Peter Richards
PHILIPSBURG, St. Maarten, Nov 3 2010 (IPS) – Despite the gains associated with antiretroviral treatments (ART) over the last decade, HIV/AIDS remains the leading cause of death among young and middle-aged adults in the Caribbean, warns a new U.N. report.
Haiti and the Dominican Republic account for about 70 percent of all people living with the virus in the region. In the English-speaking Caribbean, Jamaica is the country most affected by the epidemic, with an estimated 27,000 people living with the virus.
Overall, there were between 210,000 and 270,000 people living with HIV in the Caribbean in 2008. The disease is the leading cause of death among men and women aged 20-59, at 15.7 percent and 14.5 percent, respectively, according to the report from UNAIDS titled The Status of HIV in the Caribbean .
It was released during the 10th Annual General Meeting of the Pan Caribbean Partnership Against HIV and AIDS (PANCAP) that ended here Tuesday.
The report noted that while there has been a 40 percent decline in AIDS-related mortality in the Caribbean since 2001, half of those who need treatment cannot gain access.
Between 2001 and 2008, there was no significant decline in the number of new HIV infections. Only a 4.8 percent decline was observed during that period and, with the increase in life expectancy, there was a nine percent increase in people living with the virus in the same period.
Related IPS Articles
The report said these overall prevalence figures hide important and evolving dynamics, including that the number of women living with HIV is increasing. Currently, women and especially young women account for half of those with the virus.
The report also cites a number of achievements in the regional HIV response. More than 90 percent of pregnant women in 11 Caribbean countries are now tested for HIV annually, and about 52 percent of pregnant women receive services for the prevention of mother-to-child transmission of HIV, which led to an 18 percent reduction in new HIV infections among children in 2008.
Governments across the region provided ART to 51 percent of people in need in 2008 up from just one percent in 2004.
Responding to the latest statistics, former United Nations Secretary-General Kofi Annan, who was the special guest at the PANCAP meeting, said more resources were needed to fight the epidemic.
I recall my meeting with (the seven largest) pharmaceutical companies and appealing to them to ensure that medication they come up with reaches the poor for if that did not happen, it would be difficult for them to protect their intellectual property and have medication that can save lives and the poor, and they made contributions, Annan said.
I would want to see a situation where the international community would come to some understanding that any company that holds intellectual property on key medications sets aside one or 1.5 percent of gross profit for the kind of fund we are talking about.
We are not thinking in those terms and the time has come for us to look outside the box, Annan added.
UNAIDS executive director Michel Sidibé noted that two- thirds of countries in the Caribbean continue to criminalise homosexuality and that discrimination against men who have sex with men was blocking access to HIV prevention programmes.
Imagine yourself as a gay man in such an environment. How confident would you feel about getting an HIV test, or asking for information on prevention or treatment? he asked. Homophobia hurts wherever it haunts from classrooms to courtrooms.
Among men who have sex with men, HIV prevalence varies from an estimated 6.1 percent in the Dominican Republic to 32 percent in Jamaica. HIV prevalence among female sex workers another key affected population in the region varies from 2.7 percent in the Dominican Republic to 27 percent in Guyana.
According to the UNAIDS report, HIV prevention programmes reach less than 40 percent of men who have sex with men and less than 50 percent of female sex workers in the region.
Proponents for the repeal of legislation prohibiting gay sex maintain that the law makes no sense. The outgoing chair of PANCAP, St. Kitts and Nevis Prime Minister Dr. Denzil Douglas, who has lead responsibility for health within the 15-member Caribbean Community (CARICOM) grouping, said that the region should make a renewed commitment to revisit the discriminatory laws.
Douglas said delegates to the meeting here used the opportunity to discuss how we are going to bring back onto the table, though it has serious political overtones, how are we going to re-emphasise the need for a revisiting of the laws that have been established in our countries for so many years that continue to discriminate against people who are living with HIV/AIDS and who have been affected as a result of HIV/AIDS.
This is the new commitment that we take into this new era beyond 10 years of PANCAP, Douglas added.
Since 2001, the Caribbean region has received approximately $1.2 billion in grants and concessionary funding to fight HIV/AIDS, but Annan said that the replenishment meeting for the Global Fund that took place last month served as a reminder that the war chest was not limitless.
I remain an optimist. But I also recognise that maintaining and increasing funding for HIV/AIDS has not got any easier, he said. The global economic crisis has increased pressure on government resources across the world. Some wealthier countries have responded by freezing or reducing their investments in global health.
It is unfair that those countries which have done least to cause the financial crisis should have to pay such a high price, Annan added.