Remarks on World AIDS Day Delivered by Manoela Manova, UNAIDS Country Director Jamaica

Despite successes, the AIDS pandemic is not over.  Even today, more than 12 million people are still waiting to get on HIV treatment and 1.7 million people became infected with HIV in 2019 because they could not access essential services and some 690 000 died of AIDS-related illness.

We have 40 years’ experience in responding to the HIV epidemic. This is what we know: we can’t beat a public health threat like AIDS or COVID19 with testing and treatment alone. We also need trust.

We all need to be ensured that if we are infected, our public health officials will take care of us. We need to believe that government policies are in our best interest. And we need to be assured that we won’t be teased or threatened by our community just because we have an illness.

We have to actively encourage solidarity and kindness. That is the only way we can empower people to take action to protect themselves and others.

The global AIDS response is off track. It was off track even before the COVID-19 pandemic, but the rapid spread of the coronavirus has created additional setbacks. Although some countries (Eswatini, Botswana) did remarkably well and achieved or even exceeded the targets set for 2020, many more countries are falling way behind. Thus the 2020 targets have been missed by a long way. But we can learn from the successes of those countries that did well.

Jamaica’s 2019 Treatment Cascade results show where we are falling behind:

86% of people living with HIV diagnosed

52% of diagnosed people on treatment

66% of people on treatment virally suppressed

To get the global HIV response back on track, UNAIDS is calling on the world to adopt NEW ambitious targets for 2025. These new set of targets are bold but achievable and if meet them it will set the world back on course to end AIDS by 2030.

These targets are holistic — they focus on a high coverage of HIV and sexual and reproductive health services together with the removal of bad laws and policies and on reducing stigma and discrimination.  UNAIDS has modelled, that failure to make any progress on societal enablers targets and stigma and discrimination will result in additional 440,000 AIDS related deaths and 2.6 million new HIV infections between 2020-2030.

And let’s look into Jamaica:

• 2 of every 3 Jamaicans have discriminatory attitudes towards people living with HIV (67%).
• Prejudice and ignorance don’t protect us. We need solidarity and knowledge to end AIDS.

These NEW targets address the inequalities on which HIV, COVID-19 and other pandemics thrive and put people at the centre, especially the people most at risk and the marginalized — sex workers, transgender people, people who inject drugs and gay and other men who have sex with men.

Let’s look at our Men and boys in Jamaica:  

• In 2019, there were more than twice as many HIV infections among Jamaican men (1100) than women (<500)
• Two-thirds of Jamaican women living with HIV were on treatment (67%) compared to just 3 of every 10 men (31%).
• Men (860) were four times more likely than women (<200) to die due to AIDS last year

Jamaican men might seem tough, but they need special support to get tested for HIV, get on ARV treatment and stay on course.

Implementing just the easiest or most politically acceptable programmes will not turn the tide against COVID-19 or end AIDS.

COVID-19 is a wake-up call for countries to strengthen health systems. The Covid pandemic has shown that investing in health saves lives and economies. Health must be fully funded, both in times of plenty and in times of economic crisis.

But COVID-19 is also an opportunity. For the first time for many years, the Global interest in infectious diseases is higher than ever before. We must build on this.

We have estimated that a comprehensive community-led response to COVID-19 in high-density settings, would cost US$ 6.08 per person per month, far cheaper than the cost of treating a person with COVID-19.

No country can defeat pandemics on its own. Challenges like HIV and COVID-19 can only be defeated through global solidarity and shared responsibility to ensure that health systems are universally strong, and no one is left behind and right to health is respected, protected and universally provided.

To end AIDS and prevent other pandemics like COVID-19 we need bold political leadership, we must invest in health, we must eliminate stigma and discrimination,  we must put people at the centre of everything we do and ground our responses in human rights. 

What can Jamaicans from all walks of life do to help the country end AIDS?

Know your HIV status.

If you are HIV-negative, take steps to stay that way. Delay sex.  Abstain. Be faithful. Use condoms. Use PrEP if you are at the highest risk of HIV exposure.

If you are HIV positive - Stick to your treatment. 

Thousands of people in Jamaica know they are living with HIV but are afraid to confront it because they worry about gossip, insults and prejudice.

1 in 3 Jamaicans living with HIV has an undetectable viral load (35%)

These people CANNOT transmit HIV. That’s why we need to support people to get tested and start early and stay on treatment. Undetectable = Untransmittable

We need to get the word out that if we support people living with HIV to stay on their treatment, we’re also helping to prevent new infections. This is our responsibility and contribution to ending AIDS in Jamaica. And we need to replace ignorance and abuse with information and support.  

On this World AIDS Day let us emphasize that only solidarity at all levels global national, at community and family level and shared responsibility will help us beat the coronavirus, end the AIDS epidemic and guarantee the right to health for all.