Where are we now?

“Together we will end AIDS”—a new report released today by UNAIDS ahead of the 19th International AIDS Conference in Washington D.C. next week—offers a status update on the global HIV epidemic. It shares the latest data on new HIV infections, people receiving antiretroviral treatment, AIDS-related deaths and HIV among children. The report also gives an overview of international and domestic HIV investments and the need for greater value for money and financial sustainability.

30 years since the start of the AIDS epidemic and about a decade since life-saving anti-retroviral treatment (ART) first became available in the Caribbean, this new data reflects both regional successes and challenges. While there has been significant progress in some aspects of the region’s HIV response, other areas require urgent attention.

In 2011 AIDS-related deaths stood at an estimated 10,000—about half as many as in 2001. This is in large part due to the relatively high antiretroviral treatment coverage of 67 percent for the Caribbean as a whole. At present 230,000 people are living with HIV in the Caribbean. The estimated number of persons who were newly infected with the virus last year was 13,000. About 1,100 children became infected with HIV in the Caribbean in 2011. (The majority of these cases are in the Dominican Republic and Haiti, which together comprise 68 percent of the region’s HIV epidemic). In fact, many Organisation of Eastern Caribbean States (OECS) countries are close to achieving elimination targets for the prevention of mother to child transmission (PMTCT).

The overall adult HIV prevalence for the Caribbean is one percent and heterosexual transmission remains the main route of HIV infection. However, there are high rates of infection among certain key populations. Prevalence among men who have sex with men (MSM) ranges from an estimated five percent in parts of the Dominican Republic to 20 percent in Trinidad and Tobago, 19 percent in Guyana to 32 percent in Jamaica. HIV prevalence for female sex workers ranges from 4.8 percent in the Dominican Republic to 24 percent in Suriname, five percent in Haiti and Jamaica to 17 percent in Guyana.

“We have a lot to show for the work we’ve done,” noted Dr. Ernest Massiah, Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Caribbean Regional Support Team. “But we must do far more to reduce HIV among sex workers and men who have sex with men. We also have to be honest about the sexuality of adolescents and young people. We need to ensure that all these groups have not only information, but also access to condoms and sexual health services.”

Approximately US1.6billion was spent on the Caribbean’s HIV response between 2001 and 2009. By 2010, 64 percent of AIDS spending in the region came from international donors. Most World Bank funding for the region’s AIDS effort came to an end that year. The bank’s economic reclassification of countries has had implications for Global Fund financing. With the exception of Haiti, Guyana and Belize, all Caribbean beneficiaries are now considered to be Upper Middle Income countries.

According to the report, globally, domestic resources in low- and middle-income countries now support more than 50 percent of the global response. At present the Bahamas, Trinidad and Tobago and Suriname are the only Caribbean countries that do not depend on external financing for antiretroviral treatment (ART). Barbados, Cuba and St. Lucia are moderately reliant on foreign sources. In Antigua and Barbuda, Dominica, the Dominican Republic, Grenada, Guyana, Haiti, Jamaica, St. Kitts and Nevis and St. Vincent and the Grenadines, however, all or almost all financing for ART comes from international sources. Many Caribbean countries, while eligible for further funding from Global Fund, may only qualify for programmes for the continued provision of treatment and communities that are most at risk for HIV infection.

“We will have to spend less money, better. That means we’ve got to invest it in the methods that are proven to work and on the people most affected by the HIV epidemic,” Massiah stressed.

READ THE REPORT

Photo caption:

Dr. Ernest Massiah, UNAIDS Caribbean Regional Support Team Director