Jan. 22 2007 — The first Caribbean Summit on HIV-AIDS Sunday presented evidence of the common problems preventing countries in the region from curbing the spread of the disease: poverty, limited economic resources, discrimination and stigmatization.
"There was a fifth horseman of the Apocalypse, and his name is AIDS," said Sir George Allyene, United Nations special envoy for HIV-AIDS in the Caribbean, delivering the keynote speech at the inaugural summit. "Prophets of doom" predicted the "kiss of death" to the Caribbean economy as the number of infected people continues to rise, Allyene said.
The summit took place Sunday at the Buccaneer Hotel on St. Croix. A welcome reception was held Saturday evening at Government House, Christiansted. Present were ministers of Health, government officials and community stakeholders from several Caribbean countries, including U.S. Congressman Donald Payne, a member of the International Relations Committee and founding member of the Friends of the Caribbean in Congress, and V.I. Delegate Donna M. Christensen, chair of the Congressional Black Caucus Health Braintrust.
The summit's aim was to explore ways the Caribbean and the U.S. government could collaborate to bring added economic stability to a region that, on the whole, has fewer resources to deal with a growing population affected by HIV-AIDS.
During his keynote address, Allyene spoke about the relationship between HIV-AIDS and a booming tourist economy. He suggested that commercial sex plays an important part in the transmission and spread of HIV-AIDS. Using per-capita income as an indicator of the prevalence of the disease is a "fallacy," he said.
HIV-AIDS is one of the top five causes of death in the Caribbean, Allyene said. The rise in adult mortality associated with the disease causes, among other things, the reduction of work productivity, absenteeism, illness and impaired morale because of the stigma that comes with a diagnosis. For a society living on the edge of poverty, he said, having to use funds on medical expenses can "drive a family into abject poverty."
"More attention needs to be given to prevention," Allyene said. Another indicator fueling the spread of HIV-AIDS is the "gross inequality in the power between the sexes," he said. Although women are better educated on the whole, Allyene said, they are at a disadvantage when "negotiating sexual relations." To combat this inequality, Allyene advocated making the female condom cheaper and more available.
"The female condom is five times more expensive" than its male counterpart, he said. Another emerging problem: the free movement of people in the region, including those with HIV-AIDS. "Will the countries be able to treat the people?" he asked.
Allyene said he looks forward to the day when "the Caribbean as a whole passes a law to make it illegal to discriminate against people with HIV-AIDS."
Payne, who represents New Jersey's 10th congressional district, revealed a startling fact: 46 percent of all HIV-AIDS patients living in New York City are from the Caribbean. Before the anti-retroviral (ARV) drug became readily available, the federal government used to be reluctant to send patients back to their homelands, he said. But with more Caribbean countries having the treatment, more infected people will be sent back to their places of origin.
In Barbuda, women ages 15 to 29 are the fastest-growing population of people infected with HIV-AIDS, said John Maginley, Antigua and Barbuda's Minister of Health, Sports and Youth Affairs. Pointing to the plague of commercial-sex workers, a country with a population of 75,000 having 4 to 5000 sex-for-hire workers is a "huge challenge," he said. Antigua offers free ARV treatment, "but can we provide it for all undocumented persons?" he asked. Antigua is also concerned about the influx of people from other countries, Maginley said.
The Caribbean Community and Common Market (CARICOM) has recently modified the mandate for free movement, which gives residents the right to seek employment in any member state, eliminating the need for work permits and permits of stay.
Maginley also questioned whether the campaign to inform residents about HIV-AIDS is reaching the targeted population. Additionally, the issue of health care workers leaving Antigua for better pay in the U.S and Canada is crippling the health care industry, he said.
The mood of the conference lightened when Jerome Walcott, Barbados' Minister of Health, revealed that his country has made some progress turning back the tide of the HIV-AIDS pandemic. A loan from the World Bank allowed Barbados to embark on a vigorous program to supply ARV to those who need it, he said.
"We can see the immediate benefits," Walcott said, indicating he would like to see the reduction in the price of the ARV treatment and the introduction of generic drugs, which would reduce the cost even further. Like his colleagues, Walcott also questioned whether the message of prevention is getting through to the target population. Stigmatization prevents people from getting tested and treated, he noted, also expressing great concern about the free-movement plan.
Haiti is second only to Africa in reported cases of HIV-AIDS, according to Dr. Robert Auguste, the country's minister of health. Haiti has 190,000 people with the disease. "The challenge is to have more people on ARV treatment," Auguste said. Currently 7000 people take the treatment, but the goal is 20,000. "With limited economic resources, the future is uncertain," he said.
Some startling statistics about HIV-AIDS cases in St. Lucia came from that country's minister of health, Stephenson King. He urged governments to speak out and develop new policies to deal with the crisis and provide free ARV treatment and counseling.
Heads of government should apply for the PETFAR program funds to help in the HIV-AIDS fight, Payne said. PETFAR is a $15 billion initiative of President George W. Bush that uses treatment and education to combat the AIDS epidemic in Africa and other threatened regions.
"CARICOM has to make a bigger and stronger demand for funds," Payne said. "If you stand up and say you have a problem, I believe funds can come."
In the remainder of the one-day summit, panels held various discussions on issues surrounding HIV-AIDS in the region, including private-sector and governmental intervention and creating policies and legislation for treatment and prevention.
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