AIDS in Latin America and Caribbean Can be Controlled, say Experts

By Jim Teeple
Miami
29 March 2004

AIDS experts meeting this week in Miami, Florida say they are optimistic the AIDS epidemic in Latin America and the Caribbean can be controlled. The experts say the key to controlling AIDS and HIV, the virus that causes AIDS, is to treat the disease as a social problem, as well as a medical emergency.

HIV and AIDS are a serious problem in Latin America and the Caribbean. An estimated 200,000 people in the region were infected with HIV last year and nearly two million people are living with HIV/AIDS.

Infection rates are higher in Caribbean countries than in Latin American countries. And, no country has a higher rate of infection in the region than Haiti, where last year an estimated 30,000 people died of AIDS. Despite these grim numbers, AIDS experts say there is some good news, and the best news comes from Haiti.

Dr. Paul Farmer is a world-renowned AIDS expert who has run an innovative program to control HIV and AIDS in Haiti for 20 years. He says AIDS control efforts in Haiti are having a positive effect.

"The good news is that two decades of hard work has borne fruit," he said. "You can see that whether you look at declining sero-prevelence, that is to say the amount of disease infection in the population. We are pretty sure that the overall infection rate has been halved and that is very good news. It is not by accident, but the fruit of a lot of hard work."

Dr. Farmer says AIDS education efforts are having a dramatic effect in Haiti with 90 percent of city dwellers and 70 percent of rural Haitians aware of how HIV is spread.

Dr. Farmer's Partners in Health Program runs clinics and hospitals in rural Haiti that train local villagers as community health care workers, paying them on average $40 a month to monitor and treat the health of their neighbors.

Dr. Farmer was also one of the first to pioneer the delivery of high-cost anti-retroviral drugs to poor people around the world, negotiating with drug companies to provide low-cost drugs to HIV infected patients for an annual cost of about $300.

His approach to treat HIV and AIDS as a social problem as well as a medical disease is being emulated in other parts of the region, most notably in Brazil, where a similar approach has cut AIDS deaths by 50 percent to about 90,000 deaths a year.

Dr. Fernando Zacarias who directs HIV and AIDS programs for the Pan American Health Organization says public education programs are effective - especially at getting men to use condoms. He says condom use by males in the region has gone from four to nearly 50 percent in recent years. He says treating HIV and AIDS as a social problem can lower infection rates.

"People have finally realized that this is not a medical problem," he said. "It is a societal problem that requires interaction, partnerships and alliances between several sectors. People have to be committed. From the technical standpoint we realize that you need a combination of prevention and care. You cannot do it just by focusing on one strategy. I think that is part of the success that people are taking a comprehensive approach to the problem."

Dr. Zacarias says he and his colleagues who work on HIV and AIDS in the region are cautiously optimistic that the AIDS epidemic can be controlled. He says while, overall, HIV infection rates continue to climb in the region, they have not increased as much as predicted just a few years ago. That, he says, is due to more resources being put into educational efforts and social programs in Latin America and the Caribbean that are designed to slow the spread of the disease.