other donors to provide additional resources to low and middle
income countries for the strengthening of HIV/Aids programmes
and health systems and for addressing human resources gaps,
including the development of alternative and simplified service
delivery models and the expansion of community-level provision
of HIV/Aids prevention, treatment, care and support, as well
as other health and social servicespolitical declaration
of the UN General Assembly Special Session on HIV/Aids.
The declaration comes out of last weeks UNGASS and is
in response to the several impassioned and logical appeals
of ministers, prime ministers, presidents and kings from developing
countries classified by international financial agencies as
middle income states.
As pointed out at every turn by Prime Minister Dr Denzil Douglas,
who addressed the assembly in his role as spokesman on health
issues for Caricom, the middle income categorisation has meant
that the majority of Caricom countries have not been able
to access grant funding from The Global Fund on HIV/Aids,
TB and Malaria.
The fund was established in 2001 out of the first UNGASS on
HIV/ Aids to help the poorest of countries counter what UN
Secretary General Kofi Annan says is the greatest challenge
of our generation. Sixty-five million people worldwide
have contracted the virus, 25 million have died, 15 million
children have been orphaned by the disease.
Last year, more people contracted the virus and more people
died from Aids than any previous year, stated Annan.
Moreover, and as argued at the assembly, increasingly, there
is the trend to increasing feminisation of HIV/
Aids, a result of older men taking advantage of the vulnerability
of young females.
But let us get back to the issue of the funding or the lack
of it based on our status in the Caribbean as middle income
countries. Up till now, only the poorest states of the region,
Haiti, Guyana, Suriname, have so far been able to access grants
from The Global Fund.
And according to the declaration, the leaders have agreed
to have the fund continue according to its policy framework,
ie, focus on the poorest of states and ask other donors to
fund the needs of the middle income countries.
In the circumstances of the situation facing the fundhaving
to mobilise US$18 billion in 2007 for distribution, that figure
reaching US$23 billion in 2008, as stated by UNAids executive
director Dr Peter Piot, and with a projected US$900 million
shortfall in the immediateit is quite unlikely that
there will be any leftovers upon which Caricom can depend.
The question is would Caricom and other similarly placed countries
be able to persuade these additional donors to
their cause based on the political declaration made last week
at the UNGASS?
The financial criteria have been established by agencies such
as the World Bank and the IMF. This is not a new battle for
Caricom which has been on the offensive to have the criteria
changed in other fora on development and environmental issues.
There has been little success to date.
Caricom, through the Pan Carib-bean Partnership Against HIV/Aids
(Pancap), has been pointing out that because of the free movement
of people under the Caricom Single Market and Economy, there
is really no difference between Haitis rate of infection,
as high as 13 per cent, and the lowest in the region, just
over one per cent, or the Dominican Republic at nine per cent
and, say, T&T at two per cent.
Caribbean people of this generation, much like the original
Amerindian inhabitants, do not recognise national boundaries
in seeking out jobs, better living conditions. They have been
going with the flow long before the CSME and will
continue to do so, HIV/Aids notwithstanding.
One other Pancap argument for assistance of the middle income
countries of the region is based on the migration of large
numbers of health personnel to the North, such people having
been trained at public expense in the Caribbean. The requirement
therefore is for some form of compensation for the utilisation
of human resources that would have been used to counter the
The developed world has been notorious in failing to meet
its commitments to development assistance to the underdeveloped
world. The declaration commits them to establish timetables
to achieve the targets of 0.7 per cent of gross national product
for official development assistance by 2015 and to reach at
least 0.5 per cent of their GNP by 2010.
It will take combined, intensive and continuous lobbying and
pressing of regions such as Caricom in every possible fora
to achieve the declaration goals aimed at achieving universal
access to testing, treatment, care, support and prevention
work for the Caribbean and other similarly-placed developing
regions of the world.
And if there is any need for reminding, universal access for
the Caribbean must be considered in the context of the region
being second only to sub-Saharan Africa in infection rates
amongst the adult population.
There were a few other significant elements of the declaration:
One, the encouragement of pharmaceutical companies,
donors and multilateral organisations, and other partners
to develop public-private partnerships in support of research
and development and technology transfer.
Two, the encouragement of bilateral, regional and international
efforts in promoting bulk procurement, price negotiations,
and licensing to lower prices for HIV prevention products,
diagnostics, medicines and treatment commodities, while recognising
that intellectual property protection is important for the
development of new medicines...
Developing countries such as India and Brazil have gone some
distance in producing generic products from the patented medications
of the large pharmaceuticals. Guyana, among Caricom countries,
has started production and would obviously need assistance
to develop the industry further. In this regard Guyana can
seek assistance from The Global Fund, given its categorisation
among the poorest countries.
Notwithstanding the reality of an international community
with a variety of religious and cultural practices, the declaration
was able to encourage responsible sexual behaviours,
including abstinence and fidelity, at the same time
that it advocates expanded access to essential commodities,
including male and female condoms and sterile injecting equipment,
the latter to reduce infection rates among drug users.
Significantly for the Caribbean, the declaration requires
that there be a transformation in the culture and institutional
norms that foster the sexual exploitation of women and girls.
If we are truthful to ourselves we will admit that such practices
exist here at home, in schools, on the job and in institutions
such as government, the church, the police service, literally
everywhere. We cannot shirk this responsibility.