While Guyana is on track to eliminate mother-to-child transmission of HIV and AIDS in another year, Minister of Public Health Dr. George Norton on Wednesday made the worrying disclosures that every year there are about 500 new cases of persons infected by the virus and another 200 die from related complications.
Norton, who was speaking at a press conference at his ministry to discuss the upcoming United Nations General Assembly High-Level Meeting on Ending AIDS, said Guyana remains at second place behind Sub-Saharan Africa as the most affected by the virus. It is estimated that about 8,000 Guyanese are living with the virus but some of them are unaware of their status.
And according to UNAIDS, in 2015 about three of every five persons living with HIV were receiving antiretroviral therapy (58%), which is up from approximately one in five (22%) a decade ago.
“It is still important to note that we have made some progress, particularly with the elimination of the transmission of this virus from mother to child and, like Cuba has done already, eliminated that completely. If we continue improving on our management, [we] should be able to achieve that goal in our near future,” he said.
As to whether the Guyana is on track to be certified as having eliminated the mother-to-child transmission of the disease, UN Secretary-General Special Envoy for HIV in the Caribbean Dr Edward Greene said the Caribbean expects to be the first region in the world to eliminate this condition and about eight countries are in line for this certification. However, there is a problem in most of the countries in the region of not having enough data on syphilis, which may have caused some delays even though PAHO is now willing to certify the countries with the two sets of data by July. At least of five countries may be certified but as it relates to Guyana, Greene said its certification can come in another year.
Country Director of the UNAIDS office Dr Martin Odiit, however, said that it could be two years as time cannot be very certain at this time.
‘Tall order’
Norton will be representing Guyana at the high level meeting in New York, from June 8 to June 10, which will focus on the importance of accelerating the HIV response, in order to set the world on course to end the epidemic by 2030 as part of the Sustainable Development Goals.
He said it is important for the country to have representation at high level meetings such as the upcoming one. He described as a “tall order” for Guyana to achieve the UN set target of reducing the viral load in HIV infected persons by 90% to reduce the risk of transmission and one that may not be achieved unless the country adapts the fast track approach and “it might mean much more than doubling up, we might have to triple up our efforts.” He said that every effort that is being made worldwide would have to be evaluated by Guyana to see where the country can adapt and improve the management of the disease and its related complications.
The UN members are expected to adopt a Political Declaration on Ending Aids to scale up the pace of progress and reach a set of time-bound targets. To achieve this feat, countries will have to take a Fast-Track approach during the next five years. By increasing testing, early treatment and the proportion of people living with HIV who have undetectable viral loads, the UNAIDS Fast-Track approach aims to achieve: fewer than 500,000 people newly infected with HIV, fewer than 500,000 people dying from AIDS-related illness; and eliminating HIV-related discrimination.
“What we are hoping for is that at the end of the high level meeting we would come out with a…global consensus about how we can collectively, and with solidarity, move forward towards ending AIDS by 2030,” Greene said.
According to him, unlike many other regions the Caribbean is noted for its consolidated approach and functional cooperation in negotiations. He said the region is approaching the upcoming meeting with the same spirit of regional cooperation, led by Caricom and PANCAP with the support of UNAIDS.
“When we talk about a consolidated approach, when we talk about ending AIDS for us as small countries in the Caribbean, we can do it if we consolidate our positions and we collaborate in shared responsibilities,” Greene said.
Greene said that at the high level meeting it is hoped that the stage would be set for 90% of persons living with HIV/AIDS worldwide to be tested and a similar amount of those tested treated and by 2020 90% of those treated with viral loads low enough as to not transmit the virus.
“So fast tracking really speaks to testing and treating but it also speaks to prevention; [there’s] no use having treatment if we don’t have prevention and prevention strategies mean that each country must invest at least a quarter of the budget in health to prevention because prevention of AIDS would not only stop the trend but it would also stop the trend of some associated diseases like TB,” Greene said.
‘Left behind’
Human rights would also be examined at that meeting and Greene pointed out that people infected and affected by the virus have human rights, including the rights to access affordable medicine and not to be discriminated against, whether it is at the work place, health centres or through the laws of the country. “Those are things that discriminate against people and they leave people behind, they leave them marginalised,” he said.
He added that the meeting would place specific emphasis on how the key population, such as the LGBT population, is dealt with. Young women are also left behind because of issues related to domestic violence and cervical cancer, it was noted.
“In the context of the high level meeting we are seeking some responses that might help us along the way…,” he said, while adding that in Guyana sex education is still important and promoting sexual and reproductive rights.
He said the UN hopes that at the meeting an agreement would reached for sustainable financing without which the disease would not end. “The appeal is for donors, like the Global Fund and PEPFAR, to be continued to be financed through shared responsibility of private sector and philanthropic organisations so that they, in turn, can make an investment, especially to end AIDS among the key population,” he added.
In the Caribbean, Greene said there is scope to end the epidemic but because the region consists of middle and upper income countries it does not have access to concessional funding like the low income countries. He suggested that Caribbean countries come up with a formula to invest in the reduction of AIDS.
Meanwhile, Dr Odiit warned that should the current pace on HIV and AIDS continue there are indications that the “epidemic would rebound to such an extent that the world would not be able to contain it in the short term.” For this reason, part of the political declaration is the expectation that countries would commit to fast tracking their responses, he noted.
As it relates to Guyana, Dr Odiit said progress on the fight against disease has been made in terms of the number of persons on treatment, which he called an achievement. “But what we are saying is that business is not finished if we [are] talking at being at 58% of people living with HIV receiving ART and we want to go to 90% by 2020. You can see you still have some work to do,” he said, while adding that this is the situation in most countries.
He described the timing of the upcoming meeting as being a pivotal juncture, when the world has to make a serious decision.
He said UN is seeing commitment from the Guyana government and while there is still a lot to be done, including strengthening the health and data systems, the evidence has shown it is possible.
