Guyana's social progress made over the last decade has begun to erode significantly because of the high percentage of HIV/AIDS in its population.

This was the sobering message conveyed to the United Nation General Assembly Special Session (UNGASS) on the Aquired Immune Deficiency Syndrome (AIDS) held earlier this week in New York by Minister of Health, Dr Leslie Ramsammy. The conference started on Monday and concluded on Wednesday. The minister said the erosion is happening despite the debt relief received by the country which resulted in substantial investment in the social sector and which led to reduced malnutrition, improved maternal and infant mortality rates and greater educational opportunities for children. The minister stressed that for countries like Guyana, "the real possibility that HIV/AIDS can destroy our already fragile economic base necessitates that debt relief is not merely reduction of the debt burden, but forgiveness of debt."

Plugging for financing to battle the epidemic, Ramsammy told the conference that unless Guyana can urgently access additional funds then its capacity to introduce and sustain programmes for surveillance, voluntary counselling, testing, capacity building and treatment, especially obtaining anti-retroviral drugs, will continue to be severely limited. "If my country is to continue to survive as a viable nation, these new and additional resources must be found urgently," the minister appealed. Ramsammy said there is a frightening possibility that the country's prevalence rate of 5.5% of HIV/AIDS might well reflect significant under-reporting of those afflicted by the disease. He cited the prevalence rate of 45% and 29% respectively among sex workers and persons with sexually transmitted infections.

The minister further stressed that the country does not have the resources to protect itself against the HIV/AIDS pandemic. Guyana, he said, is working feverishly to acquire money to fight the epidemic and it is in this light that negotiations are ongoing with the World Bank for a concessionary loan from the bank which has pledged some US$155 million to help tackle HIV and AIDS in the Caribbean region. Dr Ramsammy yesterday said at a press conference at the Ministry of Health that President Bharrat Jagdeo is continuing negotiations with the bank as there are some conditionalities that need to be worked out.The bank has since approved projects for the Dominican Republic worth US$25 million and for Barbados at US$15 million.

The Caribbean region is the hardest hit by the epidemic outside of Africa. Discussions are also continuing, he said, on Guyana's drive to acquire cheap drugs and in this vein discussions are continuing with India's Cipla company which is offering a triple drug cocktail to the world's poor at $350 per patient per year.
The conference was the world's response to what was described as a "global crisis."
The minister told the conference that Guyana is "truly under siege and on the precipice of disaster." He said that HIV/AIDS threatens to decimate large numbers of the country's productive population and disclosed that unprecedented numbers of Guyana's children are being orphaned. "The fabric of Guyanese society is being relentlessly torn apart and our social and economic development, already lagging behind most countries in the Americas, is threatened with destruction," Dr Ramsammy told the conference.

He informed reporters that a study done by the University of the West Indies showed that for Guyana to implement an effective programme to combat AIDS it probably needs US$45 million annually.
This, the minister, said is far in excess of the national budget for health
According to the minister, the Caribbean has taken a position that it should have a representative on the board of the global AIDS fund which will come into effect by year end.
He disclosed that regional leaders have decided on a caucus which will discuss a Caribbean approach to the drug companies.

Some of the main points of the UN declaration to combat AIDS are that by 2003 countries must ensure national strategies and financing plans that confront the stigma, silence and denial and eliminate discrimination against people living with HIV or AIDS. Such efforts it said requires partnerships with grass roots groups, businesses and HIV-infected people themselves.

The UN also declared that by 2003 there must be national prevention targets, recognising and addressing factors leading to the spread of the epidemic, especially in groups with high infection rates.
It was also declared that by 2005 significant progress must be made in implementing "comprehensive care strategies" to provide access to affordable medicines, including anti-retroviral drugs, diagnostics and related technologies. By 2005, it was also agreed that the UN must reach an overall target of annual expenditure of between $7 billion to $10 billion in low-and middle-income countries for care, treatment and support for people living with HIV/AIDS.

[Editor’s Note: All credits for this report goes to Stabroek News, in which it was first published as “Guyana under siege from AIDS” on 06/30/2001.]

THE HIV/AIDS CHALLENGE

IN THE horrendous battle against the HIV/AIDS epidemic that has made the Caribbean one of the most affected regions of the world, outside of sub-Saharan Africa, the focus shifts this week to the CARICOM Summit in The Bahamas, after last week's global forum on this terrifying killer disease, provided by the United Nations.

The special session on AIDS was the brainchild of UN Secretary General Kofi Anan, who has appealed for contributions from the international community for a special fund of US$10 Billion to fight the HIV/AIDS pandemic, Anan told special UN session on AIDS, that "we cannot deal with AIDS by making moral judgements, or refusing to face unpleasant facts..."

Colin Powell, Secretary of State of the USA, whose government is currently the single largest bilateral contributor in the fight against AIDS, was blunt: "I was a soldier and I know of enemy in war more insidious or vicious than AIDS, an enemy that poses a clear and present danger to the world..."

Reflecting a strongly shared sentiment of the region, Prime Minister Owen Arthur of Barbados, current Chairman of the Community, stressed the urgency of "massive" international financial support for this region to combat HIV/AIDS that have already afflicted at least half a million people in the Caribbean. According to the most recent data, over seven percent of pregnant women in the urban areas of Guyana tested positive for HIV.

Caribbean governments are engaged in a 'Pan-Caribbean Partnership Programme' with the Pan American Health Organisation (PAHO) , supported by the international donor community, to combat the spread of the HIV/AIDS epidemic, including efforts to secure subsidised and affordable cockails of drug treatment.

Partnership Programme

The primary aim of the anti-HIV/AIDS partnership scheme, according to the Community Secretariat here in Georgetown, is to maximise available resources, facilitate the documentation on sharing of information, expertise and good practices, vigorously mobilse financial resources and minimise the duplication of efforts

It is obvious that the Caribbean cannot risk utilising very scare financial resources, on any sustained basis, to combat HIV/AIDS. Not with levels of poverty ranging from 25 to 45 percent (excluding Haiti with its endemic poverty rate of at least 70 percent); high levels of youth unemployment and rising incidence of violent crimes across the region. While, therefore, the promise of significant concessional loans from the international financial institutions and traditional donoor governments are most welcome, the harsh reality is that this needs to be combined with an enlightened plan to write off debts---not merely rescheduling---less these countries end up in a worse and painful dilemma in their fight against the global number one killer--AIDS.

This is an idea that needs to be discussed during this week's CARICOM Summit that has on its agenda the HIV/AIDS crisis facing this region. We wish the leaders the best in their honest and constructive efforts to deal with HIV/AIDS.