– UNAIDS Director
Emphasising that the end of HIV is within reach, Director of the UNAIDS Regional Support Team, Dr. Ernest Massiah, said that the Caribbean could become the first region in the world to halt the spread of the virus.
Dr. Massiah in a statement issued yesterday to commemorate World AIDS Day 2011 said that zero new HIV infections, zero discrimination and zero AIDS-related deaths, could be more than a pipe dream if we “seize the moment by eliminating mother to child transmission, scaling up evidence-based prevention and treatment strategies, working to eliminate stigma and discrimination and securing a sustained HIV response.”
He pointed out that the Region has had many successes in this regard, adding that since the mid-1990s the epidemic has slowed considerably. In 2010 the Caribbean had an estimated 12,000 new infections, stats that have since plummeted from 19,000 in 2001.
In fact, some countries have had remarkable success in the realm of prevention, Dr. Massiah said, with new infections over the last decade declining by 25 percent both in the Dominican Republic and Jamaica and by 12 percent in Haiti. Over the same period the Caribbean’s total AIDS-related deaths moved from 18,000 in 2001 to 9,000 in 2010. In 2009, the Prevention of Mother to Child Transmission (PMTCT) coverage was 59 percent, up from 22 percent in 2003, he added.
However, he noted that last month’s Caribbean HIV Conference, held in the Bahamas, helped the region to harness its collective wisdom and crystallise a way forward. He stressed too that “our path is now clearer” even as he disclosed that already increased access to HIV prevention services for pregnant women has led to a steep decline in the number of babies newly infected with HIV and the number of AIDS-related deaths among children.
“We must scale up these programmes so that we achieve 100 percent coverage and eliminate this form of transmission,” which according to him, is entirely possible.
He added too that unprotected sex remains the primary mode of transmission in the Region, adding that “we must reach out directly to key populations like women and girls, men who have sex with men, young people and sex workers. We have to scale up evidence-based prevention programmes and abandon techniques that do not work.”
We now know that early treatment helps to reduce the risk of transmitting HIV by 96 percent.”
This, Dr Massiah said, means that treatment not only saves lives, but prevents new infections. As a result, he noted that there is a need to prevent drug resistance and increase antiretroviral treatment coverage from just under 50 percent to more than 80 percent of people living with HIV.
However, he asserted that if people are to present themselves for testing and treatment “we must also address stigma and discrimination. Prejudice can discount the investments we make in this response.”
Many of our attitudes and actions amount to a disincentive to others to get tested, to access
treatment or to disclose their status. When we discriminate the virus wins,” Dr. Massiah asserted.
One of the new realities, he said, is that The Global Fund has announced plans to replace its next call for country proposals (Round 11) with a new transitional funding mechanism. The new mechanism will focus on the continuation of essential prevention, treatment and care
services currently financed by The Global Fund, making new funding available only in 2014, according to the Director.
“Now more than ever we need new funding sources and to make strategic investments that deliver maximum results and value for money,” he stressed, even as he noted that at the Caribbean HIV Conference, one suggestion was that just one percent of the Gross Domestic Product (GDP) could cover both HIV and non-communicable disease (NCD) responses. However, there are other avenues to explore, he added.
The Director explained, though, that whatever course is taken, persons must not only ensure that Governments make the required investment into the health of Caribbean people, but also that there is better value for the money being spent.
In essence, he noted that all inefficiencies must be squeezed out of the system.
“We know that our HIV rates place us second only to sub-Saharan Africa in terms of prevalence. But another reality of our situation is that in terms of absolute numbers, the Caribbean has the world’s smallest epidemic…260,000 of us are living with HIV and our adult prevalence is one percent.”
And though the disease presents a formidable challenge, it certainly isn’t insurmountable, he added.
“We must move from a short-term, piecemeal approach to a long-term strategic response with matching investment. If we work smarter and harder, we can wipe out HIV,” he asserted.
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