Navnoor: "New Light"

A recent piece in the UK Sunday Times speaks to the epidemic of "Gender Genocide" which statistics suggest has impacted nearly a million baby girls each year. The article focuses on a village called Dera Mir Miran, a prosperous community in terms of farming yet less prosperous when accounting for the number of girls born there.

[The village] saw the birth of four babies in the first six months of this year. Three were boys, just one a girl. The baby girl’s parents named her Navnoor, meaning “New Light”. But her mother wept because she was not a son. Navnoor’s mother, Jasmit Blaggan, moved in with her husband’s family when she married, as is the norm in India. When her mother-in-law visited her in hospital after giving birth to Navnoor, she found Jasmit crying. “I was not happy that I had a second daughter. I thought about the cost of dowry and I knew a second girl was not needed,” says Jasmit, her broad smile softening the harshness of her words. Jasmit is not alone in her concern for the future. Although sex-selection tests have been illegal in India since 1994, unwanted female babies are now being aborted on such a staggering scale that it is estimated India has lost 6 to 10m girls in the past 20 years, a large proportion of the abortions being carried out at five- to six-month term.

Regardless of the legality of sex-selection tests, it is clear that many of the areas physicians do not feel threatened by the existence of a law banning such practices. Their creative ability to convey the information cannot be underscored:

Many doctors skirt the law forbidding disclosure of the sex of a foetus by using signals such as handing out pink or blue sweets or candles after an examination. Some families talk instead of “miscarriages”. Given the demographics of villages like Dera Mir Miran, it seems many such “miscarriages” must have occurred.

The piece becomes increasingly disturbing as it discusses the quantitative evidence behind the problem.

nationally the number of girls born per 1,000 boys was 927. The natural birth rate globally is around 950; in China it is 832. But in Fatehgarh Sahib in 2001 it was 754, and in some villages less than 500. In Dera Mir Miran it was just 361.

The consequences of this practice are large and impact the human rights of women within the country.

Far from the shortage of women increasing their worth and standing in society, as some might imagine, the result is the opposite. Women are now being trafficked in increasing numbers from Indian states where sex ratios have declined less rapidly. Some are sold into marriage. Others are forced to engage in polyandry – becoming wife to more than one man, often brothers. Those that fail to produce sons are often abandoned, sometimes killed. This further perpetuates the cycle of prejudice and injustice, ensuring many women themselves prefer to give birth to a son to ensure no child of theirs suffers a similar fate.

India, similar to China, will shortly be piloting a project to make cash payments to couples when they register the birth of a daughter and later when they immunise her and enrol her in school.

Yet when Dr Bawa starts to discuss the reasons for it happening, the fact that this district has the lowest ratio of girls to boys anywhere in India seems less surprising. Initially he says the ratio is probably not as low as it seems, since parents immediately register the birth of a son but sometimes fail to register the birth of a daughter “because they are unsure she will survive”. Then Bawa changes tack and says the low ratio is happening naturally. “Naturewise,” he says, it is happening “just by chance, not related to female foeticide”. This may be due, he says, to “diet” or “behaviour and genetics” or “climate change”.

There's not enough space to devote to the stories of the women they discuss in the article, so I would recommend reading the piece completely.

The Role of Religion in HIV/AIDS Awareness

There was a recent health-related post on SikhNet which discussed one Sikh activist's commitment to fighting HIV/AIDS. Dr. Raghbir Singh Bains tells us about his experience with HIV/AIDS research across the globe and speaks about the struggles of educating the community about HIV/AIDS in Punjab.

I studied the menace of HIV/AIDS in Tanzania, Kenya and Uganda but shame shrouded every where in the world. It has been my personal experience that about ten years ago I was discouraged and tried to be dispirited by a number of religious and social organizations in Punjab (India), asking me not to talk about this evil in public. The community leaders at that time were under the wrong perception that talking about pre-marital, extra-marital sex and adultery in public was immoral and unethical.

What is the role of religious beliefs in understanding and sympathizing with those who have been infected with HIV or diagnosed with AIDS?

