Ernest Massiah, Contributor,
Ernest Massiah is Director, UNAIDS Caribbean Regional Support Team, Port of Spain, Trinidad and Tobago.
Ten years ago, in New York, 16 Caribbean heads of state joined 173 other world leaders to formally endorse a bold new plan that could change the lives of millions and usher in a new world era for developing countries - a world with more equality and better health and education. In 2000, the leaders agreed upon the Millennium Development Goals (MDGs), eight broad agendas to be achieved by 2015.
Later this month, 10 years and billions of dollars later, world leaders will meet again in New York, at the United Nations, to assess how countries and the international community have performed, what they have achieved,and how people's lives have been affected. What willCaribbean leaders report?
One of the success stories in the Caribbean has been with MDG 6, which addresses HIV. The number of AIDS-related deaths went down by 40 per cent between 2001 and 2008. Over that period, the number of new infections in children dropped by 18 per cent and the number of newinfections in adults by five per cent. Significantly, in 2010, 51 per cent of people living with HIV who need antiretroviral medication have access to it.
New infections number the same
But, 49 per cent of people who need it don't have access to treatment and the number of new infections each year has not fallen significantly over the last 10 years. Across the region, 50 per cent of all persons with HIV are women. And, in some countries, women, often under the age of 30, account for almost 60 per cent of all cases.
HIV now disproportionately affects young women, gay men and other men who have sex with men, transgendered persons and sex workers across ethnicity, race and class barriers. And there are still British colonial laws in place that criminalise sexual behaviours, reinforcing stigmas and making it difficult to respond comprehensively to HIV.
What can be done for the Caribbean to achieve the Millennium Development Goals for HIV by 2015?
First, we must speak. Openly, without shame, misinformation or bias about sex, sexual orientations and sexual behaviours, if our prevention efforts are to have impact and prevent new cases of HIV. We cannot pretend away the world in which young people exist: it is a world of frank, open conversation about love, sex and sexual orientations.
Second, HIV must no longer be stigmatised. It should not be an issue associated with fear or avoidance. People living with HIV are productive citizens with the same right to protection by the law, access to healthcare and other services, and with the potential to make valuable contributions to Caribbean societies. In 2010, HIV is not about death, it is about people living and enjoying productive lives.
Third, we must encourage and support the many citizen groups that are vital to the response to HIV. These groups support individuals and families, taking care of children and providing counselling, friendship and solidarity. They protect the vulnerable, they provide information and, in many cases, an alternative lens through which to assess the state of HIV in the Caribbean.
(photo from UNAIDS sponsored Walk for Tolerance in Montego Bay Jamaica 2010)
The stigma associated with HIV is a relic of the early 1990s, when fear informed ignorance. This is also linked to prejudice and rejection of what is perceived and judged as abnormal sexual beha-viour and wrongful sexual orientation. It is precisely these stigmas that threaten the public's health: they prevent people from getting tested, getting and sharing their test result with others and from seeking treatment, if needed. Unrecognised and untreated HIV can spread. In 2010, stigma and prejudice should have no place in Caribbean societies.
True development will require significant achievement on all the MDGs. Trade, health, education, poverty and environmental sustainability and gender relations interact with each other. There is an old saying: one hand alone cannot clap. But, making the right sound is not easy. An educated, healthy population with equal opportunity for all, with environmental stability and economic prosperity is not unattainable. But, many hands will have to clap to achieve this goal.
In five years' time, what will the 16 Caribbean countries say in New York, at the United Nations, about the Millennium Development Goals? Goals scored? Or match ended nil-nil: we played to a goalless draw?
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