HIV/AIDS threat

Stabroek News
July 2, 2001

Last week's United Nations General Assembly Special Session on AIDS shone a welcome spotlight on the global pandemic that is threatening the very survival of some nations.

The relevant statistic for Guyana is that five percent of its citizens may either have AIDS or are carrying the Human Immuno-deficiency Virus (HIV) which causes AIDS. Five percent may, however, not take account of significant under-reporting and undetected cases. Moreover, in some categories the percentage is vastly higher. One study here found that 45% of prostitutes sampled had AIDS or were HIV positive. This particular group has a significant multiplier effect on the rest of the populace because of the number of potential partners who can end up being infected.

Think of it in this way. In any room with around 20 persons, statistically one or more of these persons either have AIDS, AIDS-related complex or are HIV positive.

At the UN conference in New York, Guyana's Health Minister Dr Leslie Ramsammy put the jeopardy in stark and chilling terms. Guyana was under siege from the disease and is on the edge of a precipice. Gains made over a number of years were being rolled back and this country could not afford the price tag - perhaps as much as US$45M per annum - to keep the killer disease at bay.

The government's and Dr Ramsammy's mettle will be sorely tested in this area. The challenges are evident. Within the compass of the UN declaration, Guyana has to mobilise its own resources and that of willing donors. The World Bank has approved a US$155M loan for the region to battle the disease but noticeably only Barbados and the Dominican Republic have bolted out of the starting blocks with specific allocations. We need to get on our way.

Secondly, the government itself needs to make a significant investment as the toll from this disease will in the long run cost more in terms of the deaths of workers in their prime, the burden on the health system and the social repercussions of dismembered families. The government should start Guyana's own AIDS fund with the state being the main donor. Corporate Guyana must also be brought on board. It also stands to be significantly affected by deaths and incapacitation of the employee pool. Is there any prospect of funds from the lotto game being channelled in this direction?

Thirdly, the government and civil society have to invest heavily in saturating the public with information on the disease, how people can protect themselves from it and the safe sex message. There is little room for prudish sensibilities in this endeavour. It has to be full-blown - in schools, churches, workplaces, social clubs, cinemas, in the villages and on the streets. The awareness programme has to be decentralised and the various civic groups such as Lifeline would have to be enlisted and aided to become the foot soldiers in this campaign.

The message has to be tailored for the various segments of the population taking account of the different mores, customs and religions in this multi-ethnic society.

The media can help but too often it is seen as the easy way out. Its reach is not exactly universal and messages are sometimes ephemeral and one-off events. This is where local government in association with community health centres and health huts have to be used to drive home the message in their own communities equipped with much better knowledge of local conditions.

Fourthly, money has to be spent on treating HIV/AIDS patients. The government has already made a commitment to tackle mother-to-child transmissions. Talks have to be pursued with Cipla and other companies which are offering the triple drug therapy at much reduced prices to clinch a deal.

Fifthly, groups such as prostitutes must be given special attention not only to prevent them catching the disease but to stop them from becoming transmitters of the virus. They must be encouraged to undergo regular testing. Voluntary testing must also be offered to the public at large.

Sixthly, condoms and other contraceptive aids which can ward off the virus have to be made widely and freely available by the government at places where they are most needed: bars, clubs, discos, hotels, resorts etc.

All of these issues will presumably be refined in the overall AIDS strategy that the Ministry of Health and the National AIDS Programme Secretariat are responsible for.

Now that the conference is over, the new government and the health minister must set out in clear terms how they will go about retracting Guyana from the edge of the AIDS precipice.