The financial model for supporting HIV programmes in the Caribbean must be reconsidered and new efficiencies are needed, a new report has said, while pointing to a reduction in development assistance from donor governments.
UNAIDS yesterday released the report, ‘The status of HIV in the Caribbean’, which emphasized the need for continued funding in HIV at the national level. Governments are expected to better estimate the costs of supporting existing HIV responses, identify how these needs can be financed by national resources, and adopt measures that will help contain future costs.
The report was released ahead of World AIDS Day which is celebrated annually on December 1; this year the day is being observed under the theme, ‘Universal Access and Human Rights’.
UNAIDS Country Coordinator, Dr. Ruben Del Prado said that the financial and economic crisis have translated to donors having less fiscal space and budgets will tighten. In addition, he said, funding will shift to regions and countries where HIV infections are higher.
Dr. Del Prado presented the new report at a press conference yesterday before joining with members of other UN agencies in Guyana to light a ribbon in front of the UNDP building at Brickdam.
Dr. Del Prado used the opportunity to comment on what he called the “unacceptably high” HIV prevalence rate among homosexual men. He said that recent studies have shown that the numbers are still high while overall prevalence rates have reduced in many countries in the region.
HIV prevalence is also highest among sex workers, particularly female sex workers. The figures vary from 2.7 percent in the Dominican Republic to 27 percent in Guyana between 2006 and 2008. Recent figures indicate that the current prevalence rate in Guyana among female sex workers is 15 percent.
It is estimated that some 270 000 persons are living with HIV/AIDS in the Caribbean with Jamaica, Haiti and the Dominican Republic accounting for a significant number. The report found that between 2001 and 2008, there was no major reduction in the number of new HIV infections.
It was also reported that the number of females living with HIV is increasing. Women, especially young women, account for 50 percent of Persons Living with HIV (PLWHIV). But there is wide variation by country in the estimates of PLWHIV who are females; ranging from 26 percent in The Bahamas to 59 percent in Belize, Guyana and Trinidad and Tobago.
Dr. Del Prado spoke of the lens through which HIV/AIDS is viewed saying that stigma and discrimination continues to be the social drivers of the epidemic, in addition to the criminalization of same-sex relations. He said that people who discriminate are, “backward, stupid and dumb”.
The report pointed to some successes across the Caribbean saying that antiretroviral (ARV) treatment coverage has been scaled up; moving from 1 percent in 2004 to 51 percent in 2008, resulting in a 40 percent reduction in the number of AIDS-related deaths in that year. Paediatric AIDS treatment coverage has also reached 55 percent and has contributed to the reduction of AIDS-related mortality.
In addition, progress has been made in the area of voluntary counseling and testing over the past five years. In 11 Caribbean countries, more than 90 percent of pregnant women are tested for HIV every year. Prevention-of-mother-to-child transmission (PMTCT) coverage has also increased to 52 percent.
UN Resident Coordinator, Kiari Liman-Tinguiri also speaking at the event pointed to the continued support of the UN for Guyana’s response to HIV through the consolidated joint UN programme. “We can make human rights and the law work for HIV and put an end to punitive laws, policies, practices and stigma and discrimination which work against the tide of success”, he added.
The Guyana Joint UN Programme of Support 2009-2011 focuses on seven pillars and includes support for a well-defined and well-governed faith leaders-led partnership, with a mission, vision and strategic direction, aligned with the National HIV programme, and support for the reduction of the burden of HIV and tuberculosis on migrant and mobile populations, among others.
