Access to prevention services, treatment remain keys to eliminating HIV/AIDS in region

UNAIDS’ Caribbean Regional Support office said the region can become the first in the world to halt the spread of the HIV virus, in its message for World AIDS Day 2011 on Thursday.

Director of the UNAIDS Caribbean office Dr Ernest Massiah said,  “Zero new HIV infections, zero discrimination and zero AIDS-related deaths could be more than a pipedream 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.”

In a press release, Dr Massiah added that the region has had many successes and the epidemic has slowed considerably since the mid-1990s. “In 2010, the Caribbean had an estimated 12,000 new infections. This is down from 19,000 in 2001,” he noted.

Other countries have also recorded significant success in the area of prevention and, over the last decade new infections have declined by 25% in both the Dominican Republic and Jamaica and by 12% in Haiti. During the same period, the Caribbean’s total AIDS-related deaths decreased from 18,000 in 2001 to 9,000 in 2010. Also, in 2009, the Prevention of Mother to Child Transmission coverage was 59%, up from 22 % in 2003.

Last month’s Caribbean HIV Conference held in The Bahamas helped the region to chart a way forward. The meeting noted that increased access to HIV prevention services for pregnant women has led to a steep decline in the number of babies newly infected with the virus and the number of AIDS-related deaths among children, though unprotected sex remains the primary mode of transmission in the region.

“We must reach out directly to key populations like women and girls, men who have sex with men, young people and sex workers,” Dr Massiah said, adding that the agency has to boost evidence-based prevention programmes and abandon techniques that do not work. UNAIDS knows that early treatment helps to reduce the risk of transmitting HIV by 96 per cent.

“This means that treatment not only saves lives but prevents new infections. We must prevent drug resistance and increase antiretroviral treatment coverage from just under 50 percent to more than 80 percent of our people living with HIV,” he added.

Stigma and discrimination must also be addressed. Dr Massiah noted that prejudice can discount the investments made in this response and negative attitudes and actions are a disincentive to others to get tested, treated and to disclose their status. “When we discriminate the virus wins,” he asserted.

Additionally, The Global Fund has announced plans to replace its next call for country proposals (Round 11) with a new transitional funding mechanism, the release said. This new mechanism will focus on the continuation of essential prevention, treatment and care services currently financed by Global Fund, making new funding available only in 2014. UNAIDS noted that new funding sources are needed now more than ever in order to make strategic investments that deliver maximum results and value for money.

Dr Massiah said while there are other avenues to explore, it is vital that governments make the required investment into the health of Caribbean people and that they get better value for money being spent. All inefficiencies must be squeezed out of the system, he added.

He noted that the prevalence of HIV rates in the Caribbean is second only to sub-Saharan Africa but “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.”

Though this is a formidable challenge, it is not insurmountable, the director said, explaining that region must advance from a short-term, piecemeal approach to a long-term strategic response with matching investment. He also argued that “If we work smarter and harder, we can wipe out HIV.”