AIDS: The need to be vigilant

Health Minister Nimal Siripala de Silva has said how happy he is for the country's tourism image that the 8th ICAAP (International Congress on AIDS in Asia and the Pacific) is being held in Sri Lanka. The Minister's remarks may seem as if he has missed the wood for the trees, for this conference is not about tourism (even though it has temporarily filled the city hotels) but on the contrary, about building awareness about the deadly disease that is ravaging nations across the world.

Many may question why Sri Lanka, being a low prevalence country in HIV/AIDS cases, is hosting this major AIDS congress where some 2,500 delegates from more than 60 countries are meeting at the BMICH over the next few days to deliberate on the challenges and strategies of combating AIDS. This is because we can hardly afford to be complacent and fall back on our usual argument that given our religious and social set-up, AIDS is not likely to affect us.

One has only to look at how AIDS exploded in Africa to realize the dangers; no one thought it would hit that region until it was too late. Africans themselves prefer not to dwell too much on this deadly scourge but there is no doubt that they are grappling with a problem of gargantuan proportions. Researchers predict that AIDS death toll in Africa could hit an astronomical 100 million in 2025. This week, the influential Anglican Church in Nigeria has urged couples to voluntarily take an AIDS test so that they make an informed decision about their future.

Asia is the next time bomb in terms of the numbers of infected persons in China and India. Given Sri Lanka's proximity to India, there is every reason for both Government and civil society to be proactive.

On the premise that prevention is always better than cure, it's a courageous decision by the Government and the NGO sector to host the 8th ICAAP and allow the spotlight to fall on issues that our populace usually prefers to keep hidden under the bed sheets.

Though a sound healthcare system and the much-vaunted literacy of our population have been plus points in keeping HIV at bay, other emerging factors, such as increasing migration -- both internal and international, conflict, the presence of foreign sex workers, economic development which has seen young adults moving from rural areas to the cities, the increasing numbers of heroin users etc have all brought the spectre of AIDS closer to us.

Sri Lanka's vulnerability because of its exposure to migration has been cited by many. Over one million Sri Lankans work abroad - and many go abroad on holiday, with travel to our closest neighbour and other countries in Asia prone to the disease, being particularly high. War and conflict situations are another factor where the spread of HIV/AIDS can occur. A UN AIDS report states that "conditions of high vulnerability also include high mobility of military, IDPs and separation of spouses related to overseas employment".

The problem of Western paedophiles and foreign prostitutes here under the guise of dubious BOI projects -investors, health clinics and casinos -- is well known and one which the local authorities have chosen, by and large, to ignore. There is the occasional well publicized raid on a massage parlour but sustained follow-up action has never been a strong point, given the levels of corruption within the Police, and political pressure in such cases.

It is to our credit that Sri Lanka started AIDS awareness programmes as far back as the late 1980s. Doctors, media personnel, volunteers and community leaders individually and collectively got together to spread the message. Yet, alarming levels of stigma and discrimination still face AIDS patients. The World Bank-funded National HIV/AIDS Prevention Programme refers to how people are afraid of disclosing they are HIV positive due to the stigma the disease carries, has stressed that addressing stigma and discrimination will be vital to maintain the low incidence of new infections.

A positive step forward is that the private sector has begun an awareness programme, an initiative together with the chambers of commerce and the International Labour Organization (ILO) to minimize stigma and discrimination in the workplace. Religious and youth groups must be in the vanguard here to reach out and speak passionately on this issue.

Although the official figures estimate that there are 5,000 cases of Sri Lankans living with HIV or HIV positive persons, the general consensus is that this may be an underreported figure. The biggest challenge for Sri Lanka, once the business of this ICAAP is concluded will be to take off from the positive efforts of neighbouring countries in combating HIV and implement similar initiatives to keep this country in its current status, in the least, as a low prevalence nation.