Sunday Times 2
Sri Lanka: Championing the AIDS response
View(s):
Somar Wijayadasa at the World Aids Day at the UN/New York in 1998. Pic courtesy UNAIDS
The World AIDS Day, observed on 1 December every year (since 1988), raises awareness of the HIV/AIDS pandemic, and mourns those who have died of the disease. It inspires me to recall how AIDS killed millions of people around the world causing a substantial impact on the health and economy of many nations.
The advent of birth control pills, antibiotics for sexually transmitted diseases, legalised abortion, wide availability of marijuana, LSD and intravenous drugs gave rise to heterosexual activity and gay activism, and challenged traditional norms of sexual life.
Since the first identification of HIV/AIDS among gay men in the United States of America, in 1981, about 76 million people have been infected with HIV, and 39.6 million people have died of AIDS.
The disease was widely spread among gay men who have sex with men, people with multiple sex partners, injecting drug users and sex workers — throughout the world. Initially, no one knew what it causes, how it spreads, and there was no cure. As such, stigma, discrimination, and alienation were the norm, and contracting HIV/AIDS was nothing but a death sentence.
Sri Lankan experience
While many countries have been traumatised by the disease, Sri Lanka is categorised as a country with low HIV prevalence — thanks to governments’ foresight and intervention. According to the National STD/AIDS Control Programme (NSACP) of Sri Lanka, that spearheads monitoring, prevention and treatment programmes, “there are about 3,300 people living with HIV, which is only estimated at 0.1% of the general population.”
However, with many Lankans employed abroad, thriving tourism, flourishing sex trade (including young boys and girls), drug users, increasing LGBT activity, and still undetected or unreported cases, Sri Lanka could be vulnerable to an increase in HIV infections.
According to NSACP Director Dr. Sisira Liyanage, “HIV infection is not a notifiable disease and providers do not have a legal requirement to report all cases to the NSACP.” It is commendable that Sri Lanka provides free antiretroviral treatment to all HIV patients.
The 2014/15 Annual Report of the NSACP (http://www.aidscontrol.gov.lk) provides data on HIV in Sri Lanka.
UN’s defining response to HIV/AIDS
In 1987, the World Health Organisation (WHO) created the Global Programme on AIDS, but was inadequate to deal with the growing pandemic.
The UN Building is lit with the Red AIDS ribbon, demonstrating the Organization's commitment to the battle against HIV/AIDS, and to spotlight the General Assembly Special Session on HIV/AIDS on June 25-27, 2001. Pic courtesy UN Photo Library, New York
Concurrently, several UN agencies (WHO, UNDP, UNESCO, UNFPA, UNICEF and the World Bank) had their own health related programmes but their effectiveness was severely compromised by inter-agency rivalries, and they categorically refused to work together.
Thus, in 1993, an inter-agency working group – the Committee of Cosponsoring Organisations (CCO) – comprising the heads of the above six UN agencies was established with the responsibility to create a coordinated programme to combat the epidemic.
The CCO met in New York, and as Federico Mayor, the Director-General of UNESCO (in Paris) could not attend all meetings, I was assigned to represent him.
After two years of painstaking deliberations, the Joint United Nations Programme on HIV/AIDS (UNAIDS) was formalised. In May 1995, the UN endorsed it stating that “only a special United Nations system programme is capable of orchestrating a global response to a fast-growing epidemic of a feared and stigmatised disease whose roots and ramifications extend into virtually all aspects of society.”
By the time the UN got its act together, about 22 million people had been infected with HIV and 6 million had died of AIDS worldwide — a staggering indifference by the United Nations to the growing challenge of the HIV/AIDS pandemic.
UNAIDS which was initially cosponsored by six UN agencies was later joined by UNHCR, WFP, UNODC, UN Women, and ILO.
These eleven co-sponsors from different parts of the UN family now work together in a cohesive and broad-based partnership against the epidemic — making it the first ever, and the most innovative multi-agency programme of the United Nations.
Current HIV infections: Traumatic
We are now thirty-five years into the HIV/AIDS pandemic, and the virus is still growing at a frightening rate of about 6,000 new HIV infections every day.
AIDS-related deaths have dropped to 4000 a day thanks to antiretroviral drugs that have turned what was once a terminal illness, into a manageable disease.
About 15 million people are now on antiretroviral treatment. Yet, 22 million HIV patients have no access to these lifesaving medications.
It is unlikely that the pharmaceutical companies would rush to make a vaccine to eradicate HIV when they profit more by selling antiretroviral drugs.
According to UNAIDS, “with 36.9 million people living with HIV/AIDS today, over 2 million new HIV infections, and about 1.5 million AIDS related deaths in 2014, HIV/AIDS still poses a serious threat to communities all over the world.”
Calling for eradicating AIDS by 2030, Michel Sidibé, Executive Director of UNAIDS, has been vigorously promoting a vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.
UNAIDS cannot do it alone. All states — rich or poor — should have a viable national policy on HIV/AIDS to effectively control the disease. Sri Lanka has set an example for others to emulate.
(The writer, a Moscow educated International Lawyer, was a UNESCO delegate to the UN General Assembly from 1985-1995, and was Representative of UNAIDS at the United Nations from 1995-2000.)