Miami Herald - Tuesday, August 27, 2002
Melody Duvall and Franklin Huang

With one of the highest HIV/AIDS prevalence rates in the Eastern Caribbean and having suffered a prolonged period of economic stagnation, Dominica is a case study in the enormous challenges faced by many countries attempting to combat or prevent an HIV/AIDS outbreak.

Curtailing the spread of HIV in Dominica remains a daunting task because most foreign organizations have yet to establish programs on the island. What's more, the local population is largely uninvolved in grass-roots efforts to confront the disease. Pregnant mothers and newborn infants supposedly have access to anti-retroviral therapy in already established mother-to-child transmission (MTCT) prevention programs.

NO FUNDS AVAILABLE

However, no domestic or outside funds have been made available to provide either testing or therapy to HIV/AIDS-positive mothers or their children. This reality forces pregnant women who are HIV-positive to give birth without access to treatment during gestation, leaving their newborns at a high risk for contracting HIV. The tragedy is that a simple and relatively affordable drug regime could nearly eradicate this mode of transmission in Dominica as it has in other parts of the world.

While we have seen AIDS death rates in the United States drop sharply with access to better treatment, stickers found in Dominican health clinics still declare, "AIDS -- with it you'll die."

As a recent U.N. report declared, most young people in the less-developed world still lack the knowledge to protect themselves from HIV. But in only two weeks in Dominica, we have educated more than 400 school children ranging in age from 12 to 15 about AIDS/HIV and its prevention. Multiply the two of us by 10 and all Dominican school children could be taught HIV/AIDS prevention with very little cost in money and time.

Unfortunately, Dominica is running out of both. Ironically, according to the World Health Organization, Dominica boasts one of the great healthcare systems in the world, ranked higher than that of the United States. This health infrastructure, severely hampered by a deteriorating economy, could be crippled by HIV/AIDS.

The Dominican healthcare system -- the collective achievement of its nurses, community health workers, doctors and government -- provides the means to stem the spread of AIDS but currently has scant international assistance to bolster its limited resources.

RESOURCES AND MANDATE

The growing global consensus about the threat that HIV/AIDS poses to all nations, reduced drug prices and the creation of agencies such as the Global Fund and the Gates Foundation provide the resources and mandate needed to do battle with HIV/AIDS. But the people and organizations behind this increasingly concerted effort must respond when epidemics strike smaller, lower-profile nations.

With the political will and leadership to obtain and apply these resources, Dominica can protect its economy and its people's health from a disease that will rip this society asunder if unchecked. Partial or delayed action will only make the epidemic harder and more costly to stop.

Franklin Huang and Melody Duvall are medical students at Washington University in St. Louis and co-founders of Students Teaching AIDS to Students -- Dominica.

Copyright - 2002 - Melody Duvall and Franklin Huang. All rights reserved. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the authors.
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