– but UN Special Envoy says Trafficking in Persons now a threat

THOUGH there are many challenges to the fight against HIV and AIDS, Guyana has much to be proud of says Dr. Edward Greene,the UN Secretary- Genera’sl Special Envoy for HIV in the Caribbean.“I think that remarkable progress has been made,” Dr. Greene said, having looked at a comparative study of Guyana’s prevalence rate between 2000 and 2015.

“In fact, in 2001 you had about 7-8 per cent of persons living with AIDS on treatment and according to figures for 2012, you had approximately 50 per cent of the people living with AIDS receiving treatment,” Dr Greene noted.
But while there has been progress, he said “we need to increase that number (of persons receiving treatment).”
Figures which show a major reduction of death from AIDS in Guyana over the past 15 years is also another reason to be optimistic.
According to Dr. Greene, there has been a 70 per cent reduction in deaths here.
But of the successes achieved in the fight against HIV/AIDS here, the UN Special Envoy for HIV pointed to the reduction in mother-to-child transmission as one of the leading success stories.
“This is most important, I think you have something to celebrate; in fact, when you look at some of those statistics, Guyana is doing very, very well in this regard.”
Meanwhile, Dr. Martin Odiit, Country Director UNAIDS, told this publication that mother- to- child Transmission of HIV/AIDS is an area [in which] Guyana has “definitely been doing quite well.”
“As you know, the world would like to eliminate mother- to- child transmission and this involves ensuring that mothers access treatment.
“Yes, Guyana has been doing very well. We are now at a point where we are yet to determine whether they have reached the WHO and UNAIDS agreed level, where you could say they have eliminated mother- to- child transmission.”
A study Dr Odiit said must be conducted to determine whether Guyana has achieved the status of eliminating mother- to- child transmission. This, he said, should be done over the next few months. Should the results of the survey favour Guyana, Guyana will become certified, like Cuba, for eliminating mother- to-child transmission of HIV/AIDS.
Cuba earlier this year became the first country in the world to receive validation from the World Health Organization (WHO) that it has eliminated mother-to-child transmission of HIV and syphilis.
The elimination of transmission of the virus has been described as one of the greatest public health achievements.
“This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation,” said Dr. Margaret Chan, WHO Director-General in June.
As a result, the UNAIDS Country Director believes that the Caribbean is well poised to eliminate mother- to -child Transmission of HIV/AIDS.
“The Caribbean is one Region we hope to be the first to declare [free of] mother- to- child transmission,” Dr Odiit said.
Trafficking in Persons
But all is not well in the fight against HIV/AIDS in Guyana. There are several challenges that must be fought.
Dr Greene noted that based on information provided to his office, there has been an increase in HIV/AIDS in “certain areas.”
One such area he highlighted is young women and girls who are the subject of Trafficking in Persons (TIP).
He explained that there is a tendency for there to be a spike in the prevalence of the epidemic in young women and girls, along with men who have sex with men and commercial sex workers.
“What is really a problem, the biggest problem, is the fact that HIV/AIDS is being linked now to TIP in particularly young girls, some younger than 15 years of age,” Said Dr Greene.
Much more needs to be done in the fight against TIP and the education of persons who are vulnerable, he said, noting that education is key to the reduction of HIV/AIDS.
“We are happy to focus on the successes of course, but we also have now at this time to focus on the challenges, because what we are trying to advocate from the UN not only from Guyana, but for the entire Caribbean and world is that we are hoping to aspire to end the HIV epidemic by 2030.”
Though TIP is a worldwide problem, the situation in Guyana has been described as “troubling.”
“If you are to deal with Guyana, it is very troubling because in Guyana, TIP we are told, is really something that affects very, very young people; young girls in the mining districts.”
He explained that there are many public health implications that can arise from TIP and those implications could have far- reaching effects.
“There are serious public health implications and specifically implications for AIDS,” said Dr Greene. He believes that there needs to be much more stakeholder participation to tackle the problem of TIP.
“So really how we could tackle it? We need to have community workers, we need to have the technical people provide us with the types of policies we need to implement, but most important we need champions.”
He continued: “What I would tell you from our discussions with a range of people here is we have found some champions that would help us to try and take the message and implement the policies, put legislation in place and enforce it; put guidelines in place for schools and community centres and give awareness to adults to protect the rights of children.”
He recognised and applauded the work of First Lady Sandra Granger through her “Every woman, Every Child” initiative, within which TIP is being addressed. “One of those champions is no other than the First Lady.”
Stigma and discrimination
On the issue of stigma and discrimination, Dr Greene said there are three pillars geared at eliminating the AIDS epidemic : treatment, prevention and HIV/AIDS- related stigma and discrimination.
“Those are the things we have to do to end AIDS.
“Eliminating stigma is very important, because to the extent people feel discriminated against or stigmatised, to that extent they don’t come for treatment and they can’t be given preventive measures, so what we have to do is try our best to eliminate stigma and discrimination,” he told this newspaper.
To this end, much emphasis has been placed in implementing workplace policies to ensure that persons are not discriminated against or stigmatised.
This process has been rated successful with a few minor hiccups, said Dr Greene.
He said guidelines were developed for workplaces to follow so as to eliminate stigma and discrimination and the majority of Caribbean states have implemented these.
“They have put in practice the elements for the workplace policy to be implemented. That too is an achievement.”
He noted however, that the change of governments in certain states may have hindered some territories from fully implementing the policies. “With respect to workplace policy, I think we have a healthy movement towards achieving it in the short- run, meaning by the end of 2016,” he added.
He noted that much assistance is provided by the Ministries of Education, Health, Social Cohesion and Social Protection in this regard. But, while the support of the aforementioned ministries is good, there must be great support from the Ministry of Finance.
“It shouldn’t be limited to those ministries, it should be across the board, because to eliminate Stigma and discrimination we need a minister of finance to increase the support for this venture,” said Dr Greene.
‘Justice for All’
The Pan- Caribbean Partnership against HIV and AIDS (PANCAP) in 2013 initiated a Justice for All (JFA) programme designed to achieve broad- based goals for ending AIDS in the Region. The elements of enhancing family life and focusing on those in need, increasing access to treatment including affordable medicines, reducing gender inequality including violence against women and girls, promoting sexual and reproductive health and rights, including age- appropriate education, achieving legislative reforms for modifying and repealing AIDS- related discriminatory laws are high on PANCAP’s agenda.
Dr Greene admitted that following the first round of national consultations, a regional consultation held in Jamaica in 2014 produced a PANCAP declaration which CARICOM Heads of Governments deferred at their July 2014 conference, due to objections to some of its elements by a group of faith- based organisations.
Thereafter, at the 19th Special Council for Human and Social Development (COSHOD)- Health, it was agreed that the Declaration be revised on the basis of a new round of consultations that should identify recommendations that can be implemented by the end of this year; in the medium term 105-2018 and long term after 2018.
Dr Greene has since requested to lead a series of engagements that are aimed at adopting a phased implementation of actionable recommendations of the PANCAP Declaration, taking into consideration the new 90-90-90 targets.
“By 2030 we need to get 90 per cent of the people with HIV; 90 per cent of those tested and 90 per cent of those on treatment with viral loads low enough to prevent transmission,” the UN Special Envoy for HIV in the Caribbean said.