Let Communities Lead

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“World AIDS Day arrives at a defining moment. AIDS-related deaths have fallen by almost 70 per cent since their peak in 2004, and new HIV infections are at the lowest point since the 1980s. But AIDS still takes a life every minute. We can and must end AIDS as a public health threat by 2030.”- António Guterres- Secretary-General of the United Nations. Did you know that over 3 500 people acquire HIV daily? According to the World Health Organization (WHO), since the beginning of the epidemic, 85.6 million people have been infected with the HIV virus and about 40.4 million people have died of HIV. Globally, 39.0 million people were living with HIV at the end of 2022. Every year on December 1st, the world unites to commemorate World AIDS Day. This annual event serves as a reminder of the global struggle to end HIV-related stigma, an opportunity to honour those we have lost, and a rallying cry to continue working toward a day when HIV is no longer a public health threat. World AIDS Day is an opportunity to raise awareness, educate and improve understanding of HIV as a global public health problem. In 2023, we mark the 35th commemoration of this important day with the theme: “Let communities lead”. The World Health Organization (WHO), adds, communities living with, and affected by, HIV, networks of people from key populations and youth leaders have been, and continue to be, essential for progress in the HIV response. They provide essential prevention, testing and treatment support services, build trust, generate innovative solutions, promote health, monitor the implementation of policies and programmes, and hold providers accountable. The world can end AIDS with communities leading the way. Unfortunately, stigma and discrimination continue to prevent people from getting tested and treated for HIV. Communities are at the front lines of the response to reach them. The impact of this epidemic has been profound, affecting individuals, families, and entire communities across the globe. Remembering the lives lost not only honours their memories but also emphasizes the urgency to end the HIV epidemic. The commitment to end HIV as a public health issue by 2030 requires each one of us working to end the disparities regarding access to prevention, care, and treatment. We should also give support to organizations that work tirelessly to serve those at risk and living with HIV. Latin America and the Caribbean. According to the Pan American Health Organization (PAHO) the Caribbean has the highest incidence rate of reported AIDS cases in the Americas. The HIV epidemic in the Region disproportionally affects certain sub-population (key populations), including gay men and other men who have sex with men (MSM) transgender women, and female sex workers. In 2021, there were an estimated 3.8 million people with HIV in the Americas, of which 2.5 million live in Latin America and the Caribbean. PAHO adds, that approximately 1.5 million people living with HIV were receiving antiretroviral treatment (ART) in Latin America and 230 thousand in the Caribbean by the end of 2021. UNAIDS reported that nearly 90% of new infections in the Caribbean in 2017 occurred in four countries: Cuba, Dominican Republic, Haiti and Jamaica. With between 350,000 and 590,000 Caribbean people living with HIV/AIDS, the region has an adult HIV prevalence rate between 1.9% and 3.1%, second only to Africa (7.5% and 8.5%). As a whole, the Caribbean is facing a generalized epidemic. The most recent national estimates showed HIV prevalence among pregnant women reaching or exceeding 2% in eight countries: the Bahamas, Belize, the Dominican Republic, Haiti, St. Lucia, Suriname, and Trinidad and Tobago. The Caribbean had a reduction of 28% from 2010 to 2021, down from an estimated 19.000 new cases to 14.000 per year. Jamaica ranks sixth on the global statistics regarding sexually transmitted diseases rate per 100,000 population at 29.6K, the list published by the World of Statistics is headed by South Africa at 37.3k, then Botswana at 34.1K and third on the list is Lesotho at 32.5K per 100, 000. Interestingly, the top three countries are all from the African continent. Perhaps, this alarming evidence regarding sexually transmitted diseases should not come as a total surprise given the tendency in the society for men to ride ‘bare back’ that is to have sex without a condom. It therefore means that the messaging has to be revisited. As a result more work is required from non-governmental organizations (NGO's) and the Ministry of Health and Wellness especially as it relates to the youth and marginalized communities in addressing HIV and STI transmission rates. This disturbing statistics will undoubtedly, increase HIV/AIDS transmission cases. HIV/AIDS became an issue in Jamaica in 1982 when its first case was reported. In Jamaica, it is estimated that 32,000 persons are living with HIV and as many as 50% are unaware of their status. The most urbanized parishes have the highest cumulative number of reported HIV cases: Kingston & St. Andrew – 1570.1 cases per 100,000 persons, and St. James – 2094.6 HIV cases per 100,000 persons. Gender prevalence amongst adults (15-49) shows women at 1.3% compared to men at 2.1%. Of the estimated 32,000 Jamaicans living with HIV, approximately 11,000 are on treatment. In 2015, the United Nations (UN) Sustainable Development Goal (SDG) 3 established that by 2030, the world would “end the epidemics of AIDS. As part of the SDG strategy, UNAIDS and partners developed the “Fast Track Response Strategy” in 2016 and, using standardized epidemiologic guidelines, defined “ending AIDS as a public health threat” as a 90% reduction in HIV incidence and mortality by the year 2030, compared to a baseline year of 2010. Given that the world is basically 6 years away from making this a reality; there needs to be a reset regarding prevention and education strategies concerning the fight against HIV/AIDS. div class="separator" style="clear: both;">
More Funding Needed. Director for the UNAIDS multi-country office for the Caribbean, Dr Richard Amenyah, is urging governments in the region to allocate more money to support the work of civil society organizations (CSOs) who are at the forefront of the fight to tackle the spread of HIV/AIDS. Dr Amenyah warned that the Caribbean has a long way to go to create an environment that encourages meaningful community participation, which is vital for effective public health interventions to close the gaps in prevention and treatment for the region to get closer to ending AIDS by 2030. He pointed out that while the Caribbean has made significant progress in addressing the HIV epidemic, it remains the region with the second highest HIV prevalence after sub-Saharan Africa due to myriad factors, including limited testing and treatment coverage among some groups, discrimination, and low levels of funding, among others. Communities connect people with person-centred public health services, build trust, innovate, monitor implementation of policies and services, and hold providers accountable. It is important to note that in Jamaica the two main CSOs leading the fight against AIDS and supporting people living with HIV are the Jamaica AIDS Support for Life (JASL) and the Jamaican Network of Seropositives (JN+), both of which receive little or no direct financial support from the Government. Most of their money comes from international donors, such as the Global Fund. UNAIDS identifies the following as problematic in the fight against AIDS. Funding shortages, policy and regulatory hurdles, capacity constraints, and crackdowns on civil society and on the human rights of marginalized communities, are obstructing the progress of HIV prevention and treatment services. If these obstacles are removed, community-led organizations can add even greater impetus to the global HIV response, advancing progress towards the end of AIDS. The Way Forward. It should be evident by now that in order to meet the United Nations target of ending AIDS as a public health threat by 2030 that a collaborative effort spearheaded by local communities will be required in order to tackle the patriarchal myths regarding sex and gender relations. There needs to be a paradigm shift not only in terms of the culture but also regarding how we shape the message going forth to the target audience. As the international community observes World AIDS Day, let us remind ourselves that this year is more than a celebration of the achievements of communities; it is a call to action, an urgent action to empower and support communities in their leadership roles in tackling HIV/AIDS. Check your HIV status today. Let Communities Lead! In the words of UNAIDS Executive Director Winnie Byanyima, to follow the path that ends AIDS, the world needs to let communities lead. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #WorldAidsDay #LetCommunitiesLead

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