Declaration of commitment on HIV/AIDS and the Political Declaration on HIV/AIDS

High-Level meeting on a comprehensive review of the Progress
achieved in realizing the Declaration of commitment on
HIV/AIDS and the Political Declaration on HIV/AIDS

June 10, 2008

United Nations, New York

Permanent Mission of the Republic of Guyana to the United Nations
801 Second Avenue, New York, N.Y. 1001
Mr. President, Mr. Secretary General, Excellencies, Distinguished Delegates,

Guyana is on track to meet its targets for universal access in prevention, treatment and care for HIV. Since the historic meeting of 2001, the HIV epidemic in Guyana has been stabilized and there are definite signs of reversal.

Guyana would like to highlight one of our continued struggles in the fight against HIV– the problem of outward migration of skilled health care personnel. We are dismayed that after many meetings and conferences, an equitable solution is not anticipated soon. Guyana’s position is that recipient countries should assist developing countries to enhance their training capacity.

Guyana has integrated the challenge of co-infection with TB in our fight against HIV. HIV-TB co-infection is already too deadly and a targeted global approach is required to deal with this problem, particularly with the growing issue of MDR-TB.

Our country has now adopted guidelines for earlier treatment of persons living with HIV. Treatment of persons living with HIV must revert to the discretion of their doctors and must not be restricted by imposed CD4 cut-offs or because of financial considerations.

Since 2001, significant progress has been made in making medicines and commodities for the fight against HIV more affordable. But commodities, such as female condoms, various laboratory reagents and medicines, such as those needed for 2nd line treatment are still too expensive.

Prevention, treatment and care for HIV must become fully integrated into the provision of health care for all. Important links to maternal and child health, immunization, mental health and non-communicable chronic diseases programs are crucial for success. In this regards, Guyana regrets that we have not been able to persuade our partners that use of HIV funding for programs such as VIA screening, HPV-testing and HPV vaccination for cervical cancer is integral in the provision of effective anti-HIV programs.

Guyana believes there is need for a far more aggressive prevention strategy in which all tools are optimally utilized. The intensification of school education programmes on reproductive health, including sexually transmitted infections, must be a major undertaking of countries and this must become a part of the leadership coming from the UN.

The leadership of the United Nations is vital as we tackle those foci which still drive the epidemic in many countries. Commercial sex is still a major source of infection. Commercial sex workers, their clients and/or their managers must be targeted in an aggressive programme to become part of the solution, without restrictions due to legal, cultural and religious considerations.

Without legislation to address stigma and discrimination linked to HIV, there is little chance of rapid mitigation of stigma and discrimination. There are existing laws that need to be amended or repealed and there is need for new laws to specifically address stigma and discrimination linked to HIV. The UN must take a more leading role in ensuring there is global agreement around these issues. In particular workplace programs, how we deal with health and life insurance and immigration policies must occupy space on the global agenda.

ries. Guyana lauds the international efforts (particularly from developed countries) to mobilize resources so that every country is able to mount a comprehensive response against HIV. This ought to be strongly acknowledged. We, however, urge donor countries, Global Fund and other funding agencies in their re-examination of eligibility criteria, to ensure countries are not excluded merely on the basis of GDP. Many of the countries in the Caribbean and Latin America are small, vulnerable states which have enormous challenges and need assistance in order to protect their gains and extend their services.

Mr. President, the battle against HIV can only succeed if there is a strong multi-sector approach. Yet it is time we acknowledge that HIV is a public health threat and leadership in the fight to stop HIV must come from and be integrated with the public health system. The Exceptionality of AIDS must not be a vehicle to shift responsibility from public health to some other authority or sector.

In this regard, disease-specific responses have served Guyana and the world well in the fight against HIV, but it is time now to also focus on health system strengthening. We will not be able to provide effective prevention, treatment and care in any country on a sustainable basis unless we are able to build strong health systems. We cannot build capacity for human resources, supply chain, information system, health financing etc. for HIV, unless these health system strengthening gaps are addressed comprehensively in countries.

In closing my delegation understands that Dr. Peter Piot is leaving his post as the first Head of UNAIDS later this year and that he is attending this special meeting for the last time in his capacity as Head of UNAIDS. We want to express our deep gratitude to him for his leadership and commitment to the fight against HIV in the last 12 years. We will miss him. UNAIDS has been critical in coordinating the advocacy and in ensuring global focus on HIV is not distracted. There are other critical challenges confronting the globe today, such as escalating food prices, climate change etc. These equally daunting challenges are compelling reasons for enhanced relevance and a strengthened UNAIDS as we move resolutely towards universal access and the MDGs.

Thank you.

The Honourable Dr. Leslie Ramsammy
Minister of Health
Republic of Guyana