By Zadie Neufville
KINGSTON, Jamaica, Apr 24 2002 (IPS)

The pending closure of Jamaica’s oldest and largest non-governmental support group for people living with HIV-AIDS is raising questions about funding policies that activists say rob millions of people in the developing world of much needed care and medication.

Head of the National AIDS Committee (NAC), Verity Rushton, says Jamaica AIDS Support (JAS) is just one of many NGOs in the developing world being forced to close because the policies of funding agencies say they can provide money for programmes, but not for the staff needed to run them.

With the rate of HIV in the Caribbean second only to sub-Saharan Africa, activists say there is urgent need to address the problem.

The 10-year-old JAS provides medical care and general support to people living with HIV-AIDS. Most of its clients are unable to afford any medical care or support service.

Rushton says agencies, including the World Bank, insist that the money they give for HIV-AIDS care should not cover the operational and administrative costs of the projects. So while hundreds of millions of dollars are available for HIV-AIDS care, education and prevention programmes, many are ineffective because governments like Jamaica’s can’t afford to staff them.

JAS, the force behind several successful educational, care and training projects for high-risk groups and those with the virus, will have to cease operations Apr. 30 because it can’t pay the rent, utility bills or the 28 people that run its projects and supervise more than 200 volunteers.

For the last six years, 80 percent of JAS’ operational costs have been met by a grant from the government of the Netherlands. On a monthly budget of 25,000 dollars, the organisation provides testing, individual and group counselling, home-based care, advocacy, lobbying and referrals to doctors and other service providers.

But that funding dried up more than six months earlier than originally expected and many believe the JAS will share the fate of its 16-bed hospice, which was forced to close 18 months ago when Dutch government funding ran out.

And while health officials and NGOs acknowledge the need to address flaws in funding guidelines if third world countries are to make any progress in the fight against HIV-AIDS, “there is no money to fund the staff to campaign for those changes”, says Rushton.

Alternative funding sources are also limited. JAS board member Matthew Pragnall is disappointed that despite two years of fund raising, the stigma associated with HIV-AIDS is still causing corporate institutions to stay away.

“It’s unbelievable to see how hard it is to get corporate bodies involved even though the virus affects all levels of employees – from directors down,” says Rushton, whose organisation serves as a bridge between government and NGOs.

Health Minister John Junor has joined the ranks of lobbyists and fund seekers for the organisation, as have the island’s chief medical officer Peter Figueroa and Pan American Health Organisation (PAHO) officials in Jamaica.

Health officials say JAS plays a number of essential roles: it is a key part of the government’s new National Strategic Plan to halt the spread of HIV-AIDS; a major player in the government’s international lobby programme; a major participant in the island’s prevention education programme, and a bank of expertise on HIV-AIDS in the Caribbean.

“The JAS came at a time when there was no support for, especially, the poor with the virus,” Figueroa says, and it still serves those most in need.

Estimates are that about 20,000 people here are living with HIV and up to 90 per cent of them are unable to afford even the cheapest care, meaning that many must turn to organisations like the JAS for care, medication and counselling.

About a quarter of the more than 5,545 Jamaicans diagnosed as living with AIDS since the first case in 1982 have benefited from the organisation’s services.

Twenty-nine-year-old Christopher (whose full name is being withheld to protect his privacy) has been HIV positive for more than five years. He believes the poor and under privileged have the most to lose if JAS goes.

“They (JAS) were the only ones I could trust with my identity. It has given me a livelihood so I can live as a normal person,” he said.

Devon, HIV-positive and jobless, depends on the organisation for almost everything, “sometimes food too”, he says. The 32-year old caregiver lost his job when the hostel closed.

Many JAS clients risk being thrown out of their homes, rejected by relatives, dismissed from their jobs and beaten if their HIV status becomes public knowledge.

The JAS in-house care that replaced the hostel provides the only alternative to the over-crowded homes for the indigent that have become refuge for many men and women living with the virus who have no place to go.

Head of the national HIV-AIDS campaign, Yitades Gebre, says JAS’ work in prisons and among the gay and lesbian communities would be missed the most. “The biggest gap and unmet need is the outreach programme for the gay community. The JAS is accepted and trusted by lesbians and gays and is better able to address the needs of these groups than the ministry of health,” he says.

And while government can provide low cost anti-retroviral drugs, not many Jamaicans can afford the medication.

It is for these reasons, activists say, that the demise of the JAS could kill “the effort to provide information, refuge and care to those in need”. “It will see the death of the HIV-AIDS NGO sector and set back the fight 10 years,” says McKnight.

Many others say the JAS’ expertise is crucial to reaching high-risk groups like inner-city residents as government readies new care and education initiatives and a project to distribute and monitor medication under the “people-friendly AIDS/HIV policies” recommended by the PAHO.

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