Published: October 2006
Misinformation and denial of evidence based HIV/AIDS treatment and prevention spreads within Caribbean Region
By Eugene Schiff**
In the interest of sharing and disseminating relevant information about the HIV/AIDS epidemic in the Caribbean Region, we offer the following summary discussing HIV/AIDS treatment access in Guyana. The report and links below are meant to provide context, and supplement as well as commend the Guyanese Government and Ministry of Health for their response (as reported in the article copied below) to religious leaders' dangerous and misleading statements about HIV/AIDS.
After Haiti, Guyana is among the countries hardest hit by the HIV/AIDS epidemic in the Caribbean Region and all of the Americas. An estimated 12,000 Guyanese are HIV+, and in February 2006, about 4000 needed ARV medicines, according to an in-country officer working for the CDC (Centers for Disease Control and Prevention). Government figures were slightly more conservative, but now, ten months later, even the lower estimates of those needing ARVs have likely increased by at least 1000. As of September 2006, 1546 individuals were receiving antiretroviral therapy (350 more than 10 months ago), and the government and donors have taken important steps at an early stage to provide antiretroviral treatment, including, at first, government initiated generic production of these medicines and free access at point of care to people living with AIDS. Several officials noted that Guyana receives more donor resources per capita per person living with AIDS than any other country in the world. However, it is a deadly paradox that despite abundant resources, 60-75% of people with AIDS in Guyana that need ARV treatment still doesn't have these lifesaving medicines. AIDS is now the leading cause of death among adults ages 25-44 (UNAIDS/WHO Epidemic Update, 2005).
More AIDS Deaths in tiny Guyana than Austria, Belgium, Ireland, Denmark, Finland, the Netherlands, Norway, Sweden, Switzerland, and Cuba combined
Guyana is about the size of the UK, but has a total population of less than 1 million people. Yet according to one source (the CIA World Fact Book), in 2003, the last year for which such ranked data was listed, more Guyanese died of AIDS (1100 AIDS deaths) than the total number of deaths due to AIDS in Austria, Belgium, Ireland, Denmark, Finland, the Netherlands, Norway, Sweden, Switzerland, and Cuba combined. These countries, for comparison, have not only developed more effective antiretroviral treatment programs to reduce the number of AIDS deaths, but probably had significantly better reporting systems in place as well, meaning the true extent of the AIDS epidemic and AIDS related mortality in Guyana could be even greater than current estimates suggest. Despite its extremely small population, in 2003 Guyana reported more AIDS deaths than Hong Kong, Japan, the UK, the Philippines, Bangladesh, Egypt, Germany, Portugal, Spain, Italy, or France.
Limited Access to Second Line Treatment and Lab Diagnostics
During a research visit by Agua Buena to Guyana in February 2006, officials revealed less than 1% of Guyanese with access to ARV treatment were receiving second line medicines, despite the fact that many had been receiving drugs, some at irregular intervals for as many as three years or more, and drug resistance to first line medicines is likely and expected in at least 10-20%. Yet just a dozen people (12) were receiving second line treatment at the time, and no studies or tests of drug resistance had been undertaken. PLWA activists and networks were raising the issue that technology for genotype or phenotype resistance testing doesn't exist in Guyana, and that viral load tests are limited to one private hospital, but they noted governments and donors reluctance to assume to high costs of these more advanced procedures, which are nonetheless a standard of care in the United States, Europe, and elsewhere, and available now in several countries within Latin America. A current PEPFAR report indicated that about 400 CD4 tests are performed each month, yet this averages to just 1.2 CD4 tests per year for the 3914 registered in clinical follow up, far below the minimum of 2-3 tests per year (one CD4 test every four-six months) recommended in resource poor countries. Because of these critical limitations, people living with HIV/AIDS with family abroad and who could afford to travel (a small minority), instead sought care in both the private or public sector in New York, Miami, England, Trinidad, Barbados, and elsewhere.
Antiquated British Colonial Laws Criminalizing Homosexuality Force Sexual Minorities Underground, impeding more effective prevention and treatment programs.
Community based groups, UNAIDS, activists, and PLWA working to support and reduce discrimination against sexual minorities in Guyana expressed concern that current legislation, religious groups and conservative politicians continue to support colonial era laws criminalizing consensual adult homosexual intercourse, "buggery," or "indecent acts between males," laws which serve to increase stigma against gays, lesbians, transvestites, and commercial sex workers, and make efforts fund programs and reach these populations through prevention and education efforts much more difficult and potentially illegal. Individuals expressed concerns that messages from fundamentalist Christian and Muslim leaders, and even by popular dancehall artists, within Guyana and outside, have undermined campaigns for increased condom use, legalizing homosexuality, treatment literacy and education, and effective sex education in schools.
The Guyanese Government and major international donors, including the US Government and the Global Fund for AIDS, Tuberculosis and Malaria must address these issues, bring forth new legislation that protects the rights of all Guyanese citizens, regardless of their sexual orientation or HIV+ status, and create innovative efforts and partnerships to reduce stigma and discrimination still surrounding both HIV/AIDS and homosexuality in Guyana and elsewhere. Increased efforts are also required to scale up access to testing and antiretroviral medicines in cities and especially in rural provinces, where information, services, and care remain scarce and transport expensive, and religious messages like the one below may be doing considerable harm by sending dangerous and unfounded messages and hopes to people living with HIV/AIDS.
Sources and links for further information:
· Amnesty International Report: 'I am not ashamed!': HIV/AIDS and human rights in the Dominican Republic and Guyana - http://web.amnesty.org/library/pdf/AMR010022006ENGLISH/$File/AMR0100206.pdf
· Guyana PEPFAR Bi-Monthly Situation Report, July 1 – August 31, 2006
· Government of Guyana HIV/AIDS Program
· Agua Buena Human Rights Association
Guyanese officials criticize US preacher
Mon Oct 30, 12:01 AM ET (by the Associated Press)
Guyanese health officials have criticized an American television evangelist for a series of advertisements they say suggest people can be cured of HIV/AIDS by attending the preacher's services in this South American nation.
The ministry of Rev. Ernest Angley, a Pentecostal preacher who exhorts illness-causing demons to leave a person's body at "crusade services," was involved in an "obscene exploitation of people's vulnerability" by claiming that people with HIV/AIDS could possibly be cured, Guyana's Health Ministry said in a Saturday statement.
"We are unaware of the existence to date of any cure anywhere in the world for HIV infection," the statement said.
Ray Spangler, a spokesman for the Ernest Angley Ministries, which is hosting several services in Guyana and neighboring Suriname this week, said the ads indicated that prayer and faith can be the remedy for many afflictions. He said Angley is "well aware" there is no medical cure for HIV/AIDS.
"If a person comes to the crusade and gets help through prayer then that's wonderful. If nothing happens, continue taking your medicine," Spangler said. "It does not hurt to have prayer if you are sick."
Angley is an evangelist known for his televised services at the Grace Cathedral in Cuyahoga Falls, Ohio, where believers appear on stage to receive a prayer and a healing touch from the preacher.
His services are regularly aired on Guyanese television and the events in the former British colony were expected to draw thousands.
Eugene Schiff Caribbean Region Coordinator Agua Buena Human Rights Association Skype: Ecsx2000 www.aguabuena.org firstname.lastname@example.org
Laura Porras, email@example.com
Richard Stern, firstname.lastname@example.org