Caricom adopts ambitious targets to defeat HIV/AIDS pandemic

UNITED NATIONS (CMC) — As the three-day extraordinary United Nations' Summit on HIV/AIDS concluded here on Friday, the Caribbean Community (Caricom) has joined the global community in adopting ambitious new targets aimed at ridding the world of a pandemic that has claimed more than 30 million lives since it was first reported three decades ago.

The UN's High-Level Meeting on HIV/AIDS this week brought together 3,000 participants, including 30 heads of state and government, along with senior officials, representatives of international organisations, civil society and people living with HIV, to chart a path for the future of the AIDS response.

The declaration, adopted by the UN General Assembly, including Caricom states, contains "clear, measurable" targets, geared towards halving sexual transmission of HIV by 2015, reducing HIV transmission among people who inject drugs by 50 per cent by 2015, and ensuring that by 2015 no child will be born with HIV.

The targets are also aimed at increasing universal access to antiretroviral therapy, getting 15 million people onto life-saving treatment by 2015, and halving tuberculosis deaths in people living with HIV by 50 per cent by 2015.

"These bold new targets set by world leaders will accelerate our push to reduce the transmission of HIV," said General Assembly President Joseph Deiss.

"The challenge that now remains is to implement these commitments; and, here, leadership and mutual accountability are crucial."

Member-states also pledged to close the global resource gap for AIDS and work towards increasing funding to between US$22 billion and US$24 billion per year by 2015.

Addressing the High Level Summit, on behalf of Caricom, St Kitts and Nevis' Prime Minister Dr Denzil Douglas, who is also Caricom's lead head for human resource development, health and HIV/AIDS, said, in 10 years, collective action and an increasing level of shared responsibility have given hope that "better must come" to people living with HIV and AIDS.

"Through the dedicated work of natural and behavioural scientists, philanthropists and NGOs (non-governmental organisations), as well as the leadership at the national and global level, great strides have been made," said Dr Douglas, who also chairman of the Pan-Caribbean Partnership against HIV and AIDS (PANCAPP).

"Scientific research has produced medicines, in particular the generics, to aid care and treatment. The application of behaviour change, through social marketing interventions, has contributed, in no small measure, to arresting the spread of HIV, reducing the number of deaths, from HIV and AIDS and increasing awareness of prevention policies," he added.

In so doing, Dr Douglas said there is the growing realisation of the need for inclusiveness, aimed at the eradication of HIV-related stigma and at enabling equitable access to HIV-related information and services, especially for the most at risk populations.

The St Kitts and Nevis' prime minister said the membership of Caricom and PANCAP has always played a "very active role" in this global process for an accelerated approach to HIV, stating that it is no doubt in the region's self-interest to find solutions, since it still remains second only to sub-Saharan Africa in prevalence rate.

Nevertheless, he said the Caribbean holds out the prospect of being among the first group of countries in the world to achieve universal access.

He said the UNAIDS score card on universal access 2010 demonstrates that "much progress has been made in the Caribbean".

Dr Douglas said over the 10-year period, since the first United Nations General Assembly Special Session on HIV/AIDS, the prevalence rate in the region has stabilised at one per cent overall, with significant variations among respective countries.

He said new HIV infections have declined by 14 per cent, and AIDS-related deaths from HIV and AIDS have also declined by 43 per cent.

Dr Douglas said efforts to reduce stigma and discrimination have intensified, with programmes targeting the formal education sector, the youth, the workplace, and faith-based organisations, among others.

He said engagement of regional universities, other regional institutions, NGOs and the media has also "provided the impetus to the accelerated approach to HIV and AIDS".

But he cautioned that while there is "much to celebrate", the warning signals in the Caribbean still prevail, disclosing that an estimated 17,000 persons became newly infected with HIV in 2009.

He said there are indications that transmission rates among key populations, such as men who have sex with men, are increasing.

