Five
years ago, a person would not willingly admit to
having the HIV infection as the stigma surrounding
the disease was so great, it was considered taboo.
Today, while there are still reservations about
publicly declaring the condition, individuals can
feel more comfortable discussing the issue.
This is the stage Jamaica has reached since the
Ministry of Health put in place certain measures
to educate the public on the spread and control
of this deadly disease. The year 2005 should yield
even better results as the Global Fund recently
pledged a grant of some US$23 million to assist
Jamaica in its fight against HIV/AIDS, over the
next five years.
Yitades Gebre, Senior Medical Officer/Executive
Director of Jamaica HIV/AIDS Prevention and Control
Project informs JIS News that Jamaica has already
received US$2.3 million of this grant this year,
with a projected
US$3.9 million to be disbursed next year. A sum
of US$3.5 million will follow in the year 2006.
This grant will be used to educate the public, provide
treatment and preventive measures, as well as to
implement a national policy to address issues relating
to the HIV/AIDS.
According to statistics from the National HIV/STD
Prevention and Control Programme, a total of 578
new AIDS cases were reported in Jamaica from January
to June of 2004. Of this figure, 334 are males and
244 are females.
Dr. Gebre points out that about 1.5 per cent of
the adult population is HIV positive with some 12
to 14 deaths being reported each week.
He notes that for the first time in 2004, there
has been a significant decline, at least 27 per
cent, in the number of persons dying from AIDS.
This reduction, he says, is as a result of the Ministry’s
Public Access Programme, which provides expensive
anti-retroviral drugs and certain tests at a much
lower cost.
Medications and tests, usually considered to be
out of the reach of most patients, have become more
affordable and accessible through the Public Access
Programme.
Dr. Gebre explains that since June of this year,
persons who experience severe financial difficulties,
have been able to access the service free of cost,
while for others, the cost is subsidized.
Currently, there are 500 patients enrolled in the
programme, and Dr. Gebre says plans are in place
to have that number increased to 1,000 by next year.
“The most important reason for the decline
in AIDS death is the availability of anti-retroviral
drugs for people living with HIV and AIDS. So many
more persons are on treatment in 2004, compared
to the previous years,” Dr. Gebre points out.
He notes that previously, medication was not readily
accessible or affordable to the persons who needed
it. However, since June of 2004, with donations
from Lasco, and the Clinton Foundation, the Ministry
of Health has been able to provide medication for
as many as 500 persons over the last six months.
“We
have also received a grant from the Global Fund,
and through this mechanism the government provides
treatment in the public sector, otherwise, in
the past, people would have to get treatment from
the private physicians and they have to find their
own resources to buy drugs wherever they were
available,” he tells JIS News.
Dr. Gebre says that generic drugs currently available
on the market have helped significantly, as they
are much cheaper than the brand name ones.
Explaining further how the Public Access Programme
works, Dr. Gebre says the programme is a scaling
up of treatment and care for people living with
HIV/AIDS. “It’s primarily provided
through the public sector such as health centres
and hospitals. We have identified as many as 14
new treatment sites for anti-retroviral drugs,
such as the Kingston Public Hospital, Bustamante
Hospital for Children, University Hospital of
the West Indies, the Centre for HIV/AIDS Research
Education (CHARE),” Dr. Gebre notes.
He tells JIS News that there will be at least
one treatment site for each parish. “In
each of those parishes, in the regional hospital,
we are expanding our treatment facilities and
individuals can access treatment through these
sites,”
Dr. Gebre says.
One monthly anti-retroviral drug, which costs
over $2,000 at private institutions, can be had
at the subsidized price of a $1,000 through the
Public Access Programme.
Dr.
Gebre says there are at least 8,000 persons who
need immediate treatment through the Public Access
Programme. The others will be worked into the
system over a period of time. “We are scaling
up actually. We haven’t reached all the
people who need treatment. It is about 8,000 who
actually need immediate treatment, and then out
of this 8,000 our target by June 2005 is to treat
as many as 1,000 people. We will be able to exceed
our target by then,” he adds.
Currently there are over 22,000 reported cases
of HIV/AIDS in Jamaica.
“Because of stigma and discrimination having
to do with HIV and AIDS, people may not access
services which may be life saving for them. One
of the assumptions in the earlier days was that
once treatment is available then the stigma and
discrimination may decline, but stigma and discrimination
still exist,”
Dr. Gebre informs JIS News.
“We are trying to address and reduce this
problem by providing educational campaigns, including
the necessary supporting mechanism and legislation
to reduce stigma and discrimination,” he
adds.
He points out that close to 70 per cent of the
transmission is from heterosexual encounters;
bisexual and homosexual transmission is about
6 per cent, while 6 -7 per cent is from mother
to child.
Even while condom use has increased significantly,
Dr. Gebre says thousands of people are still engaging
in unprotected sex with non-regular sexual partners.
“Overall, condom use is still high. However,
there is a pocket of the population, almost 20
per cent to 25 per cent of both men and women,
who are not using condom with a non-regular sexual
partner. That translates into hundreds of thousands
of adult men and women who are putting themselves
at risk…women more than men,” he adds.
The rate of new HIV infection in women in the
age group 20-24 is increasing steadily more than
men in the same age group, according to statistics
from the National HIV/STD Prevention and Control
Programme. The statistics further indicate that
the number of newly reported AIDS cases in adolescent
girls in the age group 15-24 years was three times
higher than boys of the same age group.
From January to June this year, there were 31
adolescent girls and boys reported with AIDS.
Researchers claim that poverty, ignorance, early
sexual experiences with older men and embarrassment
to seek advice on protection are responsible for
the increase among adolescent females.
For the first half of 2004, there were 40 children
under the age of 10 years reported with AIDS,
compared to 22 children in the previous year.
However, there were fewer Paediatric AIDS deaths,
as 18 children died of AIDS compared to 29 in
the previous year. This is also attributable to
the improvement in care and treatment for HIV
infected children and a decrease in mother to
child transmission of HIV.
For the coming year, Dr. Gebre is hopeful about
the number of projects slated to come on stream
to deal with HIV/AIDS. One such project will look
at educational campaigns aimed at changing the
behaviour of high-risk persons, namely young men
and women, people living in depressed areas, commercial
sex workers and homosexuals.
During 2005, persons living with HIV/AIDS can
also expect to have increased access to treatment.
Through the implementation of a national policy,
the high level of discrimination and stigma will
be dealt with through a human rights approach.
There is also expected to be a scaling up of prevention
programmes through the latest project dubbed,
Priority Location Aids Control Efforts (PLACE).
Dr. Gebre, in explaining how this will work, tells
JIS News that surveys have been done to identify
the locations where people are most likely to
meet new sex partners. Once these places are located,
he says this will provide the opportunity for
interventions through different approaches.
Currently, the Ministry of Health collaborates
with several other ministries in dealing with
the HIV/AIDS epidemic. These include the Ministries
of Education, Labour, Security, Tourism and Local
Government.
Other funding agencies such as the German Technical
Co-operation (GTZ), Canadian International Development
Agency (CIDA), United Nations Global Programme
on AIDS, the Pan American Health Organisation/World
Health Organization (PAHO/WHO), Caribbean Epidemiology
Centre (CAREC), United Nations Population Fund
(UNFPA) and the United Nations Educational Scientific
and Cultural Organisation (UNESCO), have played
significant roles in the development and implementation
of prevention programmes.
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