AIDS committee raises concerns about Guyana’s 2012 AIDS Response Report
There has been evidence of the lack of due process with respect to the compilation and analysis of Guyana’s 2012 Country AIDS Response Progress Report. At least this is according to the National AIDS Committee (NAC) in a statement issued to the media.
According to the body it had occasion to draw to the attention of the Ministry of Health, the National AIDS Programme Secretariat (NAPS) and the UNAIDS Country Director, as well as to their respective Monitoring and Evaluation officers, the lack of process regarding the Guyana UNGASS Report 2006-2007.
The Report was submitted by the Presidential Commission on HIV and AIDS but according to NAC “almost the same errors were made with respect to genuine consultation around the 2008-2009 Report, although it should be stated, one major error was corrected.”
The error corrected according to the statement was the impression that the NAPS Programme Manager was the officer in charge of NAC and responsible for submitting the National Composite Policy Index (NCPI) report/s.
It was pointed out that the NAC in February 2012 decided to opt out from filling out the questionnaire as provided by the hired consultant (Part B only) since no clarity was provided even to the most basic queries with respect to the preparation process, time-lines and the ‘consensus/verification’ exercise.
The statement revealed that as in past years, the Report underlines the central role of the “Presidential Commission on HIV/AIDS”, a mysterious body, which from its inception has never formally met, or has held meetings to which the NAC –listed on the organizational chart as an advisory body to the Commission, has never been invited.
“The NAC considers the number of interviews conducted for the Report (35) to be unnecessarily restricted for a Report of this nature. The NAC also believes that Reports of this nature should be undertaken by consultants who have no association whatever with organizations who are beneficiaries of HIV funding.
The 2012 Report, according to NAC, reflects more an official view of the programme to combat HIV/AIDS which suggests: steady progress in controlling the spread of the virus; adequate coverage of drug availability to HIV-infected persons and shows advances in ‘the threat posed by HIV to the status of ‘chronic’ rather than ‘incurable’.
These developments, it was noted, provide the evidence for supporting the goal of normalizing the response to HIV into the mainstream health service by its ‘integration’. This encouraging tone, the statement outlined, is characteristic of official reports to international bodies, highlighting the positive and down-playing the negative.
“In this case the tone responds to the additional stimulus of the Government being forced to assume greater financial responsibility for sustaining the prevention, treatment and care programmes previously funded by the international agencies on which austerity measures may well take their toll.”
In essence it is the belief of NAC that reducing HIV to the status of other chronic illnesses such as asthma and diabetes reduces the demand to provide funding. In particular, sustaining the reportedly 82 percent coverage of antiretroviral medicines poses a major financial challenge for the Government and the Report would have benefitted from findings of the 2011 study/consultation organized by the MOH/NAPS and UNAIDS on Universal Access and sustainability, the Report added.
“Absent from the current Report, as in previous Reports, is information as to how funds were spent at the national level and sources of funds (Annex 3), as cited, for example in the Barbados UNGASS Reports.
“Nor did the End of Term Review Meeting on the Guyana National HIV/AIDS Strategic Plan 2007-2011 organized by the MOH/NAPS on April 12, 2012 provide any financial status information as an invaluable tool in the development of the ‘HIVison’,” the statement added.
Whether the Report is an accurate assessment or the result of massaging statistics to suggest a more palatable situation, what stands out as remarkable is that the results appear to have been achieved without any effort to date on the part of Government to address public health issues which have hampered the fight against HIV.
These, according to NAC, includes no steps to provide constitutional protection against discrimination; no impact levels of sexual violence against women; slow progress in reducing stigma against HIV positive people; no focus on indigenous people as possibly the most vulnerable minority to HIV by virtue of their isolation, itinerant miners, forced prostitution and labour exploitation.
Additionally, NAC has noted that the government has resisted international pressure to de-criminalise homosexual activity to allow MSM in particular, unimpeded access to treatment and care and further noted that no legal steps have been taken to address this problem.
It was pointed out that there is no logical reason why the problem has abated. Indeed according to the Report the BBSS Study done in 2009 claims that the percentage of men who have sex with men who are living with HIV is 19.4 percent.
But unfortunately these claims are undermined by conflicting statistics, the NAC statement asserted.
UNAIDS & UNGASS Reports show MSM as among the best-informed of vulnerable groups, with the highest percentages of members tested and who collect their test results. How such responsible behaviour is compatible with the high prevalence rates referred to earlier needs to be clarified, it was further noted.
Against these uncertainties, the statement said that Caribbean governments continue to feel complacent over their performance in combating the spread of HIV, adding that their comfort zone is reinforced by the absence of locally-driven advocacy for law reform on the sexual orientation issue.
“The campaign to combat the HIV virus, rather than being a vehicle for challenging discrimination, has lost out over the years to the self-interest of organizations – both civic and official – local and international. Rather than being the first order of business over two decades ago in the fight against HIV, policy and legal reform has been given lip service at all levels.”
“The recently-released 2012 Guyana HIV/AIDS Report must be seen as a reflection of a process which has successfully drained the response to HIV of any traces of political, public health or legal concerns, leaving only technical issues which can be comfortably dealt with by routine health procedures,” the statement added.