In addition, he said unprotected sex between men and women, especially sex work, is believed to be the main mode of HIV transmission, making the Caribbean the only region, besides sub-Saharan Africa, where women and girls outnumber men and boys among people living with HIV.

In 2009, Dr Douglas said, an estimated 53 per cent of people with HIV were female, stating that high infection levels have been found among female sex workers, including four per cent in the Dominican Republic, nine per cent in Jamaica, and 27 per cent in Guyana.

"We, in the Caribbean, have come to recognise that while progress has been made, the gains will be fragile unless innovative and bold steps are taken toward an HIV-free generation," he said.

Caricom ministers and representatives, who also addressed the summit, aligned themselves with Caricom's statement, stating that that their respective countries are doing everything in their power in addressing the deadly disease.

Barbados' Minister for Family, Culture and Sport Stephen Lashley said the achievements and progress of its National AIDS Programme continue to get "necessary support at the highest level".

Lashley said following a successful World Bank "First Project", Barbados has started the execution of the "Second Project", with "a systematic focus" on universal access to care, treatment and support by "reducing new infections, eliminating stigma and discrimination, and significantly reducing AIDS related deaths."

He said there are 18 government ministries, with over half having a "functioning" HIV core group, and that each ministry has an annual action plan for HIV.

"So we have been putting in place the measures and frameworks necessary for achieving the goals set at the beginning of the second World Bank project," he said.

In addition, he said efforts are aimed at increasing the percentage of sex-workers who report the use of condoms with their most recent client.

Jamaica said it has made "noteworthy" progress in addressing the HIV/AIDS pandemic, with Health Minister Rudyard Spencer telling the global body that there was an 18 per cent decline in the number of persons who reported with advanced HIV and AIDS cases in 2009 compared to the previous year.

He said AIDS deaths have also declined significantly, moving from 665 in 2004 to 378 in 2009.

Paediatric AIDS deaths also declined by 19 per cent, moving from 32 cases in 2008 to 26 cases in 2009.

Spencer said the expansion of HIV testing in the public sector has resulted in coverage for about 84 per cent of pregnant women and 98 per cent of babies delivered in the public sector.

But despite these advances, he said Jamaica faces "challenges relating to inadequate human resources to effectively scale up testing, treatment and support services.

"The tight fiscal space, which is not unique to Jamaica, undermines the government's commitment to advance in any significant way effective HIV and AIDS strategies," Spencer warned.

"The country will need the continued consistent support of the donor community not just to maintain the gains that we have made but to make great leaps forward in the achievement of various international targets relating to HIV and AIDS," he added.

For its part, Guyana said it has seen "significant progress" in combating HIV/AIDS, which was first diagnosed in the country in 1987.

UN Ambassador George Talbot said resource allocation to the health sector, especially for HIV and AIDS, has been "scaled up," resulting in significant decline in HIV/AIDS infection rates and deaths, while access to HIV prevention, treatment, care and support has increased.

In addition, Talbot said Guyana has seen "substantial decreases" in mother-to-child transmission of HIV. He said female sex workers and men having sex with men, among the most vulnerable groups, have decreased in prevalence.

He said the Bharrat Jagdeo administration is "committed to enhancing programmes for access to prevention, treatment, care and support."

Overall, he said Guyana's advances could be attributed to "political commitment at the highest level," as seen in its Presidential Commission, as well as dedication to a multi-sectoral approach and the forging of partnerships, including at the regional and international levels.

Haiti called for political will to support what it described as the "cross-cutting" global response to HIV-AIDS.

Director-General for public health and population, Gabriel Thimothé, said the disease is still a "generalised epidemic," with a 2.2 per cent prevalence rate.

He said that since HIV disproportionately affects women, mother-to-child transmissions are on the rise.

Thimothé said the recent earthquake and cholera outbreak in the impoverished, French-speaking Caribbean country has exacerbated the country's woes and "makes it more difficult to fight the epidemic".

Nevertheless, he said the government is "taking comprehensive steps to combat the disease".