THE Sixth Latin American and Caribbean Forum on HIV/AIDS and Sexually Transmitted Infections (STIs), held from August 28 to 31, 2012, provided an opportunity for delegates to deliberate on the progress, challenges, and lessons learnt in HIV responses across the region.
The Forum was hosted by the Government of Brazil, in collaboration with the Horizontal Technical Cooperation Group: PAHO, UNAIDS, UNDP, UNESCO, UNICEF, and civil society regional networks; and more than 4,000 delegates — including Government officials, health experts, community leaders, scientists, indigenous populations, youth, and people living with HIV — attended.
Participants engaged on a range of issues, from AIDS financing and new HIV prevention technologies to strategies for closing treatment access gaps.
According to Violeta Ross, Co-founder and Chair of the Bolivian Network of People with HIV and AIDS, AIDS is no longer seen as a major problem, especially in Latin America, where high treatment coverage is recorded; but the data is misleading, because treatment is expensive.
Several countries still have enormous difficulties in ensuring access to treatment for everyone. The Ministry of Health of Brazil announced that it would expand its national AIDS treatment programme to include at least 35,000 more people. Brazil currently provides free antiretroviral treatment to 223,000 people living with HIV — a coverage of 69%, according to Government estimates.
Prior to this week’s announcement, Brazilians with a CD4 count of 350 cells per cubic millimetre of blood were eligible for antiretroviral treatment.
Under Brazil’s new policy, treatment eligibility will start at an earlier stage of HIV infection — at a CD4 count of 500 cells per cubic millimetre of blood.
In a statement issued on Tuesday, August 28, Brazil’s Health Minister, Alexandre Padilha, explained that this decision was based on recent studies that have shown improvement in the quality of life of people living with HIV, and a reduction of adverse effects in the immediate and long terms.
“Brazil’s AIDS programme sets an example not only for Latin America, but for the world,” said Dr Luiz Loures, Director of the UNAIDS Political and Public Affairs branch, and a participant in the opening ceremony of the forum.
He noted that Brazil’s decision to provide earlier treatment for people living with HIV may trigger a “snowball effect,” and influence health policies in other countries around the world.
Many other countries in Latin America have scaled up access to HIV treatment in recent years. According to the latest data from UNAIDS, an estimated 70% of people eligible for antiretroviral treatment in the region were receiving it at the end of 2011.
Wide access to treatment has helped reduce annual AIDS-related deaths from 63,000 a decade ago to 57,000 in 2011; but despite progress, key populations across the region — particularly men who have sex with men (MSM), and transgender people — continue to be disproportionately impacted by the epidemic, and have limited access to HIV prevention and treatment services.
This message resonated throughout the forum in Sao Paulo.
An estimated half of all HIV infections in Latin America result from unprotected sex between men. According to national estimates, the reported HIV prevalence among transgender people in Argentina (34%) and Peru (20.8%) stands in sharp contrast to that of the general population: 0.4% and 0.23% in these two countries respectively.
Advocates at the forum emphasized the importance of community mobilization in accelerating HIV responses among vulnerable populations.
“Evidence-based strategies presented at the forum show that strengthening community work, including among sexual minorities, can transform national HIV responses,” said Simon Cazal, Executive Director of Somosgay, an organization that works to promote the human rights of lesbian, gay, bisexual, transgender and inter-sex (LGBTI) people. “The LGBTI movement has set priorities, giving rise to stronger activism. We have shown that, with few resources, we can accomplish a lot if we are strategic and if we work alongside communities.”
Many delegates underscored the need to bridge the AIDS response with other social movements. “We have to evolve. We cannot just fight for more condoms and medicines,” said activist Enrique Chaves, Director of Advocacy for the non-profit organization AID for AIDS International. “We must acknowledge that the struggle for access to health and HIV services is also a matter of access to employment, housing and education. We have to connect our agenda with the broader agenda of development, the struggle for social justice,” he added.