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World: WHO Report On HIV/AIDS Says It's Time To Change History

A report issued today by the World Health Organization (WHO) calls for a comprehensive HIV/AIDS strategy that links prevention, treatment, care, and long-term support. RFE/RL looks at the HIV/AIDS epidemic in the Caribbean nation of Haiti, one of the poorest countries in the world, where the international community has made significant strides in the fight against the disease.

Prague, 11 May 2004 (RFE/RL) -- Joseph Jeune is a 26-year-old peasant farmer in Lascahobas, a small town in the impoverished Caribbean nation of Haiti. Early last year, his parents bought a coffin. Suffering from the advanced stages of AIDS, Jeune appeared to have only weeks to live. But six months later, he had regained 20 kilograms after receiving treatment for HIV/AIDS and tuberculosis co-infection.

The World Health Report 2004 -- titled "Changing History" and released today by the United Nations' World Health Organization (WHO) -- shows how the program that saved Joseph Jeune can save millions of other people in low-income countries. Thomson Prentice is the managing editor of the report.

"There is a lot of stigmatization. [Infected people] are rejected even by their own families. Therefore we give them hope, zest for living [and] for fighting."
"Joseph Jeune is a wonderful example of how treatment can save a young man's life, even in one of the poorest countries in the world -- which Haiti is -- if there is sufficient will and organization to do it," Prentice said.

Joseph Jeune receives care at a small clinic in his hometown. The clinic's HIV/AIDS and TB treatment programs are part of a wider initiative to strengthen the health service infrastructure across much of Haiti's central plateau.

The effort involves nongovernmental organizations, the public sector, and community groups. It receives much of its support from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which attracts, manages and disburses resources through public-private partnership.

Prentice stresses that such efforts are benefiting not only people with HIV/AIDS but others with diseases such as tuberculosis. Haiti's primary care clinics are now receiving up to 10 times more patients for general medical care daily than before the project began.

Effectively tackling HIV/AIDS is the world's most urgent public health challenge. Unknown a quarter of a century ago, the disease has already killed more than 20 million people and an estimated 40 million others are currently living with it.

In Haiti, an estimated 250,000 people in Haiti are currently living with HIV/AIDS. Last year some 30,000 patients died from AIDS.

Such figures could be a time bomb in an impoverished country like Haiti. But AIDS fighters say there is good news from the Caribbean nation -- news that could serve as a model for regions currently on the cusp of massive HIV/AIDS epidemics, like Eastern Europe and the former Soviet Union, which have one of the world's fastest-growing rates of infection.

Prentice says it is crucial that the world community acts now to stem a global explosion of HIV/AIDS:

"The crucial moment now is about doing something to change the picture of that epidemic worldwide but particularly where it is at its worst, which is mostly in Africa, but also in Asia and elsewhere. The opportunity now exists to save millions of lives in the next few years by delivering treatment to those who need it and who otherwise will die," Prentice said.

Over the past 20 years, the organization GHESKIO has been promoting the integration of the private, public, international, and humanitarian sectors in the fight against HIV/AIDS.

Doctor Jean William Pape is a professor of medicine at Cornell University in New York state and the director of GHESKIO in Port-au-Prince. He says this approach has been paying off. Innovative treatment and prevention programs have cut Haiti's HIV-infection rate by 50 percent since 1993.

"Paradoxically, we have managed to curb the AIDS epidemic, although Haiti has been facing multiple social, economic, and political crises over the past 20 years. If a country like Haiti has been able to curb the AIDS epidemic, it is possible for other countries to do it as well," Pape said.

Over the past 10 years, clinics have increased HIV screening seven-fold. At least 14 million condoms last year were sold at low prices or given away free. Mother-to-infant transmission of HIV has been cut to 2 percent.

Nevertheless 5,000 children are born HIV-infected every year. There are an additional 200,000 children orphaned by AIDS.

Thirty-six AIDS orphans live in La Maison de l'Arc-en-Ciel, or Rainbow House, a UNICEF-supported orphanage and outreach program. For the 15 children who have the virus, La Maison dispenses anti-retroviral drugs provided by GHESKIO.

In addition, La Maison teaches mothers to live with HIV, and to keep and care for their children. They receive food and information on health care.

Danielle Penette, the founding director of La Maison, explains the importance of such a program. "It is important that children remain with their mother. You know, there is a lot of stigmatization. [Infected people] are rejected even by their own families. Therefore we give them hope, zest for living [and] for fighting. And we make them understand that with healthy nutrition and good hygienic conditions, they can live better and longer. And after only one month [infected young mothers] have the will to fight. They regained courage. It is extraordinary to see the change," Penette said.

An additional program directs its efforts at teaching community leaders about HIV/AIDS, in order to make the local community an active partner in caring for children orphaned by AIDS.