As a result of notional misunderstanding of philosophy, religions in the past denounced those who fell ill with the virus that causes AIDS. Such religious forerunners advocated that fate of the victims was divine punishment for their immoral behaviour. They believed that those who die of AIDS, will go direct to hell. Surely, the followers at that time fell short to understand the inner depth of the religious concepts. They forgot to conceptualize that service to sick, needy and vulnerable people was in fact the leading service to the humanity and Almighty Lord. Inattentiveness of social and religious overlords provided little or no support or co-operation to people struggling against the disease due to the nature of its main modes of transmission, including sex chaos and intravenous drug use. Instead of helping the needy people, even the political leaders used human beings either as a commodity or an object of political manipulation or an element of the production and consumption machine only.

The piece goes onto discuss how Sikh leaders have responded to the growing epidemic in Punjab.

Religion provides us with important moral and ethical guidelines and supports us in addressing the day to-day problems mounting in the society. Keeping in view the universal challenges thrown out by HIV/AIDS, the Jathedar of Sri Akal Takht Sahib (temporal and spiritual throne of the Sikhs) issued an appeal to the global people during the year 2006 to help curb the menace of AIDS in the world. The Jathedar also led the huge rally from Amritsar to Khadur Sahib (India) in which thousands of youth participated. Such constructive campaigns are needed to be organized by other religious and spiritual leaders to stem the transmission of HIV.

Cultural Isolation A Health Threat to Punjabi Farm Workers

New America Media is the country’s first and largest national collaboration of ethnic news organizations. NAM’s goal is to promote the editorial visibility and economic viability of this critical sector of American journalism as a way to build inclusive public discourse in our increasingly diverse, global society. Here is a piece about environmental health issues of Punjabi farm workers from NAM that caught my interest:

Language and cultural barriers have long isolated Punjabi farm laborers in the Sacramento Valley. Activists stress the need for communication as workers continue to suffer from exposure to toxic chemicals, as well as low wages and little access to health care.

According to the 2000 census estimates, there could be as many as 2,000 Punjabi farm laborers living in Sutter and its neighboring Yuba County in the Sacramento River valley, where Punjabis have been farmers since the turn of the century. Most are recent immigrants from remote Punjabi farming communities, who have entered the U.S. legally through family connections. Others are the elderly relatives of established Punjabi American families.

Part of the problem is that California government agencies designated to protect the rights of farm workers, such as the Employment Development Department and the Agricultural Labor Relations Board, do not have Punjabi-speaking outreach workers.

Last year, five Indian American farmers paid fines for failing to provide workers with coveralls when they worked with insecticides and ground fumigants known to be highly toxic. When sprayed by workers not garbed in protective gear, the chemicals can be absorbed into the body through the skin, causing hives, flu-like symptoms, stomach cramps, diarrhea and blurred vision. Exposure has also been linked to impaired neurological development in fetuses and in infants, chronic fatigue syndrome and Parkinson’s disease. But the most common and far-reaching violations are the seemingly trivial ones — a failure to post emergency medical care information, or to provide fresh drinking water. Dehydration among Punjabi farm workers is of particular concern because of their propensity to develop cardiovascular disease.

In Mahal Plaza, a Yuba City housing complex for low-income farm workers, two women in their seventies, white dupattas drawn over their heads, sit in the sun, knitting and chatting. “The work is hard, and we are old, but we keep doing it so we can contribute something to our families,” said one woman. “We have no choice but to do this work — it’s all we know.” The women sort and pick peaches and climb ladders to prune the trees in the winter. The majority of Mahal Plaza’s residents seem to rely on the county’s public health department for basic health services, and on fee-for-service private physicians, for non-primary care.

Harpreet Kaur (not her real name) has been working in peach orchards and nurseries for several years. She would love to find a full-time job at a factory, because the work is a little safer and is done indoors. But to qualify to live in Mahal Plaza, a majority of one’s income has to come from farm work. If Kaur took a job in a factory, chances are that she, her husband and their two teenage daughters would be without a home. Like many of the men living in Mahal Plaza, Kaur’s husband doesn’t work. Last spring, while moving irrigation pipes in a Marysville orchard, his foot got stuck under a pipe. In his struggle to extricate it, much of the skin was gouged off his leg. “The foreman followed the rules and took him to the hospital,” said Kaur, “but he wasn’t invited to work again.”

But what poses the greatest danger to the Punjabi farm-working community, according to Kamaljit, is its cultural isolation. “Most of us don’t speak English, and the people who want to help us don’t speak Punjabi,” she said. “We don’t know what we’re missing out on. Something wrong could be happening, but we would never know it.”

