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HEALTH: Haiti and Cuba, a Stark Contrast in AIDS Fight

Felipe Seligman

UNITED NATIONS, Jun 2 2006 (IPS) - Although some real progress has been made to reverse the HIV/AIDS epidemic in Latin America and the Caribbean, experts say huge gaps persist in the actions taken by governments in the region.

“There are countries like Brazil and Argentina, where there is a high HIV/AIDS incidence but also a positive government response to the issue. And you can find countries like Bolivia, where there is neither legislation nor money available in the federal health budget to address AIDS,” Gracia Violetta Ross Quiroga, a Bolivian civil society representative from the group REDBOL, and who found out she was HIV-positive in 2001, told IPS.

Quiroga was in New York this week attending the 2006 High-Level Meeting on HIV/AIDS, which took place at U.N. headquarters from Wednesday to Friday. She said she was disappointed that there were so few Latin American government representatives at the summit.

“My country, for example, didn’t send even one official,” she said. “They need to understand that there are other important issues beyond coca.”

Luiz Loures, associate director of the UNAIDS Global Initiatives Division, told IPS that, “This low presence of Latin American representatives shows its low commitment to the HIV/AIDS epidemic.”

However, he emphasised that some Latin American countries are making sincere efforts to deal with the disease and “we must recognise the strong presence of countries like El Salvador or Brazil, which sent to New York, respectively, its national president and its minister of foreign affairs.”

Haiti and Cuba offer a stark example of the paradoxes seen in the Latin America and Caribbean region. Although they are less than 50 miles apart, the two islands are completely different worlds.

Haiti has the highest prevalence of HIV/AIDS in all of Latin America and the Caribbean. According to the UNAIDS latest report on the pandemic, 3.8 percent of adults aged 15 to 49 are infected. This adds up to 190,000 Haitians living with HIV.

“Haiti’s prevalence represents 60 percent of all Caribbean infections, and if you add to that the Dominican Republic, which shares the same island, it’s about 80 percent of HIV in the entire region,” Evan Lyon, a doctor working with the group Partners in Health, which assists people living with HIV in Haiti, told IPS.

“On the other hand, Cuba has one of the lowest HIV incidences in the world,” he said – less than 5,000 thousand people, or 0.1 percent of the population.

According to the UNAIDS report, while 100 percent of Cubans infected with HIV get antiretroviral therapy, only 20 percent of HIV sufferers in Haiti have access to life-saving drugs.

U.N. Secretary-General Kofi Annan noted at a press conference earlier this week that HIV/AIDS rates are directly related to poverty. Because of that, he stressed, “The Millennium Development Goals (MDGs), the eight goals, including the goal of dealing with HIV, are focused on poverty.”

Haiti ranks number 153 in the U.N. Development Programme’s Human Development Index, while Cuba is number 52.

Lyon pointed out that Haiti’s high HIV/AIDS rate is also rooted in its history of political and economic instability, just as Cuba was spared in part because of its relative isolation.

“HIV arrived in Haiti by tourism and sex tourism. That didn’t happen in Cuba. Because of the U.S. embargo, not so many U.S. and European tourists used to visit Cuba in that time (when the disease was taking root),” he said.

The UNAIDS report, released at this week’s meeting, devotes 629 pages to the progress that has been achieved so far and the impact of AIDS on societies and people’s lives.

“The report shows that we need to be alert. We could be in a better situation. However, it also shows that much progress has been made and it could be used to stimulate countries to keep fighting against HIV/AIDS,” said Loures.

Even Haiti has seen some progress over the last decade. “HIV infection levels have decreased in urban parts of the country… and the percentage of pregnant women infected in Haiti declined by half from 1993 to 2003-2004, notably in urban areas where prevalence fell from 9.4 percent in 1993 to 3.7 percent in 2003,” UNAIDS said.

However, the report shows that more than 40 million people around the world are now living with HIV. The epidemic is responsible for over 20 million deaths and the toll is growing each year.

About 1.8 million people live with HIV in Latin America. In 2005, 66,000 people died of AIDS and 200,000 were newly infected. Among young people 15û24 years old, an estimated 0.4 percent of women and 0.6 percent of men were living with HIV last year.

The Caribbean is the second most-affected region in the world after sub-Saharan Africa, with an HIV rate of 1.6 percent. More than 330,000 people live with HIV there, and half of them are women.

“The region has been doing a good job in regards to treatment, but needs to break taboos ands stigmas to start to deal with prevention,” Loures told IPS.

In recent years, the number of women infected in Latin America and the Caribbean region has been rising. “This increase means that we are not doing what we need to do,” Raquel Child, an HIV/AIDS prevention specialist at the U.N. Population Fund, told IPS.

“Investigations show that the main reason for this is informal relationships and bisexual relationships. But many countries keep insisting on the idea that heterosexual relationships are still the main problem,” she said.

Loures offered a starting solution to the epidemic in Latin America. “What is needed is a combination of three things: governmental decision, availability of resources and social mobilisation – which may be the most important one – for an open discussion in society and the implementation of real measures.”

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