By John Denny
Observer Reporter
(Charlestown, Nevis) – The Caribbean region has the second-highest prevalence of HIV infection in the world after sub-Saharan Africa, according to the World Heath Organization.
There are 15 people on Nevis presently receiving anti-retroviral drugs for HIV/AIDS, said Deputy Premier of the Nevis Island Administration, the Hon. Hensley Daniel.
“There were five more cases reported in 2007,” Mr. Daniel said. “That is the scary thing.”
Twenty reported cases for an island of 10,000 may seem small, but without intervention the problem will spread. The number of unreported cases is a mystery.
There is no mandatory testing in the Federation or Nevis, but there is voluntary testing available through the Ministry of Health.
Through his career, Mr. Daniel has been responsible for the monitoring and evaluation of 44 HIV/AIDS projects in St Vincent and the Grenadines, St Lucia, St Kitts and Nevis, Trinidad and Tobago and Surinam.
He has overseen the development and improvement of HIV/AIDS Networks in the five countries.
The cost of antiretroviral drugs in Nevis is high- EC$3,188.00 every three months for each patient, but the cost was being covered by the Global Fund for TB, HIV and Malaria, Mr. Daniel said.
Currently there are 29 people working on Nevis in various organizations to educate the public in the avoidance of HIV through the use of abstinence, behavior change and condoms, he said.
With 230 000 people living with HIV in the Caribbean, adult HIV prevalence is estimated at 1 percent. However, HIV monitoring systems remain inadequate in several countries, making it difficult to gauge recent trends in their epidemics.
AIDS remains one of the leading causes of death among people aged 25 to 44 years causing 11,000 deaths last year, according to UN AIDS.
With some 170, 000 people living with HIV, Haiti bears the largest HIV burden in the Caribbean. In three of the larger countries in this region – the Bahamas, Haiti and Trinidad and Tobago – more than 2 percent of the adult population is living with HIV. More than half of adults living with the virus are women.
AIDS is now one of the leading causes of death in some of these countries. An estimated 16,000 lives are lost each year to AIDS in Haiti, and tens of thousands of children have been orphaned by the epidemic.
The main mode of HIV transmission in this region is unprotected heterosexual intercourse; unprotected sex between sex workers and clients is a key factor in the spread of HIV.
Among female sex workers, HIV prevalence of 3.5 percent has been found in the Dominican Republic, 9 percent in Jamaica and 31 percent in Guyana.
Unsafe injecting drug use is responsible for a minority of HIV infections and contributes significantly to the spread of HIV only in Bermuda and Puerto Rico. Unsafe sex between men is a significant factor in this region but is largely hidden because of associated stigma. It is thought that as many as one in 10 reported HIV infections are the result of unprotected sex between men.
National adult HIV rates have stabilized in several Caribbean countries, including the Dominican Republic and Haiti, where declines have been observed in some urban areas.
Examining the epidemic indicates that besides mortality, protective behavior changes were at least partly responsible for those declines as behavioral surveys have shown a decrease in the average number of sexual partners between 1994 and 2000, and increased condom use especially during sex with non-regular partners.
International and domestic funding for AIDS has grown from ‘millions’ to ‘billions’ in the last decade. By the end of 2007, AlDS funding is estimated to stand at just under $10 billion – an almost forty fold increase since 1996, when just $260 million was available.
The increase has been largely due to a series of new international funding initiatives and mechanisms, notably the Global Fund for AIDS, tuberculosis and malaria, the World Bank’s Global AIDS Program and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Domestic spending on AIDS in low and middle-income countries has also continued to increase to currently represent around one third of all money going into the global AlDS effort.
As investment grows, the importance of “making the money work” is critical. Many developing countries are experiencing serious difficulties as they rapidly expand their delivery of AIDS treatment and HIV prevention services to communities. UNAIDS places particular emphasis on “making the money work”—supporting countries’ efforts to tap into new sources of financing and ensure that this financing is used most efficiently and effectively to reach the people who need it most. Better coordination is key to ‘Making the Money work’.
In 2004, UNAIDS, the United Kingdom and the United States led the endorsement by international donors, partners and national governments of the “Three Ones” principles — One national AIDS Action Framework; One National AIDS Coordinating Authority; One agreed country-level Monitoring and Evaluation System—to achieve the most effective and efficient use of resources, and to ensure rapid action and results-based management.
Since 1981 when HIV/AIDS was first described, an estimated 60 million people have been infected with HIV, of which some 20 million have died. UNAIDS reports that, globally, less than one person in five at risk of HIV has access to basic HIV prevention services. Only 24% of people who needed HIV treatment had access to it by mid-2006.
Following the commitment by G8 members and, subsequently, heads of states and governments at the 2005 UN World Summit, the UNAIDS Secretariat along with their partners, have been engaging in consultations to define the concept and a framework for universal access to HIV/AIDS prevention, treatment and care by 2010.
