Twenty one years after HIV/AIDS made its advent on the world scene, overwhelming number of people have been, and continue to be, affected daily in every nation, region, tribe, and tongue. For example: China, over 1 million; Asia and the Pacific 7.1 million; Ivory Coast 1 in 15; South Africa 1 in 4 to 5; and the count goes on.

Similarly the HIV/AIDS epidemic continues to progress in the Caribbean, decimating people and resources. The efforts undertaken in the region over the last decade have been based on prevention and palliative care. The Caribbean now ranks worldwide as the second hardest hit region after sub-Saharan Africa. The epidemic shows no signs of slowing.

THE CARIBBEAN

The HIV/AIDS epidemic in the Caribbean, Africa, and other parts of the world where mostly prevention and palliative care are available, continues to escalate in marked contrast to the more developed countries such as America, Canada and Europe, where aggressive drug treatments have greatly reduced morbidity and mortality. PLWHA's (People Living With HIV/AIDS) in these countries have reason to stand up and be counted; they live longer and better.

In 2002, Caribbean governments negotiated drastic price reductions in the cost of drugs. Even so, the cost is still out of reach of the vast majority. A quick check with pharmacists in several Caribbean countries show that prescriptions filled are way below the numbers expected when compared with the numbers of affected persons. Where persons are receiving treatment, either drugs are being sent by relatives and friends from overseas, or agencies like NGO’S and Government are subsidizing the cost.

WHO IS AFFECTED

In the Caribbean, although more men than women continue to be affected, the most rapidly growing group are women between the ages of 15 and 24. In some countries like Trinidad, the problem appears to have its main roots in the increasing numbers of bisexual men.

Moreover, when one analyzes the affected age ranges, 86% of persons are between 15 and 54. This age range represents our present and future "life" force; our lawyers, doctors, plumbers, soldiers, firemen, and nurses on whose shoulders rest the future of our nations.

NUMBERS INCREASING

UNAIDS estimates 0.5 million affected in the region. In 2002, CAREC (Caribbean Epidemiological Centre), reported a figure of less than 1% infection rate for the region. The most conservative 2001 estimates now stand at 3% overall, and many countries such as Haiti (5-13%), the Bahamas (4-5%), Barbados (3%), are now leaders in the greatest local and social unacknowledged crisis of our times.

The roots driving this epidemic in the Caribbean are poverty, promiscuity of men and women, economic dependency of women, initiation of sex at very young ages. The major problem however, is that most lack the skills to become pro-active for themselves in areas such as health, jobs, or even life skills.

LEADERSHIP ACTION NOW

Given the above, Governments, NGO's, Corporations, Institution & Organizations must take the initiative and act now. The very base and fabric of our society as we now it is at stake. Free access to drugs where needed must be given a priority.

The building disaster of increasing drug use and dependence adds additional urgency. Lack of responsible sexual behaviour in this groups coupled with the younger ages being sexually involved (under age 11 some countries 30% are sexually active), mandate new and aggressive solutions for the Caribbean.

Given the reluctance for persons to come forward to be identified in the face of the lack of any supportive treatment to prolong lives the alternative, is to put in place identification protocols to identify affected persons, especially in the very young, and to trace contacts aggressively. There is no other disease that can compare presently with the potential that HIV/AIDS has for the decimation and destruction of "life" as we know it in the Caribbean.