Productions: Panoscope

Panoscope . Media Briefings . Island Beat . Our Own Voice . Le P'tit Nouvelliste
Order Publications

Panoscope Articles Index

Keeping the promise on AIDS: Jamaica gets high marks for HIV/AIDS response

By Andrea Downer

Jamaica has made significant progress in meeting the targets, which the country committed to at the United Nations General Assembly Special Session on HIV/AIDS in 2001. However, the country’s haphazard response could prove detrimental to the success of the national programme.

Miriam Maluwa, Country Co-ordinator, UNAIDS, with responsibility for Jamaica , The Bahamas and Cuba , said the international agency is pleased with Jamaica ’s progress.

Jamaica was among 182 countries, which signed a Declaration of Commitment, DoC, and agreed to take specific steps to control the spread of HIV/AIDS and ensure that persons who are infected by the virus have access to treatment and care and that the rights of those affected and infected by HIV/AIDS, are protected.

However, Ms. Maluwa believes that the country’s success would have been far greater if the national HIV/AIDS response was less fragmented.

“The purpose of UNGASS is to look at the totality of the national response in relation to government’s commitment to the declaration. (Therefore) the various activities and programmes that are going on, they really ought to be analyzed in relation to each other and the total impact that it’s having or not having on the HIV response,” Ms. Maluwa explained.

Ms. Maluwa’s analysis of Jamaica ’s approach to tackling the problem is shared by a number of organisations working in HIV/AIDS in the country.

President of the Jamaica Network of Sero-positives (JN+), Marcus* said a lot of Jamaicans are not aware of UNGASS or what it is really about.

“I think there needs to be more awareness. I don’t think enough effort is being made to enlighten the country on the commitments and what has been achieved so far,” he stated.

“I don’t think that Jamaica ’s Review of the country’s progress in meeting the UNGASS commitments which was released sometime this year was released early enough. It should have been made public from last year, and even though it has now been released, many persons still don’t know how or where to access it,” he continued.

The Jamaica Network of Seropositives is a support organisation made up of persons who are HIV positive.

A report done by the International Council of AIDS Service Organisation (ICASO) late last year also noted:

“In fulfilment of paragraph 37 of the DoC, the Jamaica HIV/AIDS/STI National Strategic Plan was drafted in 2001 and revised in 2002 after soliciting input from a variety of civil society actors. The larger agencies felt that the process successfully represented their views; however others, mainly PLWHA, felt that the government misinterpreted their input and forced them to “rubberstamp” approval. Some CSAs who are not involved with the National Aids Council claimed that their access to information and input in policies and reviews of the National Response Programme limited.”

The majority of the civil society members, who felt left out, lived and operated outside of the country’s capital, Kingston . Kingston is the hub of the national response programme, as the administration and activities of the national response are heavily centralized.

According to the report, “Few Civil Society Actors are aware of the UNGASS Declaration of Commitment and only one CSA claimed involvement in any national review of progress toward implementation of the commitments. No CSA claimed the use of the document as an advocacy tool.”

Ms. Maluwa acknowledged that this lack of cohesion undermines the national response. She explained that while persons are involved in activities and programmes that are part of the National HIV/AIDS/STI Programme, they are not aware that their efforts are geared towards a specific purpose – fulfilling the UNGASS commitments.

“There are a lot of sporadic and parallel events and programmes being developed, but not all of them are being perceived inside a national context. Everybody who is working on HIV/AIDS ought to know and ought to be contributing to the same commitments and the same indicators,” Ms. Maluwa asserted.

Ms. Maluwa blames the lack of cohesion on a general lack of awareness by participants in the National HIV/AIDS/STI Programme. She also placed blame squarely at the feet of the UNAIDS, stating that the United Nations need to do more in order to widen the knowledge and ownership of UNGASS in Jamaica. In addition, she said the media could have played a more active role in making the public more aware about the issues associated with the UNGASS commitments and the national response.

“There needs to be more systematic reporting on substantive issues surrounding HIV/AIDS. The media seems to lean towards sensational issues such as issues relating to commercial sex workers or men who have sex with men, but stops short of examining serious issues that would prompt the kind of thought and dialogue that would lead to behaviour change and safer sex and lifestyle practices,” Ms. Maluwa stated.

Having recognized this weakness in the national response strategy, Ms. Maluwa said UNAIDS is now looking at ways in which it can assist to support and strengthen the Monitoring and Evaluation system of the national HIV/AIDS response.

“The idea is to ensure that we have one set of national indicators, which are really, partly UNGASS indicators as well as other indicators that the country has to report on and agree on a set of national indicators against which everything that is happening in the country can be measured against,” she stated.

Despite the general lack of awareness about the UNGASS commitments, Ms. Maluwa gave Jamaica high marks in a number of key areas. The critical area of treatment, which falls under prevention - an area that the United Nations asked governments to give priority in developing and executing their national response, received high marks from Ms. Maluwa.

“Before 2004, Jamaica did not have a treatment programme, however, since then, the country has established a system that ensures that people who are HIV positive and in advanced stages of the disease, can access anti-retroviral, ARV, treatment. It is now possible to monitor the CD4 count of persons living with HIV/AIDS, PLWHA, and do appropriate referrals,” she stated.

Among the key achievements in that area outlined by Ms. Maluwa are:

• The establishment of approximately 16 ARV sites that are fully functionally and fully staffed
• The establishment of a fully equipped laboratory at Slipe Pen Road Clinic in Kingston
• Employment of several adherence counselors, some of who are PLWHA, who encourage and advise people about the importance of adhering to their treatment regimen.
• Decreased cost of ARVs through subsidization by the National Health Fund, NIF.

With these improvements to its treatment, care and support facilities, Ms. Maluwa said the national response has been able to achieve specific targets, which include;

• 50% of PLWHA with advanced HIV can access treatment.
• Prevention of mother to child transmission of HIV has been increased to 90%
• 47% of pregnant women who are HIV positive have receive anti-retroviral medication to prevent mother to child transmission of the HIV virus.

Former Minister of Health and Parliamentarian, John Junor, also thinks Jamaica has made significant progress in fulfilling the UNGASS commitments. However, he said more people should be tested for HIV/AIDS.

“A lot of people who are (HIV) positive are unaware of their status. That pool is far too large and it is unacceptable,” he stated.

There is an estimated 25,000 persons living with HIV in Jamaica of whom approximately 15,000 are not aware of their HIV status. More than 1000 cases of HIV are reported annually in Jamaica . Since 1982, more than 10,000 AIDS cases were reported with a case fatality rate of 60 per cent.

The article above is part of a five country series on the Caribbean ’s HIV/AIDS response since individual governments signed the United Nations General Assembly Special Session on HIV/AIDS Declaration of Commitment in 2001. It is now five years since those promises were made and time to assess the progress made. This is a collaborative effort between Panos Caribbean and The Gleaner Newspaper.