Guyanese at greater risk from AIDS By Stacey Davidson
Guyana Chronicle
December 1, 2001 least one die every day because of AIDS
But Health Minister says there's hope in drugs treatment

HEALTH Minister, Dr. Leslie Ramsammy says Guyanese are at greater risk from the dreaded AIDS disease and the situation is daunting.

At least one Guyanese is dying a day because of AIDS, he says in a message to mark World AIDS Day today but outlines a drugs treatment programme which he feels offers hope for Guyana to tackle the extreme crisis.

"We do know that AIDS is now ranked as a leading cause of death in Guyana and is the number one cause of death among young people 15-39 years old. At least one Guyanese die every day because of AIDS", he says. (See guest editorial).

"Guyanese are at greater risk than we have ever been in our history", the minister stresses in the message.

But at a news conference yesterday, he said the Health Ministry has drugs to treat HIV/AIDS patients with the introduction of an infected treatment programme.

About $100M will be spent on the initial investment of the drugs while the ministry will negotiate with the Government to devise other ways to fund the programme, he said.

"I have access to NRTI, NNRTI (anti-retroviral drugs). These are drugs that are (to be) used in the initial treatment of HIV infected patients", he reported at the briefing at the Ministry of Health in Georgetown.

He explained that pro-tease inhibitors will be used for salvage therapy.

The Health Minister pointed out that the anti-retroviral drugs will be used initially but the pro-tease inhibitors, which have been found to be extremely effective, will be employed as "our salvage therapy". He explained that means that a person who seems resistant, is infected, and not responding to the initial therapy, will be given the stronger drugs as a salvage drug.

"...and the reason for that is because we don't want to use our best drugs first, so that the virus get resistant to these drugs quickly; and it means that we are not going to commit in Guyana willy nilly use of the drug."

Ramsammy reiterated that these drugs are not to be used in a carefree manner like antibiotics.

He said they would be available to medical practitioners in the private sector through the Ministry of Health.

"We will keep a tap on what is going on and who is using the drugs. We don't want the drugs to be just distributed on the streets willy nilly", he emphasised.

The Health Minister added that the drugs must be used according to the guidelines established by the Ministry of Health.

In January, doctors who want to treat HIV/AIDS patients will commence training locally, he reported.

"We will have a database of doctors who are going to treat HIV/AIDS patients. We will let the public know who these doctors are, but these doctors will only be given access to these drugs if they receive that training", Ramsammy said.

He announced that in February, two doctors will undergo advanced training in HIV therapy at the National Public Health Institute in Mexico.

When they return, these two medical practitioners "will be our focal point so that all other doctors will continue to have training through (them)", he said.

" wouldn't be a one shot thing, we will continue to provide training."

He assured that there will be at least one trained doctor on the use of antiviral drugs at all public hospitals.

Training will also be available to private medical practitioners if they desire, "but we will not make available these drugs to doctors who do not access the training programme", he emphasised.

The Health Minister said there has not been a rapid increase in the deadly virus this year even as statistics suggest this. But because more cases have been diagnosed this year from previous years and the ministry has been effective in diagnosing more cases, more have been recorded.

"So some of these new cases are really old cases (that) we did not pick up before, so that it may not be that we have doubled."

"This doubling rate is a combination of new cases and a more effective response mechanism", he explained.

"Before, the majority of people were missed, so now fewer people are being missed and so that's a positive indication that the public health system is now more equipped to deal with the problem", he said.

Ramsammy projected that 5 1/2 per cent of the population is infected with the disease, between the ages 15 and 40, which he described as extremely high.

"These are people who have progressed from HIV infection to being AIDS patients. New HIV positive persons exceeded all of last year and so you see the brink transmission rate and the conversion rate from HIV positive to AIDS cases are accelerating in our country."

He said these figures can only increase and though the initiative taken is costly, the Government has no choice but to take steps to control the situation.

The Health Minister said technology is in place to test and manufacture anti-retroviral drugs to treat the patients.

"We have access to technology for the (manufacture of) anti-retroviral drugs, and we have in the private sector facility, the Guyana Pharmaceutical Corporation (GPC) (which) has the facility to manufacture (the) drugs.

"GPC and the Analyst Department have the equipment that can make the quality of the drugs", he said.

He said the Analyst Department is still installing some of the equipment for the section to function.

The National Strategic Plan for HIV/AIDS which was introduced in 1998, and was not implemented, has been reviewed and will be established in a 2001-2005 programme.

"The programme will continue to be revised (in) 2002, but we are approaching 2002 with a draft plan that we are going to begin to implement and with input from other people, we would have it revised as we proceed", he stated.