Guyana and its HIV prevention fight

Jun 01, 2014 Editorial

Hearing of the gains made in HIV prevention to the extent that the prevalence has decreased, nationally, begs the question, ‘What is happening in the workplace?’ In the last decade workplace HIV prevention programmes seemed to be the rage in this country, but these days there is no word on the status of those programmes which, for the most part, were funded by international donors in the form of Global Fund; the International Development Association (World Bank); the International Labour Organisation, and the United States President’s Emergency Plan for AIDS Relief (PEPFAR).
It is perhaps noteworthy that PEPFAR which was introduced in 2003, remains the largest commitment in history by any nation to combat a single disease. In 2008, PEPFAR was reauthorized for US$48 billion over five years (2009 to 2013), with the goals of preventing 12 million new infections; treating three million people living with AIDS and caring for 12 million people, including five million orphans and vulnerable children.
The various governments benefitting from the munificence of these international stakeholders were expected to, in addition to developing action plans to combat the dreaded scourge of AIDS which is reported to result from HIV infection, contribute counterpart funds to programmatic efforts.
Sad to say this aspect of the arrangement has not always been kept by some governments with various excuses as to why they are unable to keep their part of the bargain. Ten years ago it seemed unthinkable that the money would not continue to stream into programmes to treat people with AIDS and its related opportunistic infections, and to prevent others from becoming infected.
The sad reality in Guyana is that the World Bank pulled out while the Global Fund has scaled down its financial input to the point where the likelihood of funding for HIV prevention and AIDS patient care to the extent of previous program phases has diminished considerably so much so that it goes without saying that workplace interventions will be the most affected. Interestingly, the fact that non-governmental organisations are in the forefront of prevention and palliative care serves to guarantee continued support for what has certainly proved to be sustainable efforts.
Another consideration that is an open secret is the trust that donors have in NGOs to the point where they are the first choice as principal recipients of funds. In other words international stakeholders are now disinclined to throw good money after their bad experiences with governments.
What should be of serious concern for everyone is the internal impact of down scaled or total withdrawal of external funding on workplace programs in the education and services sectors. Further, the impact of unchecked HIV infection spread due to the absence of workplace interventions can have a deleterious impact on the provision of services which can affect the stability and development of nations. Guyana will not be unaffected by this eventuality.
The answer to this dilemma resides in focused multi-sector approaches involving the private and public sectors in collaboration with NGOs, Faith-based Organisations (FBOs) and Civil Society Organisations (CSOs).
What is alarming is the readiness that the authorities in this country have to highlight new initiatives but are found wanting when it comes to sustainability. It is also important that everything that occurs in the field of HIV prevention should be available for public awareness. One danger that is not publicized is the possibility and reasons for people being given HIV-positive results which turn out to be false.
The level of apathy in the Guyanese population makes it very unlikely that litigation would follow any such occurrences here.
Donors should rethink their role and focus their collective efforts towards providing assistance in a development context inseparable from HIV and AIDS. The government policy should be so constructed to ensure development dialogue continues across sector.
But development must not be achieved at any cost and with this in view that the issue of trafficking in persons particularly in the interior mining areas must be revisited. In the past colonial employers responded to their workers’ ‘needs’ by creating compounds in which beer drinking and prostitutes were deliberately provided as antidotes for desires to be with one’s family. These became colonial methods of labour retention. We live in the shades of the past.

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