravely ran over to his aid, but he then fell through the ice. Zuray said, "He was in a heck of lot more danger of falling into that channel and getting swept away than I did."
In another interview on the Russell Scott Show, Zuray spoke about the dangers of extreme weather in Tanana. He discussed how even taking off protective clothing in deep freeze temperatures can be dangerous. He also noted that in Tanana, the coldest temperature he ever experienced was -76 degrees.
Incredibly, the coldest temperature ever recorded in Alaska is -80. That came from Prospect Creek, which is about 150 miles north of Tanana. While that recording is from 1971, temperatures in Alaska lately are alarming.
12 Camera Crew and Cast Are Great Friends
When Yukon Men first started filming, before it became a hit show, the many of the townsfolk in Tanana were unsure about how it would all work out. After all, this is a town with around 300 people living in it. Everyone knows each other and outsiders might find that intimidating.
Over the years, the crew that work on the show have been welcomed into Tanana with open arms.
When speaking about how easily the camera crew integrated with the Tanana people, Stan Zuray said, "That is hard to do in this place or any place, actually. The camera crew actually lives with us in the village and are real friends with many of the people." The other cast members feel the same way. Pat Moore said, "The guys have been able to adapt into the community." Wright said that "they kind of feel like part of the family now, even the dogs are used to them now."
James Roberts takes it a step further. "I started naming my dogs after cameramen," he laughed. "I got a Reno, a Scotty, a Yoshi. I had two Tims, and I think that's it. Oh! Mitch. Because he was the meanest dog I had, and I named him after the nicest camera crewmember ever."
11 Camera Crew's Cabin Catching Fire
Several of the camera crew on the set of Yukon Men have done other shows on the network, but few experienced dangers like the ones they encountered on the set of the Alaskan show. One cameraman, who participated in a Reddit AMA, was asked about his scariest moment on the set.
His answer? "Coming very, very close to burning... while asleep," he said. "Another cameraman and myself were staying at Stan's [Zuray] fish camp in one of his cabins. It was the summer so the mosquitos were terrible...like carry you away terrible. We didn't end up putting the mosquito pick completely out before bed -- like we thought we did. It smoldered under the cabin for a few hours and we awoke to the crackle of fire and a 5-foot flame in the doorway of the cabin. Our cabin was on fire!! The only way out was to jump into/over the flame. It was scary."
Now, if jumping through flames doesn't light your, uh, fire, this cameraman and another crewmember were chastised by Stan when one of them fell off a fishway into the river. He scolded the crewmember, "When you walk on a fishway, you walk like an old man."
10 Stan Zuray In The Iditarod
One of Stan Zuray's most incredible stories tells of a day in 1982. Like every other day, Zuray worked his traplines in the woods, but opportunity was about to pounce on him.
“In those years I was just a trapper with a very limited amount of worn-out dogs out on the trapline, barely keeping them alive and feeding them," he said. "I was out on the trapline when a plane landed close to me and it was a friend of mine. He lived about 40 miles away and his wife had landed and said, "Get into town sometime and talk to my husband. He wants to sponsor you in the Iditarod race,""
That's how it began, but though Zuray's dogs weren't trained to race, they were trained to work. Those working dogs ended up bringing Zuray all the way to the front of the pack at one point. "The dogs that I had were so tough," he said. "And I guess it was the bush skills that I had were so hardened that I was able to get in the race and figure it out."
By the end of the 16-day grueling race, Zuray finished 9th and won Rookie of the Year.
In fact, Zuray's top-ten finish is a record that stood for a decade until another Rookie tied his ninth-place finish. "It was a humble and meager start," Zuray recalled. "But we ended up doing really fantastic and was one of the coolest things I’ve ever done in my life."
9 Big Crime In A Small Town
Though an episode of Yukon Men touched on the tragedy, the details of the incident of two state troopers in the small town of Tanana, Alaska were largely avoided. The story, however, is interesting.
According to reports, it started when a public safety officer questioned Arvin Kangas for driving without a license. Kangas allegedly pointed a gun at the man. The following day, two state troopers, Sergeant Scott Johnson and Trooper Gabe Rich, two stars of Discovery's Alaska State Troopers, flew into Tanana. When the reached Kangas' home to arrest Kangas, a struggle broke out. During the scuffle, Kangas' son, Nathanial "Satch" Kangas, shot and ended both troopers' lives.
