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For Thousands of PWHIVs, Scale Up = Death

By Richard Stern

January 2004

12 December, 2003

Dear Friends:

In response to my letter regarding the Toronto International AIDS conference, now scheduled for 2006, I have received the following letter from a person living with HIV/AIDS (PLWA) in Jamaica who wishes to remain anonymous:

"... I attended the GNP+ [Global Network of People Living With HIV/AIDS] eleventh conference in Trinidad (just over two years ago). Within 24 months after the conference, 7 of the 11 delegates from Jamaica were dead. Could it be that the information received at the conference increased their hopelessness? Was their care and treatment put foremost? Or were they invited merely to boost conference attendance figures??"

My comment:

This is not to say that AIDS conferences as such are not good or that GNP+ is not trying to improve the situation of people living with HIV/AIDS. But, on the other hand, it certainly is valid to raise questions about the results of so many activities directed toward improving the situation of those who are most in need.

We should remember that Jamaica is not Sub-Saharan Africa. It is a "high medium development" country with a huge tourism infrastructure and modern roads, airports, hotels etc. Per capita income approaches $2,000 a year. There are no patents on antiretrovirals, so prices could be as low as $1 per day for first-line treatment.

But what about health care? What about accelerating access to treatment for people living with HIV/AIDS?

Jamaica has now received approval for its Global Fund proposal which will enable many people to have access to antiretrovirals in a country where the government is not providing this.

I spoke recently with Dr. Yitades Gebre, of the Jamaican National AIDS Program and member of the country's CCM, at the Global Fund regional meeting in Panamá. He was eager to receive information about scaling up antiretroviral access in order to begin providing treatment with Global Fund support as soon as possible. In my opinion, Dr Gebre's participation as a representative from Jamaica at the Panamá meeting was enthusiastic, sincere and pro-active.

But will this "scaling up" really happen in time to save the lives of those who need treatment now?

The Global Fund is taking an average of about 9 months in Latin America (and in some cases over a year) to disburse funds for antiretroviral access because of a variety of factors related to internal CCM issues as well as the Global Fund's own procedures.

What would happen if everybody concerned, The Jamaican National AIDS program, the Country Coordinating Mechanism, the Global Fund, CARICOM, PANCAP, PAHO, UNAIDS, USAID, and other "key actors," combined their skills, intelligence and efforts to try to make the Jamaica treatment access dream a reality by March 15th, 2004 so that those who need treatment can, in fact, have hope. Can this be done?

Richard Stern
Director
Agua Buena Human Rights Association
San José, Costa Rica
www.aguabuena.org
Tel/Fax 506-234-2411


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