Battling HIV/AIDS in the Caribbean.

The recent passage of the Global AIDS Bill of $15 billion includes support for prevention efforts in Africa, as well as a growing region of concern with increased HIV infection rates--the Caribbean. In 2001 alone, 40,000 adults and children in the Caribbean died from AIDS-related illnesses. Today, nine of the 12 countries with the highest HIV infection rates in the Americas are located in the region. According to the Joint United Nations Program on HIV/AIDS (UNAIDS) the disease is already the leading cause of death among Caribbean residents between the ages of 15 and 35. Some of the largest barriers to fighting HIV/AIDS in the region are the lack of funding and cultural understanding from the international community. For instance, a portion of the $15 billion from the Global AIDS Bill will support efforts in Haiti and Guyana, but local experts say that singling out two nations in a region where mobility is commonplace is just another example of the international community not fully understanding the nature of the epidemic or the communities they are serving. Migration between islands, as well as to the U.S., help to spread the virus, while the political isolation, language differences between islands, and social and cultural taboos about sex hinder cooperation in educational and prevention efforts. A conservative estimate, according to the University of the West Indies, of the cost of a comprehensive response to the epidemic in the Caribbean would be around $260 million per year; ten times more than current HIV/AIDS-related international spending in the region.

The high cost of pharmaceuticals has been identified as one of the most difficult obstacles to overcome. Recently, however, local governments have started negotiating with pharmaceutical companies to bring down these costs. According to the Pan American Health Organization (PAHO), the price of antiretroviral drugs has decreased by as much as 54 percent between 2001 and 2002, saving over $2,000 per person. However this reduction varies by country and the amount paid in one place may be ten times that of another. Even with price reductions, treatment is still unaffordable to most in the region.

While negotiations focus on treatment, others target prevention efforts. "Together We Can," launched in 1993, is a program of the American and Jamaican Red Cross aimed at reducing AIDS among young people throughout the Caribbean. The program works with youth ages 13-19, and through workshops, discussions, educational games and interaction with HIVinfected peers, the participants are trained in HIV/AIDS awareness and prevention. Then each agrees to reach out to 30 peers in their home communities. The program has inspired a region-wide interest in AIDS education, as well as the recent creation of the Red Cross Caribbean AIDS Network.

Unfortunately, the Caribbean AIDS epidemic is still largely unknown in the global community. Only through raising awareness and funding, as well as expanding the combined efforts of prevention and education programs like the examples sited above, can the Caribbean community ultimately stem the tide against HIV/AIDS.