Vanity Fair: The Africa Issue

So, two of my favorite people: Bono and Queen Rania. My dream is to meet them both (and I'm halfway there, although I didn't officially meet Bono as much as track him down at a local bookstore in Boston and get a quick hug from him before he was whisked away... but who's counting). Anyway, this is why they continue to inspire me... Bono is guest editor at Vanity Fair this summer and in celebration of his presence at the magazine and in dedication to his commitment to Africa, VF did a spread of photos of famous people who are are dedicated to causes in Africa. It's not about the pictures, although (as usual) Annie Leibovitz does an incredible job, but it's about the challenge to do better in Africa.

The Africa issue contains an interview with Archbishop Desmond Tutu, a piece on Jeffrey Sachs (post), a reminder of Nelson Mandela's leadership, a look at Madonna's work in Malawi and much much more. It's important to remember that these celebrities are doing some great work, but they are simply an example of the true courageous work that individuals (who aren't necessarily famous) do every single day... This issue is out this week.

Have you registered?

Did You Know A South Asian has a 1 in 20,000 Chance of Finding a Match? However, South Asians comprise approximately only 1% of the National Marrow Donor Registry.

A few years ago I registered to be a bone marrow donor with Asians for Miracle Marrow Matches. Throughout the years, we've all heard stories about South Asian patients having a difficult time finding a bone marrow match. Once again, we find ourselves calling upon friends and family members to register. A fellow BU-er, Vinay, is in need of a bone marrow match. His friends and family are working hard to spread the news to the South Asian community to register in the hopes that he will find a match. I encourage you to take the steps to register in the National Bone Marrow Registry.

You can find out more information on a website that has been set up to help Vinay.

It is really easy to register:

We are asking all of you to please register at the Bone Marrow Website to help Vinay and many others just like him. Please forward this announcement to all people you know to do the same. Finding a bone marrow donor is very rare, which is why it is so important that as many people register as possible.

You can easily register with the Asian American Donor Program (AADP) Registry. The procedure to register is less than a minute and is not invasive, just a simple swab of the mouth. The AADP recommends that people read about the actual marrow donation procedure on the website before registering.

It is really important, as a South Asian, to register and I really encourage you to do so. I really believe that activism and action are an integral part of each of us.

Lest We Forget...

At 9:20am on 31 October 1984 India's prime minister Indira Gandhi was shot by two of her security guards in the garden of her home at No 1, Safdarjung Road in Delhi.

The attack led to rioting on a grand scale across India as Hindus took their revenge on Sikhs. At least 1,000 people are thought to have died and the army eventually intervened to quell the violence.

The assassination itself was revenge for the raid on Sikhism's holiest shrine in Amritsar to flush out separatist militants who had taken refuge there.

BBC - Never Forget 84
Witness84
Sikh Genocide

The Show Me Campaign

I went to see John Legend the other day (great concert!) where he profiled a campaign he is involved with in Africa whose mission it is to fight economic and spiritual poverty through fostering sustainable development. This is from his site:

Normally I travel to locations around the world to perform, but I came to Ghana to learn after being inspired by the book The End of Poverty by Columbia University Professor Jeffrey Sachs. What I loved about the book is that is appealed to both my practical and compassionate sides. It also convinced me that extreme poverty could be eradicated in our lifetime by a surprisingly realistic amount of money.

He goes onto say that:

Hundreds of thousands of kids in Africa die from Malaria, which is preventable with a $10 bed net and curable with a $2 medicine dosage. That same $10 can fertilize an entire farm and dramatically increase its crop yield for a year.

So not only does John Legend have a soulful voice. He has a soul.

I have to mention that I am also reading Jeffrey Sachs' book The End of Poverty and would really recommend it to anyone wanting to gain a better understanding of strategies for economic development around the world. It's not only a goal that we can reach, but it's also something that can be sustained.

Sicko

Here is an excerpt from an article about Michael Moore's new film about the US healthcare system. It sounds like Moore's film discusses the issues of inadquate healthcare coverage moreso than a lack of health coverage. However, i tend to think the root of the problem is the same and I look forward to this film spurring dialogue and impacting society in the same way Fahrenheit 9/11 and Bowling for Columbine shed light on Iraq and Gun Control.

