Curbing spread of HIV/Aids in region

Optimism is high among the more than 20,000 scientists, researchers, policy makers, people living with HIV and Aids and activists at the 2012 International Aids Conference currently taking place in Washington DC. The event is historic, not only because it is taking place in the United States for the first time in 22 years, following the lifting of restrictions on HIV-positive people entering that country, but also because of all the positive advancements that have been made in battling the pandemic. For the first time in three decades of testing, treatment and prevention programmes, there is hope of bringing an end to the pandemic through a multifaceted global effort. There is no cure or vaccine yet but scientists finally have powerful, effective tools to stem the spread of the HIV virus. The development of effective interventions, including combination antiretroviral therapy, have brought about significant improvements in the health and longevity of HIV-positive people.

It has also reduced the spread of the disease by reducing the amount of virus in an infected person’s blood and other body fluids, making it less likely for the virus to be transmitted to others. Antiretroviral therapy is also highly effective in blocking mother-to-child HIV transmission. One of the most significant developments in terms of prevention is the daily Aids medicine Truvada, which can be taken by healthy people to lower their risk of infection. As a result of these and another initiatives, the rate of new HIV infections has stabilised. However, major challenges remain. According to global estimates, there are 34.2 million people living with HIV and even with a drop in the rate of infections, 2.5 million people are infected every year. Funding remains one of the biggest challenges— the US$16.8 billion spent fighting Aids in poor countries is still US$7 billion short of the amount needed to ensure that more people have access to life-saving drugs. The global recession means there just isn’t enough money to ensure that more HIV-infected pregnant women get treatment to protect their babies and more men are circumcised to prevent heterosexual infection. Here in the Caribbean, where an estimated US$1.6 billion was spent on the regional HIV response between 2001 and 2009, that recent change on the donor landscape could have serious implications. By 2010, 64 per cent of Aids spending in the region came from international donors and a Caribbean-wide elimination initiative led by the Pan American Health Organisation, the Joint United Nations Programme on HIV/Aids and the United Nations Children’s Fund yielded considerable success—several countries are close to achieving elimination targets.

However, the relatively high antiretroviral treatment (ART) coverage throughout the Caribbean of 67 per cent cannot be sustained without international funding, which has already become more restrictive. As it is, Trinidad and Tobago, where there are about 25,000 people living with HIV, is one of the few countries in the region that does not depend on external financing for its ART programme. Barbados, Cuba and St Lucia are moderately reliant on foreign sources, while Antigua and Barbuda, Dominica, the Dominican Republic, Grenada, Guyana, Haiti, Jamaica, St Kitts and Nevis and St Vincent and the Grenadines get all or almost all of their financing for ART from international sources. This is the issue that must be put on the global front burner by the Caribbean delegation of more than 300 people at the Washington conference. After sub-Saharan Africa, this region has a higher HIV prevalence than any other area of the world, with one per cent of the adult population infected. There are 230,000 people living with HIV in the region, of whom approximately 13,000 were newly infected with the virus last year. This is one fight in which surrender is not an option.