The National AIDS Committee (NAC) has taken the government to task over what it sees as the administration’s failure to date to address public health issues which have hampered the fight against HIV/AIDS.
The NAC, in a statement on Wednesday assessing the recently-released 2012 Guyana HIV/AIDS Report, noted that the report “reflected more an official view of the programme to combat HIV/AIDS which suggests steady progress in controlling the spread of the virus, adequate coverage of drug availability to HIV-infected persons and shows advances in ‘the threat posed by HIV to the status of ‘chronic’ rather than ‘curable’.”
These developments provide the evidence for supporting the goal of normalising the response to HIV into the mainstream health service by its integration, the NAC said.
The NAC described the report as having an “encouraging tone (that) is characteristic of official reports to international bodies, highlighting the positive and down-playing the negative.”
In this case the tone responds to the additional stimulus of the government being forced to assume greater financial responsibility for sustaining the prevention, treatment and care programmes previously funded by the international agencies on which austerity measures may well take their toll. Reducing HIV to the status of other chronic illnesses such as asthma and diabetes reduces the demand to produce funding, the NAC added.
In particular, the NAC noted, sustaining the reportedly 82% coverage of antiretroviral medicines poses a major financial challenge for the Guyana government and the report would have benefitted from the findings of the 2011 study/consultation organised by the Ministry of Health/National AIDS Programme Secretariat and UNAIDS on universal access and sustainability.
No effort
However, according to the NAC, whether the report is an “accurate assessment or the result of massaging statistics to suggest a more palatable situation, what stands out as remarkable is that the results appear to have been achieved without any effort to date on the part of government to address public health issues which have hampered the fight against HIV.”
In that light the NAC then cited four specific issues for which it slammed the government: 1) no steps to provide constitutional protection against discrimination; 2) no impact levels of sexual violence against women; 3) slow progress in reducing stigma against HIV positive people; and 4) no focus on indigenous people as possibly the most vulnerable minority to HIV by virtue of their isolation, itinerant miners, forced prostitution and labour exploitation.
According to the NAC, on the first issue the Government of Guyana has “resisted international pressure to decriminalise homosexual activity to allow MSM [men who have sex with men] in particular unimpeded access to treatment and care.” No legal steps have been taken to address this problem so there is no logical reason why the problem has abated, the NAC charged.
Another hot-button issue that the NAC raised was the absence from the current report, as in previous reports, of information as to how funds were spent at the national level and the sources of funds as cited for example in the Barbados UNGASS reports.
The NAC also noted that at the end of term review meeting on the Guyana National HIV/AIDS Strategic Plan 2007-2011 organised by the MOH/NAPS on April 12 this year “there was also no financial status information as an invaluable tool in the development of the ‘HIVison.’”
The 2012 Country Progress Report Republic of Guyana: Global AIDS Response Progress Report for Reporting Period January 2010 – December 2011, was produced by the National AIDS Programme Secretariat (NAPS) in collaboration with UNAIDS. The NAC said it had to access this report via Google.
The NAC also highlighted its concern at the turnover of monitoring and evaluation (M&E) personnel over the last five years, both within NAPS and UNAIDS. Better M&E methods, for example, should require effective accountability early in the process so that possible delays can be flagged. At present, the NAC contended, M&E is too after-the-fact and the various milestones in work plans are not paid sufficient attention.
Legal reforms
The NAC also observed that the main civic beneficiaries of HIV appear unwilling to jeopardise their financing by campaigning locally for legal reforms. Even the LGBT community has limited its demands to technical matters affecting their access to HIV services.
“The campaign to combat the HIV virus rather than being a vehicle for challenging discrimination has lost out over the years to the self-interest of organisations – both civic and official – local and international,” the NAC declared. Rather than being the first order of business over two decades ago in the fight against HIV, policy and legal reform has been given lip service at all levels.
Meanwhile, the NAC pointed out that despite high level attention from the media, the links are still to be made between sexual violence and the spread of HIV among girls and hetero-sexual women in settled partnership (as opposed to women engaged in sex work or other forms of transactional sex).
Highlighting this category of vulnerable women is not to minimise the needs of sex workers, lesbians or any other sub-sector of women, the NAC explained. The priority is generated by the numbers of hetero-sexual women in marriages or partnerships who are vulnerable to unfaithfulness, bi-sexual partners as well as the range of sexual pressures generated by poverty.
The NAC said further that HIV programmes must stand indicted by the failure to utilize the enormous resources made available during the past decade to recognize and address the needs of women as a public health concern.
Read in this context, the recently-released 2012 Guyana HIV/AIDS Report must be seen as a reflection of a process which has successfully drained the response to HIV on any traces of political, public health or legal concerns, leaving only technical issues which can be comfortably dealt with by routine health procedures, the NAC concluded.
The National AIDS Committee is a voluntary body which promotes HIV/AIDS policy and advocacy issues, advises the Minister of Health and assesses the work of the National AIDS Programme Secretariat (NAPS) in relation to the National AIDS Programme.
The NAC also encourages the formation of Regional AIDS Committees (RACs) and networking among NGOs involved in the fight against the HIV/AIDS pandemic.
