Light at the end of the tunnel

The observation of World AIDS Day on December 1 every year is always bittersweet since along with the advances that are made in prevention, care and treatment we are also reminded of the many persons who have become newly infected with the HIV virus or have died from AIDS related infections.  This year, however, the numbers coming from the epidemiology unit of the Ministry of Health give us hope that we are beginning to see light at the end of the tunnel.  For the second year in a row the number of new infections has shown a sharp reduction. 

From highs of 400-450 new infections a year between 2002 and 2008 there was a decline to around 360 new infections in 2009 and the final figure for 2010 appears set to be below 300.  This reduction is a real one and not due to a fall in testing and discovery because the number of tests done every year has not changed significantly.  The prevention of mother to child transmission program run by the Ministry of Health is one of the most successful in the region and has reduced the number of babies born HIV positive to one or two a year.  People who are HIV positive are also leading longer and more productive lives though the number of AIDS related deaths reminds us of how important it is to be diagnosed early and remain compliant with the free medication available since AIDS remains the first or second leading cause of death for all age groups between 15 and 49 years.  However, the numbers do indicate that the actions that are being taken are moving us in the right direction and this indeed is a cause for hope.

 The fight against HIV and AIDS has many soldiers including those from government agencies such as the Ministries of Health, Education, Labour and Tourism; non government organisations (NGOs), community based organisations (CBOs), faith based organisations (FBOs) and many persons individually taking responsibility for their own actions.  Most importantly, we must recognise the efforts of persons living with HIV /AIDS (PLWHA) to deal with their situation in the best way they can despite the obstacles caused by stigma and discrimination.  PLWHA are finally empowering themselves to organise so that they can become more equal participants in keeping themselves and others healthy. 

The National AIDS Commission (NAC) is also to be commended for its efforts to ensure that all our actions are harmonised and keep us working towards a common goal, that proper evaluations are carried out to determine what is working and that the necessary resources are mobilised to run and expand successful initiatives.  The announcement on World AIDS Day 2010 that the NAC has been successful in obtaining a US$6 million grant from the Global Fund to be spent over five years on a number of initiatives aimed at preventing and treating HIV is another piece of good news.
 
This is not a fight that started today or even yesterday and the small successes we are seeing now come as the result of the dedication and hard work of those who have gone before.  We therefore need to recognise those whose shoulders we stand on.  Naturally, there have been wrong turns and ineffective responses as we have struggled to determine what works but there has also been a flexibility and pragmatism that has allowed us to keep our eyes on the goal and not become rigidly fixated on any particular methodologies. 

In this regard it is especially heartening to read of comments on condom use made by Pope Benedict XVI in his new book, Light of the World: The Pope, the Church and the Signs of the Times. While the Catholic Church does not regard the use of condoms as a real or moral solution to issues of human sexuality she (the Church) does recognise that if there is an intention to reduce the risk of infection it can be a first step towards a more human way of living sexuality.  This approach is in complete harmony with that of most secular efforts to deal with the epidemic which also teach that there is a need for every individual to take responsibility for their own sexuality but recognise that because the world and the people in it are very complex our solutions likewise must be multifaceted and wide ranging. 

Less than two years ago Pope Benedict sparked a wave of controversy when during a visit to Africa he stated that the use of condoms could endanger public health and increase the problem of HIV/Aids.  That the position of Pope Benedict has evolved and matured as he has become more informed is an excellent indication of the importance of education in dealing with HIV and other chronic illnesses.
 
This is no time to reduce our efforts since although we see light at the end of the tunnel there is still a long way to go before we can emerge from the darkness into the light and treat HIV as just one more of the chronic diseases such as diabetes and hypertension that are heavily influenced by lifestyle choices.  
 
Congratulations to all involved and keep up the good work.