Monday, December 01, 2008

Reflections on World AIDS Day

This is my column today.

Today is World AIDS Day. In other parts of the world, it’s an important day; it’s that day when individuals and organizations come together to remind themselves and others about how HIV/AIDS has changed—and is still changing —the world and their lives in grave and dramatic ways.

There won’t be any significant commemoration in the Philippines. In the run-up to today, a number of organizations including some academic institutions and some local governments conducted various public events such as symposia and lectures on HIV/AIDS. But that’s about it. For most of us, HIV/AIDS is an issue that’s passé. In the words of one local celebrity whose support was sought by one non-government organization for its HIV/AIDS prevention programs recently, “HIV/AIDS is so yesterday.” She’s correct in one and only one aspect: The issue is not new, in fact, it has been with us for a long time already.

This year marks the 20th anniversary of World AIDS Day. It’s been two decades since a special day was set aside for the purpose of bringing global attention to the AIDS pandemic. Prevention, care and support programs have come a long way since 1988 when the world was still groping for badly needed answers to a myriad of questions about the virus and its various consequences and complications. There is still no cure and no vaccine available; and perhaps there never will be. However, advances in medicine have enabled people living with the virus to live normal lives.
But in many aspects, it’s also as if the last 20 years have not happened, particularly in our country. The official documents of the celebration of World AIDS Day (www.worldaidsday.org or www.worldaidscampaign.org) state some of the reasons why the celebration of World AIDS Day this year is particularly more significant:

“Leaders in most countries from around the world now acknowledge the threat of AIDS, and many have committed to do something about it. As of 2007, nearly all countries have national policies on HIV. However, despite these policies, most have not been fully implemented and many lack funding allocations.”

“While treatment for HIV and AIDS has improved and become more widespread since 1988, many still do not have access to it—in 2007, only 31 percent of those in low- to middle-income countries who need treatment received it.”

“Despite HIV awareness now reaching nearly all areas of the globe, infection rates are still happening 2.7 times faster than the increase in number of people receiving treatment.”

“While the number of countries protecting people living with HIV continue to increase, one-third of countries still lack legal protections and stigma and discrimination continues to be a major threat to universal access.”

“More broadly, real action on HIV and AIDS and human rights remains lacking. Legal barriers to HIV services still exist for groups such as women, adolescents, sex workers, people who use drugs, and men having sex with men, and programmatic responses promoting HIV-related human rights have yet to be prioritised.”

Indeed, so much more needs to be done. According to UNAIDS estimates, there are now 33.2 million people living with HIV, including 2.5 million children. During 2007 some 2.5 million people became newly infected with the virus. Around half of all people who become infected with HIV do so before they are 25 and are killed by AIDS before they are 35. Around 95 percent of people with HIV/AIDS live in developing nations. But HIV today is a threat to men, women and children on all continents around the world.

And in our country, the imperative is even more pronounced and more urgent now.

I’ve been involved in HIV/AIDS prevention programs for more than two decades now. When we started laying the ground for the country’s response to the pandemic in the eighties, the concern and panic was palpable in the air as media started playing up the first cases of HIV infection in the country. But eventually, the attention waned as the incidence of HIV infections remained “low and slow.”

Why the rate of infections in this country has not reached epidemic proportions is still an enigma to most experts. Most of the factors that contribute to the spread of infection are present in our country: Millions of migrant workers, sex work, etc. It goes without saying of course that a number of sectors have laid claim to the perceived “success.” Some say it’s because we acted swiftly and decisively in the eighties and was immediately able to put in place the infrastructure for prevention and control. Others say it’s because sex work is not as prevalent as perceived, or at least not at the same levels as in other countries. And still others attribute it to religious and or cultural practices. For example, most men in the Philippines are circumcised.

A number of experts summarize the Philippine phenomenon in one word: Luck. We’ve been lucky so far.

Unfortunately, luck seems to be running out on us. From “low and slow” the description changed to “hidden and rising.” There’s no official description release this year yet, but it could very well be something along the lines of “mounting and alarming.”

The rates of infection on a monthly basis are doubling. In September alone, 57 new cases of infections were reported, representing a 128-percent increase over the same period last year. What needs to be noted as well is that the doubling trend started in March this year and has been on a consistent upswing since then. We’re seeing infection rates doubling and at a very fast rate.

Dr Gerard Belimac, program manager of the National AIDS and STI Prevention and Control Program of the Department of Health, was quoted the other week as saying that “the epidemic level could come in three years.” The problem is that funds for HIV/AIDS prevention and control programs is hopelessly tangled up in bureaucratic red tape and even if we do get to implement prevention programs now, the results will probably be felt only in five year’s time.
And it does seem that we need new kinds of prevention programs as most studies now say that awareness about HIV/AIDS has not translated into decrease of risky behaviors that make individuals more vulnerable to infection. Two people I know personally have been diagnosed with HIV recently and these are people who have gone through HIV/AIDS awareness and education programs.

I’ve said this before and I’m going to say it again here and now: We need to get our acts together and our leaders need to make HIV/AIDS prevention a priority program. We cannot afford to remain complacent anymore.

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