Now, while both Kangas men were sentenced to prison time through the legal system, the village of Tanana ensured that Arvin Kangas would not return. Equipped with local law enforcement since the event, some villages in the Alaska area resort to tribal court to dole out punishment.
For his actions and for manipulating his son, Satch, the village elders banished Arvin from Tanana for life. "Tribal councils always have attempted to protect the peace," said Heather Kendall-Miller, an attorney for the Native American Rights Fund in Anchorage. "It seems to me like a reasonable approach to avoid violent situations, especially when you have no law enforcement providers within a community. Try to pre-empt a bad situation before it happens."
8 Stan Zuray's Old Dogs
Now, Stan Zuray understands well that his way of life is not always understood or even agreed with by the average person. It's an alien lifestyle to many people.
Perhaps more than any other aspect of Zuray's lifestyle, his relationship with his dogs is one of the most jarring. In his Reddit AMA, Zuray spoke of his dogs as workers and not pets. "They're all for running," he said. "I realize that I don't have the emotional attachment to the individual dogs that somebody has with a single pet. But in some ways, as far as knowing my dogs and being in tune with them, I bet I have a closer relationship with them than most people would have with a pet."
In his interview on The Russell Scott Show, Zuray got into some of the more challenging details of his dogs' lives, such as when it's time for them to move on.
Zuray described using old dog fur to make mittens and clothes, or even dog food for his living dogs -- a difficult concept for people to grasp.
"With me it's a matter of respect," Zuray said. "I would go out of my way, even I didn't need the fur that moment, if I had a dog that had given me its life, pulling hard for me and being loyal all its life, that dog would be specially used. I would try to use that dog for something special, make sure its life went back into the team."
7 The Great Wildfires
In the wilderness of Alaska, there's more than the cold, the water, and the animals to be wary of. Wildfires are a major danger. Large burns devastate the food chain for trappers and hunters. In 2017, the entire town of Tanana was nearly destroyed as wildfires burned through Alaska. According to Discovery Channel reports, "Half a million acres of prized hunting and trapping land were incinerated."
Wildfires threaten the lives of the animals in the woods, but they also move their territory. Long-standing trapline territories and traditional hunting grounds were gutted, forcing the Yukon Men to travel further and work even harder. While the detection systems in Alaska are improving rapidly, the causes of these fires are not always known. They are unlikely to be human-caused, which is the first thought for most people.
According to the Huffington Post, "The majority of fires in the North are started by lightning – not humans, as is the case in the lower 48 states. In the hot summer months, it’s not unheard of for more than 2,000 lightning strikes to hit Alaska’s lowlands in a single day." Sadly, these fires are becoming more common and more severe as global warming heats Alaska up at twice the global rate.
6 Dangerous Home Remedies
On Yukon Men, and other shows like it, the stars often show off their ingenuity and ability to use what they have to accomplish tasks. Without everyday materials and resources readily available to them, they are forced to make do and find alternative methods. Sometimes, the men's creations and alternatives are remarkable and quite effective. Other times, however, the results can be shockingly dangerous.
In one episode, the Yukon Men discussed methods for treating Parvo virus, a dangerous and contagious viral disease affecting dogs. Without proper and accessible veterinarian care, the trappers drew up their own cures. The answer?
They put bleach into the dog's water and had them drink it, which is apparently quite common in the wilderness.
According to Dr. Sara Smith, a veterinarian at Delphos Animal Hospital, "Chlorine bleach is NOT a Parvo treatment or prevention, and it may cause great harm... to a dog or puppy. True, bleach deals with Parvo virus on surfaces, but those surfaces must be cleaned before the bleach is used. Contact with organic material (i.e. a puddle of feces, or a bowl of dog food) makes the bleach less active. Bleach is a strong base and is very caustic to mucous membranes in the mouth, esophagus, and stomach."
5 Wolves Not Nearly As Dangerous As Yukon Men Suggest
One of the common criticisms for Yukon Men (and really any similar reality show) is the overly dramatic picture being painted of constant danger. While these men certainly face great danger in the wilderness, not every situation is life threatening.
