A new report on the national HIV/ AIDS programme here has recommended that there be capital investments in the fight against the disease in face of diminishing donor funds. The report also found that men who have sex with men and commercial sex workers are the segments of the population with the highest prevalence rates of HIV.
The findings of the HIV/ AIDS Programme Sustainability Analysis Tool (HAPSAT), and recommendations to strengthen these projects, were discussed at a workshop held at Cara Lodge, Quamina Street, Georgetown on Wednesday. Speaking at the event, Health Minister Dr Leslie Ramsammy charged administrators who run the various HIV/ AIDS programmes to maximise the resources being channelled into these projects by producing better results.
One of the major challenges facing the Health Ministry and other stakeholders is the prospect of diminishing funding from international donors. As such, Ramsammy urged the stakeholders to give more priority to programmes that are effective in order to adapt to the changing dynamic. Carol Horning, Mission Director for USAID in Guyana, voiced similar sentiments, stating that “the reality is funding has declined and will continue to decline”.
Dr Leslie Ramsammy
The challenge of sustainability was also addressed by the health minister, saying that the lessons of history cannot be ignored. He made reference to the days when countries around the globe thought the battle against malaria had been won during the 1980s and thus ended their respective malaria programmes; the same argument was also made for tuberculosis; and, as is being witnessed today, both those diseases are once again causing significant problems for developing and even developed countries. Ramsammy therefore called for safeguard of the gains made over the past decade, while at the same time sustaining the efforts being made.
Ramsammy indicated that the HIV/ AIDS fight needed to be integrated into the broader health system, and as such, sustainability will be achieved as well as value for money at the same time. A key aspect of this sustainability was also highlighted in the report as the “need for capital investments is diminishing and donors are transitioning their activities to the Ministry of Health, which has low-cost overheads and is best positioned to identify and address opportunities for health systems strengthening.”
One of the most worrying findings of the HAPSAT report was the fact that “men who have sex with men (MSM) and commercial sex workers (CSWs) are the populations with the highest HIV prevalence in Guyana.” Recognizing this as a major issue, the report recommended that “there is a need to scale up outreach to MSM,” the report said.
Meanwhile, Ramsammy said the achievements made in the fight against HIV/ AIDS over the years need to be highlighted so that future challenges would not be seen as insurmountable. “HIV is no longer seen as a death sentence in Guyana, but is viewed as a chronic disease with which persons can live long, fulfilled lives with the help of anti retro viral medication,” the minister said.
He added that the number of infections in pregnant women went from 500 per year in 2000 to 150 per year as of last year. Infected babies also reduced from 15 annually to single-digit figures.
One of the major achievements Ramsammy highlighted was the ability to mobilise resources towards the HIV/ AIDS fight locally. He recalled when, in 1989, zero dollars were allocated to HIV/ AIDS programmes, since at that time many countries in the region and even internationally did not recognise HIV as a major public health problem. The sum of Gy$2 billion have however been allocated in this year’s budget for the fight against the disease. He conceded that a majority of the funding was from donor agencies, and as such the question of value for money comes to the fore once again, since donor funding will not always be available as “they have made a commitment to walk with us, but they have not made a commitment to walk with us forever.” The HAPSAT survey was conducted in August 2011 by Dr Itmar Katz with the aim of “providing Guyana’s National AIDS Programme Secretariat with a preliminary analysis of the unit costs and financial and human resources available and needed to sustain Guyana’s HIV/ AIDS programme through 2015.”
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