"Sicko" purposefully does not focus on the 50 million or so Americans who don't have health insurance, as scandalous as that is, but on the horror stories of middle-class working folks who believed they were adequately covered. There are so many of these they begin to blur into each other: the woman in Los Angeles whose baby was denied treatment at an emergency room outside her HMO network, and died as it was being transferred hours later; the woman in Kansas City whose husband was repeatedly denied various drugs his physician prescribed for kidney cancer, and who in the last stage of life was denied a bone-marrow transplant that could have saved his life; the woman who was told her brain tumor was not a life-threatening illness, and died; the woman who was told her cancer must have been a preexisting condition, and died.

Hypertension: What Oprah doesn't know

A few weeks ago, Oprah's show was devoted to answering health questions. Dr. Oz asked her if she knew why African Americans have such high rates of hypertension, and Oprah retorted that indeed she did and that it was because "African Americans who survived [the slave trade's Middle Passage] were those who could hold more salt in their body." To which Dr. Oz rejoiced: "That's perfect!"

This conversation caused quite a stir and I've been following the discussion of this on a listserv that i belong to. Finally, an article about it came out in the LA times. It's an interesting discussion because not only does it shed some light on the prevalence of hypertension in a minority group - but it emphasizes the need to communicate health information that is accurate. Oprah has such an impact on her audience that it means it's even more important that she provides them with concrete information about their health and well-being.

Support the Global Health Council on Mother's Day

For some children and mothers, this Mother's Day isn't a time to celebrate.

One woman dies every minute, every day from maternal causes. 99% of which occur in low-income countries.

Help develop healthy women in a healthy world by donating $10 or more to the Global Health Council in honor of your mother. In return, the Global Health Council will send her a personalized Mother's Day card.

Your gift will help the Global Health Council ensure a Global Happy Mother's Day.

Any gift you give will make a difference.

Epidemiology Definitions

An epidemic is a rate of disease that reaches unexpectedly high levels, affecting a large number of people in a relatively short time. Epidemic is a relative concept: a small absolutely number of cases of a disease is considered an epidemic if the disease incidence is usually very low. In contrast, a disease (such as malaria) is considered endemic if it is continuously present in a population but at low or moderate levels, while a pandemic describes epidemics of world-wide proportions, such as influenxa in 1918 or HIV/AIDS today.

.:Happy Vaisakhi:.

Vaisakhi is one of the most colorful events in the Sikh calendar. It's a time when Punjabi farmers harvest their crops and most importantly, the day on which the city of Anandpur in Punjab saw the creation of the 'Khalsa' - The Pure Ones.

In 1699 on Vaisakhi (also written Baisakhi) Day, hundreds of thousands of people gathered around the divine temporal seat at Anandpur Sahib. Guru Gobind Singh Ji addressed the congregants with a most stirring oration on his divine mission of restoring their faith and preserving the Sikh religion. He said that every great deed was preceded by equally great sacrifice.

Vaisakhi is the day on which the Sikh Nation - the Khalsa was born and Sikhs were given a clear identity and a code of conduct to live by. The event was led by the last living Guru, Guru Gobind Singh Ji, who baptised the first Sikhs using sweet nectar called Amrit. Around the world at Vaisakhi time, Sikhs reflect on the values taught to them by their Gurus and celebrate the birth of the Khalsa.

The message of Vaisakhi has particular relevance today in a multi-cultural and multi-faith society. Vaisakhi promotes friendship and mutual respect as the way forward. This is consistent with the command of Guru Gobind Singh Ji: Consider the whole of humanity as one, we are all children of the One God.




More:
Turban Day - Nirali Magazine
Turban Day - Sepia Mutiny
Wikipedia
Savory Sikh

Spotlight

I came across some great sites this past week and have decided to summarize them in this blog.

Seva Café is an experiment in the joys of giving and of selfless service. Run mostly by volunteers, our wholesome meals are cooked with love and served with love, offered to you as a genuine gift. To complete the full circle of giving and to sustain this experiment, we leave it to you to pay from your heart. All profits are used to support social service projects.

Project Naad is a charitable organisation committed to producing high quality freely distributable content. Check out their leaflets and presentations.

Search Kindly Search Kindly is a non-profit organization dedicated to the idea of micro-volunteerism. 100% of the advertising revenue generated from this website is donated to charitable organizations.

