Regional health authorities addressed HIV and AIDS in the
Caribbean at a meeting held in Cayman last week.
The European Commission/Overseas Caribbean Territories
Steering Committee Meeting addressed a regional project to promote an
integrated response to HIV/AIDS for the British and Dutch Overseas Caribbean
Cayman Islands Minister of Health Mark Scotland said in
his opening remarks: “As small island nations, we are acutely aware of our
numerous vulnerabilities, but oftentimes, we simply lack the resources to
develop and coordinate meaningful and long-term solutions.” He also thanked the
European Commission for funding the project, as well as its partner agencies,
the UK’s Department for International Development and the Pan-Caribbean
Partnership on HIV/AIDS.
The two-day meeting held on 16 and 17 September at the
Marriott resort, looked at the progress made in combatting HIV and AIDS over
the past year and the way forward.
Mr. Scotland pointed out that since AIDS was first
recognised by the US Centers for Disease Control and Prevention in 1981, it has
become one of the most destructive epidemics in modern history, with an
estimated 33.2 million living with the disease in 2007. He said AIDS had
already killed an estimated 2.1 million, including 330,000 children.
Caribbean region second-hardest hit
According to a March 2002 Pan-Caribbean Partnership on
HIV/AIDS report, the Caribbean region is the second hardest hit by the disease,
after sub-Saharan Africa.
“AIDS is the leading cause of death in the 15-44 year age
group, and Caribbean UNAIDS calculations suggest that close to 360,000 people
in the region are living with the virus; others put the figure at 500,000,”
said Mr. Scotland.
He quoted from a University of West Indies study in the
same 2002 PANCAP report, which estimated that the total cost of the regional
epidemic could reach US$80 million by 2020.
Mr. Scotland said that although there is a growing
awareness of the magnitude of the problem in the region, there is a lack of
comprehensive data on the prevalence of HIV and AIDS, partly due to widely held
misconceptions and the stigmatisation of those who suffer from the disease.
“Not knowing the true form of the epidemic, governments
are unable to plan effectively and AIDS organisations can’t identify their
target groups with the necessary accuracy,” he said, adding that ostracism of
people who fear they may have the disease could lead them to avoid getting
tested and to discourage others with AIDS or HIV from accessing available care.
“Locally, we too face our own unique challenge – our
seemingly low rates. Because official figures reveal low infection levels here
in Cayman, many tend to think HIV and AIDS are not a priority – which is of
course an absolute fallacy,” he said.
Locally, by late last year, 88 people in Cayman had been
diagnosed with HIV since 1985 when the first case was reported here. Of those,
half developed AIDS and 30 have died.
Mr. Scotland said part of the challenge, locally and
regionally, involves “dispelling the myth that the epidemic is just a ‘health’
“ … It is clear to me that an effective response to HIV
must be based on the involvement of all societal sectors, including health,
education, social welfare, finance and the highest levels of the executive,”
Mr. Scotland said.
He added that the aim of the meeting was to come up with
a plan that “calls for all hands on deck”.
The minister invited the medical community to bring
lawmakers, politicians and elected officials to the table. “As with all
national issues, there must be political buy-in so those on the ground will get
the support they need. For example, better reporting will only occur if
governments establish frameworks for consistent reporting, without sacrificing
confidentiality,” he said.
The health minister said governments must build strong
relationships among AIDS activists, NGOs, businesses, schools and churches
because “few governments have the resources to tackle the problem alone and so
a combined response is essential”.
Mr. Scotland said there is a strong working relationship
in Cayman between the government and NGO partners, notably the Red Cross and
the Cayman Aids Foundation. “Together with our public health officials, these
organisations keep our focus sharp, reminding us of areas that need strengthening,
such as testing. We have thus gained a new appreciation of the fact that
without compulsory testing, HIV/AIDS figures may in reality be higher. We are
accordingly looking into ways of improving our surveillance,” he said.
Involving parents in national strategies is vital, the
minister said, because the disease is most prevalent among people in their
teens and early 20s in the Caribbean.
“So many times we withhold essential information from our
young people, fearing that they might misinterpret or misuse it, but we need to
give them more credit. As such, my ministry will continue to support the drive
for sexual health education because when it comes to HIV/AIDS, ignorance is
never bliss,” he said.