Take the depiction of wolves, for instance. In one episode of Yukon Men, the narrator explains, "But that's not the only crisis. Wolves have been spotted on the edge of town." Then, one of the stars, Charlie Wright, says, "Wolves are mean, ferocious animals and they can tear a man apart real easy. … We have to get this wolf, it's not an if, its a must, because he'll go to any measure to eat. They're the worst kind."
Are they really as bad as the show makes it seem? To hear it from the narrator of Yukon Men, "There have been twenty fatal wolf attacks in the last ten years." Yet, research conducted by Adam Welz of The Guardian disputes that number. In fact, his numbers are drastically different. "Even though the US and Canada hold over 60,000 wolves," Welz reports. "I found only two records of fatal attacks by wild wolves in these countries in last ten years."
4 Hibernating Bear Hunting
While many of the hunting methods and strategies featured on Yukon Men are concerning for critics of the show, one of the most alarming sights for viewers is the bear den hunting.
For the uninitiated, bear den hunting is the practice of hunting bears while they hibernate.
According to Stan Zuray, "Bear den hunting is a traditional thing going way back prior to contact. The state recognizes it as such and law allows it some places. Common when I first came to Tanana 40 years ago." While Zuray is correct about the legality in some places, that actually changed quite recently.
Last year, President Donald Trump made this practice legal across the entire state of Alaska, so now all hunters, even those who aren't subsistence hunters, are allowed to take part. For animal rights activists and animal lovers, den hunting is a horrifying prospect.
Many rally against as it seems very unfair for the animal. Zuray, however, doesn't seem to worry about balancing the playing field. "We usually don’t care about den hunting or any hunting being sporting or "fair," he said. "We are after the meat and fur, period – not the chase. It may be because we are ignorant or something."
3 The Camera Men Are World Class
Simply watching a single episode of Yukon Men is enough to highlight the extreme conditions that these people live with every day, but when making a show like this, it's not only the cast that have to survive -- it's the crew as well. "You got to be a certain breed to survive out here, to tag along with me and keep up," says "Yukon man" Charlie Wright.
These camera guys are experienced in this life. In addition to working on many similar shows, the team that works on Yukon Men spend much of their lives in the outdoors.
"The camera guys that make it our here, they're world class outdoorsmen," says Stan Zuray. When discussing the qualifications of the camera team he works with, Zuray also added, "We do not have much contact with Discovery Channel people. The show is filmed by a smaller production company from NY and ... many of the camera men are nothing short of what I call world class outdoorsmen. One example that is easy to use is the guy that traveled with me for the first couple of years - he had been to the top of Mt Everest twice and done it since I last worked with him also. Been a good experience."
2 The Struggle Against The Outside World
One of the recent storylines on Yukon Men, is the threat of a new road being built that bring the outside world into the remote Tanana wilderness.
The road off the highway will allow for cheaper supplies to be imported and exported, but the threat to the wilderness and nature's resources worry the people of Tanana.
“There are a lot of people in the village who do the trapping, hunting and fishing lifestyles, and others who don’t do it as much. But the ones who do, they’re the ones who are going to be impacted by people coming in and taking over fishing spots and traplines,” said Stan Zuray. “There are other people who just want to use their trucks and go to town and aren’t as concerned about it.”
Yet, while Zuray, the unofficial star of Yukon Men, worries for the people of Tanana, the road won't stop him from living the way he has for the last 40 years. "I came to the Tanana area specifically because there was no road to it," he said. "I feel it is more up to the young people in town and those who were born here to decide the issue, so I voice no opinions at meetings, etc. I spent my life running from the city or better put running towards God's country and I'm good at it and will continue to do that."
1 Wolverines Are Nicer Than They Seem
Of all the animals on the show, one of the most frequently discussed is the wolverine. Perhaps because this animal is not well-known and is misunderstood, Yukon Men provides a lot of information about it. According to The Guardian's Adam Welz, however, the information the show provides appears wildly incorrect.
In the show, Stan Zuray tells the camera, "He's really dangerous", he says of the wolverine. "I don't think any human being could keep an attacking wolverine from [ending] them."