Sakhi for South Asian Women is a community-based organization in the New York metropolitan area committed to ending violence against women of South Asian origin.

Harvard World Health News is an online news digest from the Center for Health Communication at the Harvard School of Public Health. The site covers critical public health issues from around the world. It is designed to be a resource for an international audience of policy makers and journalists as well as public health researchers, practitioners, and advocates.

Provoked: Domestic Abuse

Provoked , a movie which discusses the topic of domestic abuse, is based upon the life of Kiranjit Ahluwalia. Kiranjit had an arranged marriage which turned into a marriage defined by violence and humiliation. After suffering his brutality for 10 years, she set fire to her husband one night and he died. She was charged with murder and imprisoned for life.

The trial judge declared that the violence she had suffered was "not serious" and the prosecution claimed that she had merely been "knocked about'. Because of her shame about the incidents of sexual abuse, Kiranjit could not face her family hearing about them at the trial and gave no evidence in her defence. Her plea of manslaughter due to provocation was overturned and the jury found her guilty of murder.

A key reason for the failure of Kiranjit's plea of provocation was the bias towards male behaviour in such cases. the time that had elapsed between Deepak's last attack on her and her retaliation (a few hours) was deemed to be a "cooling down" period and not a "boiling over" period as her defence suggested. Men tend to react instantaneously when provoked, whereas women cannot do so because of men's greater physical strength and size.

An appeal was granted in 1992 on the grounds that expert evidence and psychiatric reports had not been presented at the original trial. A re-trial was ordered and on September 25, 1992 Kiranjit was found guilty of manslaughter due to diminished responsibility and sentenced to three years and four months (the time she had already served). Kiranjit was released immediately.

Provoked will be released in April 2007 in the UK, and at a later date in the US.

An excerpt from Sikhism, by Eleanor Nesbitt

I just read this "short introduction" on Sikhism and found it to be very informative and well written. Here is an excerpt from the book, about Bhagat Puran Singh.

"Bhagat Puran Singh (1904-92) dedicated his life to caring for the destitute and disabled and the Pingalwara (home for the 'handicapped'), a complex situated near Amritsar's bus terminus, carries on his mission of compassionate seva, under its Patron President, Dr Indarjit Kaur. The All-India Pingalwara Charitable Society, employing over 400 people, resulted from Bhagat Puran Singh's decades of tirless effort for the abandoned, terminally ill, and mentally challenged. This began with his devotion to the helpless Piara Singh, whom he found as abandoned, dumb four-year-old, physicially deformed and mentally impaired. Puran Singh washed and tended him, gave him the name 'Piara', meaning beloved, and for years carried him on his back as a 'garland round my neck'." - page 83

Pingalwara

Wikipedia

Bhagat Puran Singh

UK Sikh Health clinic could provide blueprint

A PIONEERING health support scheme for Leamington's Sikh community is set to be rolled out across the country if it proves successful.

The Apnee Sehat clinic, located at the Sikh Community Centre in Queensway, officially opened for business on Friday (February 16). It has been set up by consultant diabetologist Dr Shirine Boardman - with the help of a £10,000 grant from South Warwickshire Primary Care Trust - and aims to provide the local Asian community with specialist help and advice in managing diabetes-related problems in an environment they feel comfortable with.

The centre is part of a pilot project due to run for one year, during which time researchers from the University of Warwick's Medical School will analyse its effectiveness - with a view to creating permanent clinics across the country in the near future. To date the successful project has been nominated for five national awards by various health service organisations. Project co-ordinator Dr Shirine Boardman said she hoped the unique clinic would dramatically reduce the disproportionately high levels of diabetes, strokes and heart attacks in the south Asian population. "It is very exciting to be able to run a pilot research clinic for diabetes which is tailored to the needs of a community which is disadvantaged by its predisposition to premature diabetes, heart disease, strokes and kidney failure," she said. "Members of the Asian community are six times more likely to get diabetes due to their genetics - but this centre will help promote self-care and will help to empower and keep patients motivated.

Hundreds of local Asian people attended the official launch on Friday, along with councillors, mayors and members of South Warwickshire PCT, which has supported the project from the beginning. Warwick District councillor Balvinder Gill added: "Hospitals are frightening places for this community and signify serious illness. "The community is also shy and they often won’t visit the doctor until it’s too late, not to mention the language problems, which prevent them from expressing their symptoms. "Having this clinic means they will feel relaxed in their own environment."

