World Bank Press Release - June 17, 2003

"Accelerating the response to HIV/AIDS in the Caribbean" was precisely the theme that brought together a group of high-level panelists last week at the World Bank. Hon. Dr. Denzil L. Douglas, Prime Minister of St Kitts and Nevis and Chairman of the Pan Caribbean Partnership Against HIV/AIDS (PANCAP), spoke of the current trends of the disease in the region, the context in which it was spreading, and the response required.

Douglas emphasized the strong need for cooperation between the Caribbean countries, whose economies could not bear the cost of highly specialized HIV/AIDS prevention and treatment programs on their own. He pointed out that due to the high level of mobility of the population within the Caribbean-a factor that is often linked to increased HIV infections-the islands are intrinsically tied together in facing the problem. With the creation of the Caribbean Single Market and Single Economy, these migratory processes will continue to grow.

The direct and indirect effects of HIV/AIDS could amount to more than an estimated 6 percent of the region's GDP, according to him.

"These economic trends have serious implications for health and health status in the Caribbean," he warned.

"In addition to relatively high levels of poverty, migration patterns, the vulnerability of the economies, and high levels of unemployment, the labor force is increasingly concentrated in the services sector and the informal economies. Workers in these sectors have much less access to social safety nets like social and health insurance. They are also more vulnerable to the health hazards of HIV/AIDS."

Increasing rates of HIV prevalence compound the forces driving the epidemic, such as poverty, violence, and social exclusion. The societal impacts are mirrored in the financial realm, where businesses lose profit due to sick leave, increased staff turnover rate that induces higher training costs, and lower productivity. In turn, the overall economy suffers, due to higher demands for medical care, premature payments from pension funds and loss of tax revenue.

"We require the support of the business community," Douglas said. "We require the support from the donor community for an adequate and accelerated response to this epidemic. In the meantime, we are pursuing the collective regional strategy through the Pan Caribbean Partnership led by the Caribbean Community and Common Market (CARICOM) against HIV/AIDS, launched in February 2001 in Barbados."

Edward Greene, Assistant Secretary General of CARICOM, spoke of PANCAP, the regional umbrella network that has played an important role in coordinating political support and resource mobilization for the region's response, notably through the regional negotiations for cheaper antiretroviral drugs and the recently prepared World Bank grant to PANCAP. It is one of several concrete steps taken by the Caribbean governments that reflect the prevalent regional commitment and will to cooperate in the fight against HIV/AIDS.

"HIV/AIDS drives people into the poverty trap and stops people from escaping the trap that is poverty," said Sir George Alleyne, UN Special Envoy for HIV/AIDS in the Caribbean and Former Director of PAHO/WHO. He argued that it was the international community's role to accelerate the response to HIV/AIDS through greater surveillance, leadership in the advocacy against discrimination, coordinating support to the Caribbean institutions such as PANCAP and the University of West Indies, and putting greater resources into the response, both in financial terms, and in terms of human resources and expertise.

Patricio Marquez, the World Bank's Lead Health Specialist for the Latin America and the Caribbean Region, noted that CARICOM had become international best practice, influencing other regions such as Central America to adopt similar arrangements. As part of the international coordinated effort to assist the Caribbean countries, Marquez indicated that the World Bank is committed to playing its role and took a significant step in this direction in 2001, when it launched a $155 million Multi-Country HIV/AIDS Prevention and Control Program in the Caribbean.

The panel discussion concluded with remarks from Tommy Thompson, U.S. Secretary of Health and Human Services and Chairman of the Board for the Global Fund to Fight AIDS, Tuberculosis & Malaria, who guaranteed the support of the United States in the global fight against HIV/AIDS. The Secretary pointed to recent U.S. initiatives, such as the $500 million International Mother and Child HIV Prevention Initiative, which was approved in July 2002 to prevent the transmission of HIV/AIDS from mothers to infants and to improve health care delivery in Africa and the Caribbean; and the five-year $15 billion HIV/AIDS Emergency Relief Plan-the first global effort to provide advanced anti-retroviral treatment on a large scale in the poorest, most afflicted countries in the Africa and the Caribbean.

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