How accurate is that information? Welz looked into it. "I searched the web and could not find a single documented case of a wolverine even attacking a person anywhere in the world, ever," he writes. Welz then claims that he contacted Jeff Copeland from the Wolverine Foundation to get more information. When he asked Copeland about how dangerous wolverines really are to humans, Copeland responded that he is "not aware of any instance in which a wolverine has [ended] a human, or even attempted to do so."
Now, it is possible that the wolverines in Tanana are more vicious than other areas, but the evidence seems to suggest that they are not as threatening as Yukon Men makes them seem.
Did we miss any secrets from Yukon Men you know about? Tell us in the comments!
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"The People's Place:" How Placemaking Can Build Today's Best Libraries
Megan MacIver
"State of the Art" Library Opens in Nova Scotia
Visitors say "The People's Place feels like a place to live"
For all those who feared the rise of the Internet would mean the fall of the library here's a story of hope. Last week, June 26, the city of Antigonish, Canada, celebrated the grand opening of The People’s Place, the product of a community-initiated Placemaking process led by Eric Stackhouse, Chief Librarian of the Pictou-Antigonish Regional Library in partnership with local “Zealous Nuts,” PPS' term for all the enthusiastic community leaders who get things done.
“You don’t expect to be shhhhhshed here”
Today’s best libraries so much more than places to check out books. Built within a paradigm of place, "The People's Place" has become a civic center at the heart of this Nova Scotia community- and an important node on the town’s main street. As Stackhouse explained, to build a truly state of the art library, “librarians have to think about our spaces differently: our role is heading toward more community development.”
This great video from CTV interviews visitors who say The People’s Place feels like a “place to live. ” Local press calls The People’s Place a “state of the art library” -and we couldn’t agree more. This library points the way toward building public buildings within a paradigm of place. It starts with including all those who will use the space in deciding how the space will look, function, and feel.
The People’s Place Building Committee “firmly believes that to create a great place, you have to build it for people.”
Computer stations at "The People's Place"
On the library’s opening day, organizers estimate about 6,000 people (out of a population of about 18,000!) showed up to celebrate. The vision for the library was guided by PPS’ principles and was designed to serve as a multi-use destination civic center- a place where people can read, learn, enjoy art, and get to know one another.
Stackhouse says “we managed to include every idea the consultations came up with, which resulted in community ownership and the result is a 100% community thumbs up. [The library is] a green building, designed to integrate into Main Street and support the businesses, and flexible. Best thing I ever did was learn the process from PPS.”
The People’s Place is a $5.5 million joint project of the Municipality of the County of Antigonish, the Town of Antigonish, and the Pictou-Antigonish Regional Library. Funding was obtained from both Federal and Provincial government sources as well as significant contributions from the community at large and the Friends of the Antigonish Library to make sure that when the library was completed it would be true to the community’s original vision.
Many local non-profits also use the library- making The People's Place a destination for people of all ages.
As well as a modern, welcoming public library, the facility hosts a Community Access Program (CAP) site, the Antigonish County Adult Learning Association (ACALA), and Health Connections. Also, several multi-purpose meeting and gathering spaces are included which can be used at no cost by non-profits. All these agencies and spaces are combined together in order to share resources and provide a single point of access by users.
Public Art is a Major Component Throughout several visioning sessions, community members agreed that public art should be a major component including over 20 pieces of sculpture, woodworking, visual art, textile, poster art, and more, including a mural by Alan Syliboy titled “The Dream Canoe”.
Libraries can change the world! Resources to make your libraries and civic centers great community places:
Libraries that Matter
Library Placemaking in Action
How to Make Your Library Great
A Library Instills Community Spirit in Nova Scotia
Libraries at the Heart of our Communities (a featured article from our partner, the Planning Commissioner’s Journal)
Public Library Design: Working from the Inside Out and the Outside In (MP3 of seminar) featurung PPS VP Ethan Kent speaking in Melbourne on Libraries as a Catalyst for Placemaking
Civic Centers in a Paradigm of Place: Reinventing the Courthouse
Get inspired by all the ideas the Antigonish community generated on this page.
Placemaking and Consultations
Antigonish Library Site Plan
Plans for the library were sensitive to its context within the rest of the town. Site plan prepared by Archibald and Jones Architects Ltd.
Tell us about your community's library: how are you making it a great place?