Global Health Photo Contest

The Global Health Council's Photography Contest is dedicated to drawing attention to health issues that have a global impact and to celebrate this year's conference theme, Partnerships: Working Together for Global Health.

Each year, the Global Health Council holds a photography contest inviting both amateurs and professionals to submit selections of their work which clearly illustrate the theme of the Council’s core issues of women’s health, child health, infectious diseases, HIV/AIDS and emerging health threats.

The Global Health Council recognizes the ability of photography to convey great emotional depth and understanding of issues which are often difficult to discuss, and seeks to highlight the important contributions to understanding and action made by the winner of the award.

The winner's work will be prominently displayed at the conference and will appear in Global Health Council publications with attribution.

Shame by Jasvinder Sanghera

I've been reading a lot about this new book by English activist Jasvinder Sanghera and it is definitely blog worthy. You might ask how this book is related to health, but you will soon realize that health is integrally linked to the well-being of both our bodies and mind.

In her memoir, Jasvinder discusses the, what seems to be "controversial" issue of forced marriage. (Why it is controversial is unknown to me, when quite clearly we have reached a time in the progression of our culture to realize that the concept of forced marriage is not only unacceptable but also conflicts with the values upheld by the Sikh religion). It is a shame to read about the difficulties the author incurred while trying to stand up for what was the right thing, and it is a further shame that she lost the support of those individuals (namely her sisters) whom she felt inspired to fight for.

Her story is heart-breaking and tragic. I found this statement interesting, "By day I fought for the rights of Asian women," she writes, "and by night I craved acceptance from the very community I rejected." There is no clear consensus as to what to do because coming from a culture that is so integrally tied, women are deeply conflicted. Family and community should not be a weight - and often times, they are.

It usually comes down to a female who has to fight for a right that is so easily provided to her male counterpart. It is therefore usually females who have to suffer through the trials and tribulations of breaking the norm and bringing shame upon their family. Often times, it is these same women who are really striving to live by the values and morals set out by their religion.

Anyway, i am looking forward to reading the book - to be allowed to enter another's experience through their memoir is profound. But i hope this book spurs dialogue around forced marriage and the consequences it has on the well-being of our community. Everyone is affected by it - mothers, fathers, sons, daugheters, sisters, and brothers. Suicide rates and depressions rates have increased (the suicide rate among young South Asian females is three times the national average) and research has shown the long-term and damaging effects of that.

NEED Magazine

I came across this new magazine called NEED, which focuses on telling the stories (through words and pictures) of the experience of humanitarian aid. There are stories from all over the world and issues that include discussions on health, work, kids, future, and dialogue among other things.

As stated on its website, NEED is the first independent magazine dedicated solely to global and domestic humanitarian issues.

Check it out, it's definitely worthy.

World AIDS Day: December 1st

Today is World AIDS Day and this year's message is "STOP AIDS. KEEP THE PROMISE." The news is full of articles about HIV and AIDS in the spirit of World AIDS Day. Here are some of particular notice:

The International Herald Tribune reports on a collaboration between the Clinton Foundation and two Indian drug companies. The result? Anti-retrovirals designed for children will be provided for an average price of 16 cents a day, or $60 a year, which is about 45 percent lower than the lowest current price. The news report also states that the prices will be available to 62 developing countries and will lead to the treatment of an additional 100,000 people in 2007. Jon Liden, a spokesman for the Global Fund to Fight AIDS, Tuberculosis and Malaria, based in Geneva, said the deal announced Thursday would allow grants already made by the foundation to treat substantially more people in 2007. "It's a hugely positive step," he said, "because one of the really difficult areas in rolling out treatment has been to have a steady and huge supply of pediatric dosages and packaging."

The BBC had a very interesting piece on how HIV affects the global workforce. The article states that the virus has had a crippling effect on the workforce of many countries. Without this, it estimates that the cumulative loss to the global workforce from the virus could rise 45 million by 2010 and almost double again by 2020. The ILO said increased access to ARV treatments could significantly reduce the impact on the global workforce. "The prospect of averting between one-fifth and one-quarter of potential new losses to the labour force should serve as a powerful incentive to target the workplace as a major entry point to achieve universal access to ARVs," the report concluded.