PSI top official advocates behaviour change to fight HIV/AIDS By Shirley Thomas
Guyana Chronicle
March 28, 2004

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AS GUYANA moves to strengthen its capacity to respond to the burgeoning problem of HIV/AIDS, a leading political international affairs advocate and former United States career diplomat has offered some timely advice.

Ms. Sally Cowall, Vice President of Population Services International (PSI), and former Deputy Director General of UNAIDS, after making an assessment of the HIV/AIDS epidemic here, has strongly urged that in order to control the spread of the disease, Guyana should premise its response on resolutely promoting `Behaviour Change'.

Ms. Cowall made this observation on a recent visit to Guyana to participate in the launch of an HIV/AIDS Prevention Initiative, one feature of which was Behaviour Change Communication. The programme, funded by USAID, is being delivered through its implementing partner - PSI.

Ms. Cowall commended Guyana's efforts in the fight against HIV/AIDS to date. Noting that behaviour change is at the heart of the response to the epidemic, Ms. Cowall cited Uganda as an example of a country, which was able to significantly reduce its HIV prevalence, using the behaviour change approach.

But equally important in the scheme of things, she said, is a broad-based collaborative approach, backed by political commitment.

Said Ms Cowall: "I learned some years ago when I was the Deputy Director at UNAIDS, that it was not medical knowledge, but political commitment which made the difference in the response to AIDS."

Alluding to Uganda's success story in lowering its AIDS prevalence, she said: "It was because the political leaders, the religious leaders, military leaders, the civil society -all began to realise that survival was at stake, the survival of individuals and the nation, and they also realised that 'business as usual' was not going to ensure survival."

Explaining behaviour change, she said that this means that, people have to change their habits and sometimes their beliefs.

"Behaviour change means individuals taking responsibility for their own conduct and their own lives: by abstaining from sex; by waiting to initiate sexual relations until they are mature enough to have them; by being faithful to one partner; by getting counselling and testing to know their HIV status; by not discriminating against persons with HIV; by not being afraid of the virus and by using condoms when circumstances make them advisable," she stated.

The PSI Vice Chairman said that, in all this, communities and governments also have to change their behaviour.

"They must learn to not discriminate against those who are HIV positive; to respect women; to not bury their heads in the sand and deny that their communities are infected or at risk; to not `blame' others, foreigners, homosexuals, and drug users; to care what is happening in their communities, and to overcome complacency 'before it's too late," she warned.

Noting that Guyana has advantage even over Uganda in the fight, she alluded to this country's many assets, namely: "a well educated, literate population and good friends in the US Government, the Canadian Government and elsewhere who are prepared to help".

Ms. Cowall was, however, of the view that in our own situation, Guyanese must lead the way. She saw the USAID-sponsored Behaviour Change programme implemented through PSI as a good place to begin.

The PSI Vice President said that, through the programme, PSI has pledged to do its utmost to work with religious organisations, NGOs, government and civil society, to help change behaviour through voluntary counselling and testing, peer education, working especially with high risk groups to provide condoms.

Noting that the time to act is now, she warned that "none of us is safe until all of us are safe."

Ms. Cowall who began her diplomatic career in 1966, spent many years in the United States Foreign Service and retired in 1995, after being United States Ambassador to Trinidad and Tobago. She also headed an International Youth Programme, at the same time, running the Public Policy Institute, and bring involved in changing US relations towards Cuba.

She recalled that when she joined the diplomatic service it was in the height of the Cold War in 1966 and by 1995 when she was ready to retire "the whole world had changed, and the Cold War was over." At this stage, it was no longer confrontation between blocks of polarised countries.

"I think the fight that we now have to face is the fight of all of us - against poverty and disease...not one country, or block of countries against another block of countries, but really a fight that we should take in the common - against our common enemy."

She identified that "common enemy" as poverty and underdevelopment, diseases ravishing the world, the most serious and complex of which, in her opinion is HIV/AIDS.

Ms, Cowall told the Sunday Chronicle that as Deputy Director of UNAIDS, she travelled "all around the world."

Ms Cowall spent about the next five years working with UNAIDS. During that time, she realised that even without a medical background, one can make a tangible contribution to making a difference. Her background in political international affairs certainly served as an asset.

During her stint at UNAIDS, she became aware of the work of PSI and other Non-Governmental organisations. Having by then, decided that she wanted to be a bit more 'grass roots' -working more on the direct responses to the HIV epidemic - she subsequently accepted the invitation to be Vice President of PSI.

She said she was very pleased to have been asked by the Government of Guyana and USAID to come and work with them in Guyana, to bring the expertise gained in Social Marketing and Public Campaigns.

"It therefore falls to my happy duty to come here for the launch of Behaviour Change Communication Campaign," she stated. Describing her visit to Guyana, she said: "It's like coming home..., I come to the Caribbean and I have a chance to get my roti and curry and calypso" These things she said she learnt about in Trinidad while serving as US Ambassador.

While in Guyana, apart from meeting with Minister of Health, Dr. Leslie Ramsammy and other health officials, and the staff of USAID, Ms. Cowall also met with CARICOM Secretary General, Dr. Edwin Carrington and Assistant Secretary General, Dr. Edward Greene

Population Services International, now working in about 70 countries around the world is committed to the health of people they serve in Africa, Latin America and the Caribbean.