The past year’s efforts in the HIV/AIDS fight have been a “major achievement” for the health sector, according to Health Minister Dr. Leslie Ramsammy.
He pointed out that in 2000 the disease was the major cause of death in Guyana, but that is no longer the case. Ramsammy, in an interview with the Guyana Chronicle, said in 2000 the number of deaths caused by HIV/AIDS totalled some 1,000, a figure which has, over the years, been drastically reduced to 200.
The Health Minister acknowledged that there will be deaths, but stressed that with support, premature deaths will be reduced.
“People with HIV/AIDS are living longer and fuller lives,” he said.
Ramsammy explained that the health sector’s focus on HIV/AIDS has seen greater and better quality support to people living with HIV/AIDS; the reduction of new infections, since sexually active persons are more conscious and are getting tested; and an increase in general public awareness.
The Health Minister said, “We are changing the equation for persons affected and infected by HIV/AIDS.”
In the past, he noted that the health sector placed much more emphasis on reducing new infections, but now the approach is two-pronged, in that the focus is on both reducing new incidents and on ensuring that people with HIV are able to grow old and die of natural causes, rather than die prematurely.
Elimination
Another important area Ramsammy highlighted was the Prevention of Mother to Child Transmission (PMTCT) programme.
“While the rest of the world focused on reducing, we focused on elimination of mother to child transmission,” he said.
According to statistics from the Ministry of Health, 800 women were living with HIV/AIDS in 2000; and of these 200 babies were born with the disease.
As of 2010, Ramsammy said this was reduced significantly, and currently, between 150 and 200 women are living with HIV/AIDS.
He said, “The number of women living with the disease is very low…of the women who tested positive HIV, only about four or five babies were born with the disease.”
The minister stated that this translates to an average of five per cent of HIV positive women giving birth to infected babies, when between 2000 and 2002, it averaged some 40 per cent.
Additionally, among MSM and commercial sex worker groups, Ramsammy said there has been a decline in the number of incidents.
However, the fact remains that years later, and after the introduction of a plethora of HIV/AIDS programmes, behaviour change is still a challenge.
Ramsammy agreed that even in light of the successes, behaviour change is quintessential to ensuring that  progress made in the HIV/AIDS fight is sustained.
Downward Spiral
Guyana is described as having a generalized epidemic; the first reported HIV case for Guyana was reported in 1987.
Today, the estimated prevalence among the adult population is around 1.5 per cent, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS), but Ramsammy said the sector’s number places that prevalence closer to one per cent.
“Our goal is zero,” he posited.
Between 1987 and the end of 2006, a cumulative total of 7,831 AIDS cases were officially reported to the Ministry of Health. In 1987, there were 1.3cases per 100,000 of population, and this increased to 56.2 cases per 100,000 of population by 2003. Cases have been reported in all 10 geographical regions of the country. The majority of the cases are among persons in the 20-44 age group.
Ramsammy stated that Guyana has had consistent progress.
“This is a really incredible success story…the decline is real…there are years when the incidents go up and others when they go down, but the general trajectory is a downward spiral,” he said.
Between 1988 and 2000, the Government of Guyana was the main source of financial support for HIV/AIDS programmes. Since then, external funding has surpassed domestic sources of funding by approximately 50 per cent.
The key elements of the government’s current response to the epidemic include strengthening of the surveillance system to produce information that will inform the design of interventions for HIV/AIDS reduction and planning care for those affected; increasing access to appropriate STI diagnosis and management as a key prevention strategy; planning to increase access to voluntary counseling and testing (VCT); planning to increase PMTCT Plus sites; AIDS awareness and education training at worksites; rigorous blood screening for HIV and other infectious markers; reducing the risk and vulnerability to infection with HIV through targeted public education efforts focused on health care providers, youth, employers, employees, entertainers, commercial sex workers and men who have sex with men; provision of free HIV services including antiretroviral therapy for HIV-positive patients; early infant diagnosis; planning for the expansion of the laboratory diagnosis and monitoring of HIV and for the diagnosis of opportunistic infections; supporting persons living with HIV (nutritional, psychosocial, economic and others); and supporting orphans and vulnerable children.
According to the National AIDS Programme Secretariat (NAPS), in Guyana, HIV prevention is multi-sectoral, and multi-dimensional, aligned with one national programme, of a scope and mix that is effective, at an intensity that is sustained, and of a scale to reach and impact everyone.
HIV prevention is also based on and driven by the promotion, protection and respect of human rights, diversity, gender and equality, and addresses the most vulnerable and the drivers of the epidemic, with priority and special consideration.
Notable too is that Guyana’s ‘combination prevention’ of HIV is devoid of dogma, and based on science; and is targeted, focused, evidence-informed, and developed, delivered and maintained at a high level of excellence.
HIV prevention, according to the Secretariat, is locally-adapted and prioritised, according to the epidemiological scenario and socio-cultural contexts, in partnership with all stakeholders, particularly those for whom HIV prevention programmes are developed and implemented.
Most importantly, the delivery of HIV prevention activities is informed by continuous research and development of innovative prevention technologies.