Caribbean can be first to eliminate HIV/AIDS

A Message from Dr. Ernest Massiah, Director of the UNAIDS Caribbean Regional Support Team on World AIDS Day 2011

PORT OF SPAIN, 29 November 2011— The end of HIV is within our reach.  The Caribbean could become the first region in the world to halt the spread of the virus. 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.

Our region has had many successes. Since the mid 1990s the epidemic has slowed considerably. In 2010 the Caribbean had an estimated 12,000 new infections. This is down
from 19,000 in 2001. Some countries have had remarkable success in the realm of prevention. Over the last decade new infections have declined by 25 percent in both the Dominican Republic and Jamaica and by 12 percent in Haiti. Over the same time period the Caribbean’s total AIDS-related deaths moved from 18,000 in 2001 to 9000 in 2010. In 2009 our Prevention of Mother to Child Transmission (PMTCT) coverage was 59 percent, up from 22 percent in 2003.
Last month’s Caribbean HIV Conference held in the Bahamas helped the region to harness its collective wisdom and crystallise a way forward. Our path is now clearer. 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 programs so that we achieve 100 percent coverage and eliminate this form of transmission. This is entirely possible.
Unprotected sex remains the primary mode of transmission in our region. 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 programs 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 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. But if we want people 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.

One of our new realities 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.
Now more than ever we need new funding sources and to make strategic investments that deliver maximum results and value for money.
At the Caribbean HIV Conference one suggestion was that just one percent of our Gross Domestic Product (GDP) could cover both our HIV and non-communicable disease (NCD)
responses.  There are other avenues to explore. Whatever course we take, we must  not only ensure that our Governments make the required investment into the health of Caribbean people but also that we get better value for the money being  spent. 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. This is a formidable challenge, but it isn’t insurmountable. 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.

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