As Guyana joined the world yesterday in observance of World AIDS Day, Minister of Health, Dr Frank Anthony said that the country is one of several Caribbean states to have made significant strides in achieving the first of the UNAIDS 2020 “90-90-90” goals.
According to UNAIDS some Caribbean countries have achieved elements of the 90–90–90 targets (90% of people living with HIV (PLHIV) aware of their HIV status, 90% of diagnosed people on antiretroviral treatment, and 90% of those on treatment virally supressed). Barbados has reached the target for testing while Guyana has exceeded it with 94% of people living with HIV diagnosed. Haiti has gotten 98% of diagnosed people on treatment. Suriname and Trinidad and Tobago have achieved viral suppression among at least 90% of people living with HIV who are on treatment.
According to Minister Anthony, towards the end of 2019, Guyana had recorded 8,700 PLHIV with 73% of those persons on antiretroviral therapy and 75% virally suppressed.
Importantly as well, the minister announced that with strategic implementation over the next year, the Pre-exposure Prophylaxis (or PrEP) programme is expected to take pre-emptive action against the spread of the disease and will be available for those who are at risk of HIV infection.
PrEP is a way for people who do not have HIV but who are at very high risk of getting HIV to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medications -tenofovir and emtricitabine – that are used in combination with other medicines to treat HIV.
“I assure all Guyanese that HIV/AIDS remains high on our agenda, and this year’s observance of World AIDs Day will see the launch of Guyana’s revised and finalised National Strategic Plan (NSP) for 2021-2025, which sets out our priorities for HIV prevention,” the minister said in his World AIDS Day statement.
This year’s observance is being held under the theme “Global Solidarity, Shared Responsibility” and it is being done at a time when the World Health Organisation warns that the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) continues to be a major global public health issue, having claimed almost 33 million lives so far globally. It is also estimated that 38 million people around the world were living with HIV at the end of 2019.
Dr Anthony said that Guyana remains committed to ending the AIDS epidemic by 2030 which would require an unceasing effort and shared responsibility by not just international and local partners, but also that of the PLHIV
He said that National AIDS Programme Secretariat (NAPS), which was established in 1992, is mandated to coordinate the national HIV response as it currently oversees 48 functional fixed voluntary counselling and testing sites and offers treatment at 26 locations across the country.
Planned for this year’s observance is a virtual discussion on the overarching HIV programme in Guyana and this will involve several local non-governmental organisations (NGOs). There will be one webinar each on Transgender Medicine and Hormonal Therapy, and Prevention of Mother to Child Transmission (PMTCT).
Step-up
Meantime, UNAIDS in its message is urging the Caribbean region to step up action around HIV testing and prevention even as it noted that COVID-19 has pushed the region’s AIDS response even further off track causing the 2020 targets to be missed.
According to UNAIDS, there were an estimated 330,000 people living with HIV in the region at the end of 2019. It said that overall Caribbean adult HIV prevalence was 1.1% last year. In 2019, 77% of people living with HIV in the Caribbean knew their status. This compares to the worldwide average of 81%. Eighty-one per cent of diagnosed Caribbean people were on treatment last year. Eighty per cent of those on antiretroviral therapy were virally suppressed. The global average was significantly higher at 88%.
In a new report, “Prevailing against pandemics by putting people at the centre”, UNAIDS called on countries to make far greater investments in global pandemic responses and adopt a new set of bold, ambitious, but achievable HIV targets. If those targets are met, the world will be back on track to ending HIV/AIDS as a public health threat by 2030, the organisation said.
It was noted that high-performing countries have created a path for others to follow and as such UNAIDS has worked with its partners to distil those lessons into a set of proposed targets for 2025 that take a people-centred approach.
These targets focus on a high coverage of HIV and reproductive and sexual health services together with the removal of punitive laws and policies to reduce stigma and discrimination. They also put people at the centre, especially the people most at risk and the marginalised – young women and girls, adolescents, sex workers, transgender people, people who inject drugs, and gay men and other men who have sex with men.
“The 2025 targets also require ensuring a conducive environment for an effective HIV response and include ambitious anti-discrimination targets so that less than 10% of countries have punitive laws and policies, less than 10% of people are living with and affected by HIV experience stigma and discrimination and less than 10% experience gender inequality and violence,” UNAIDS said.
It is believed that insufficient investment and action on HIV and other pandemics left the world exposed to COVID-19. UNAIDS posited that had health systems and social safety nets been even stronger, the world would have been better positioned to slow the spread of COVID-19 and withstand its impact.
“COVID-19 has shown that investments in health save lives but also provide a foundation for strong economies. Health and HIV programmes must be fully funded, both in times of plenty and in times of economic crisis,” it was stated.
And Pan Caribbean Partnership Against HIV and AIDS (PANCAP) Director, Dr Rosmond Adams, underscored the fact that the coronavirus pandemic has disrupted health services. He pointed out that an effective HIV response requires continuous service delivery in areas such as prevention, treatment and laboratory services. Moreover, he said, HIV care and treatment services are dependent on community action to reach those at risk and to support those currently living with HIV to ensure that they are reached and retained in care.
Dr Adams said that national AIDS programmes and civil society across the region continue to be challenged especially in the area of HIV testing, as lockdowns, and other COVID-19 protocols have prevented persons from accessing services. Also, loss of employment, lack of essential living support, and depleting nutritional supplies are some of the main issues that undermine adherence to HIV medication and COVID-19 has exacerbated these circumstances.
He said however, as the region has proven in the past, rising to any challenge with collaboration and innovation is a hallmark of Caribbean people.
“I do believe that despite the challenges of 2020, our Region can amplify the HIV response and fulfil the mandate of the Caribbean Regional Strategic Framework (CRSF) on HIV and AIDS of a Caribbean free of AIDS and new HIV infections, in which all people are happier, healthier, productive, safe and respected,” Dr Adams declared.
