Winnie Byanyima | Jamaica and the Caribbean can end AIDS

I am so moved to be on my first visit to Jamaica as executive director of UNAIDS. Jamaica’s exceptional intellectual and cultural contribution to decolonisation, and the voice with which Jamaica’s artistes have conveyed African, Caribbean, and global struggles for justice, hold a special place in my heart. As Jamaicans say of this island’s story: “We Likkle But We Tallawah”. I am here to join in the celebrations of 60 years of Independence, and to learn from the advances that continue to be made by the people of Jamaica.

Jamaica is a vital member of the United Nations and a leader in global efforts to end AIDS as a public-health threat by 2030. I was delighted to see the mayor of Kingston receive the Circle of Excellence Award, last month, during the Fast Track Cities HIV Conference in Seville. Since 2010, Jamaica has seen a 12 per cent decline in new HIV infections and a 16 per cent decline in the number of people dying from AIDS.

The Caribbean has made impressive strides in continuing to bring down new HIV infections. Countries in the Caribbean have been global front-runners in efforts to eliminate mother-to-child transmission, a first step to ending AIDS in children. Caribbean countries have made great strides in HIV testing, with over 84 per cent of people living with HIV knowing their HIV status. The Caribbean continues to advance in human rights, knocking down barriers to life-saving health services. At last, the punitive and discriminatory laws that the British colonisers left are being repealed by Caribbean courts in landmark cases. It is vital for the rights and health of everyone that this wave of change continues.

THREATENED

Despite the impressive strides being made by Caribbean countries, the health and development of people in the Caribbean are threatened by the fallout of the succession of global crises from COVID-19 to climate change to the war in Ukraine and the impact of these on households and national resources. As the risks for communities and families are increased by the rising cost of living and high fuel and food prices, the capacity of governments to effectively respond is also undermined by the squeeze on national resources. The countries most economically affected by COVID-19 are the countries deepest in debt — and the countries most affected by HIV. Globally, in 2020, for every US$10 available, US$4 was spent on debt servicing, and only US$1 was invested in health. As the food, fuel, and livelihood crisis meets the debt crisis, progress in ending AIDS and in protecting everyone’s health is now in danger.

As UN under-secretary-general, and as the leader of the UN’s work to end AIDS, I am in Jamaica to observe and learn from communities and the Government how they are addressing these challenges. I stand in solidarity with the people of Jamaica and align the UN’s technical and other global resources with national efforts to enable Jamaica and the Caribbean region to succeed.

UNAIDS is calling on the donor community to slow down its plans for exit from the middle-income region of the Caribbean and to speed up progress on meaningful and effective debt restructuring, which is urgently needed to increase and sustain health, education, and social protection. As a vital corollary, UNAIDS is supporting Caribbean countries in strengthening domestic investment and resource-mobilisation plans, and policy and law reform plans, for tackling HIV and ensuring health for all.

The most important learning of the AIDS response is that we can end AIDS as a public-health threat but only if we tackle the inequalities that drive it.

Addressing stigma and discrimination is critical for expanding access to HIV treatment and prevention services. We must ensure that no Jamaican is left behind as we push to end AIDS in the country.

Jamaica’s social programmes have shown proven results in helping to keep young people in schools, improve access to services for people living with HIV, and engage communities as leaders in providing HIV prevention, treatment, and human rights services.

CANNOT LET UP

We cannot let up. We need to push through the crises until we achieve the end of AIDS. Together we can do it, but it will require:

• Investments in health systems, leveraging community systems, and sustained and equal access to services for Jamaicans living with HIV. Increasing availability, quality and suitability of services for HIV treatment, testing, and prevention so that everyone is reached and well served. Protecting health services from fiscal consolidation is essential and is a sound investment for a solid recovery.

• Reform of laws, policies, and practices to tackle the stigma and exclusion faced by people living with HIV and other marginalised groups, including LGBT people.

• Ensuring access to the best technology for prevention, testing, and treatment, by challenging together, as the UN and as Caribbean, Latin American, Asia-Pacific and African countries, the monopolisation of medical patents and medical productive capacity by a few big companies in the global North.

• Ensuring that countries have the resources they need for health, education, and social protection by securing debt restructuring and ensuring an effective combination of international donor support and strengthened domestic resource mobilisation. This includes moving together towards more progressive taxation, closing more tax loopholes, and advancing towards greater debt restructuring.

I am thrilled to get to make this visit to this unique island and to thank you for the inspiration that you have given the world. I am so looking forward to working with the leaders from communities, national NGOs, academia, business, and government to learn from your achievements and to plan together how the UN can best support Jamaicans to end AIDS, protect everyone’s health, and advance everyone’s rights. The UN is by your side.

Winnie Byanyima is executive director of UNAIDS and under-secretary-general of the United Nations. Send feedback to columns@gleanerjm.com.