March 8, 2002

INTERNATIONAL EXPERTS REVIEW CHALLENGES AND RESPONSES TO CONFRONT HIV/AIDS EPIDEMIC IN LATIN AMERICA AND THE CARIBBEAN AT THE 43RD ANNUAL MEETING OF THE IDB UNAIDS EXECUTIVE DIRECTOR HIGHLIGHTS REGIONAL DEVELOPMENT BENEFITS FROM INCREASING FIGHT AGAINST AIDS Propose more effective prevention and treatment measures

FORTALEZA, Brazil – International experts and officials from the region today met during the 43rd Annual Meeting of the Inter-American Development Bank to examine the challenges and possible responses to the HIV/AIDS epidemic in Latin America and the Caribbean.

Speaking at the opening of the seminar were IDB President Enrique V. Iglesias and Peter Piot, executive director of the United Nations Programme Against HIV/AIDS and senator and former Brazilian health minister Jose Serra. Also participating on the inaugural panel were Ingrid Glad, Norway’s temporary alternative governor for the IDB, and Octavio Azevedo Mercadante, executive secretary of Brazil’s Ministry of Health.

At the close of 2001, UNAIDS estimated that some 1.8 million people in the region are living with HIV/AIDS, which represents an increase of 13 percent over the estimates of the previous year, said Iglesias. Moreover, between 14 and 45 percent of the persons infected are women, he added. “A truly alarming trend is the increase in the number of cases in youth,” he said.

“Unfortunately, the history of AIDS in the past 20 years has shown that the seriousness of the epidemic, and its potential impact, have not resulted in the appropriate responses,” said Iglesias. “This lack of action has had serious consequences for society: it has enabled the disease to propagate itself, has limited the ability of people to seek treatment, and it has restricted the development of adequate prevention and treatment programs.”

Iglesias noted the IDB’s commitment to promote discussion with governments, civil society, and the networks of persons who live with HIV/AIDS.

“Two decades of AIDS have made it clear that this epidemic single-handedly has the potential to eradicate all the development gains of the past 50 years,” said UNAIDS Peter Piot. “The Bank’s intensification of its work in the regional response to HIV/AIDS is therefore especially welcome.”

“The regional banks are able to translate their long-term commitment to regional development into a broad and sustained support for efforts against AIDS,” continued Piot. “Integrating a comprehensive AIDS response into every program and activity of the Bank will be an effort repaid a hundred-fold.”

In his remarks, Brazil’s José Serra reviewed the successful programs carried out by Brazil, the government´s politics in the sector, and its alliances with nongovernmental organizations.

Ingrid Glad highlighted the importance of information and education, particularly for youth, and the need for a committed leadership. She noted, on the occasion of International Women’s Day, the importance of carrying out the mandates of the Women’s Summit in Beijing in 1995.

Three panels analyzed the need for greater access and prevention, treatment and comprehensive care; the economic impact and the need for resources, and the effects of discrimination, stigmas, and gender themes in HIV/AIDS programs.

Seminar participants viewed a video prepared by the IDB which included testimonials from Latin America and the Caribbean, with emphasis on respect for human rights.

The seminar was cosponsored by the governments of Denmark, Finland, Norway, and Sweden.

IDB Initiatives

The IDB is a committed partner in the international effort to halt the spread of HIV/AIDS, identified at the Summit of the Americas in Quebec in April 2001 as a threat to the security of Latin America and the Caribbean.

IDB operations address HIV/AIDS not only from the health sector, but also as a broader social and development issue under the umbrella of its inclusion and social equity activities.

The stigma attached to HIV/AIDS has led to widespread discrimination. In addition, the disease has a high incidence in excluded populations, such as those with high levels of poverty, low education and limited access to health and information services, that restrict their ability to cope with its impact.

In Latin America and the Caribbean there are areas where more policy-level support is needed if the spread of the epidemic and its social consequences are to be avoided. For example through the implementation and enforcement of anti discrimination policies in employment and housing, expanded access to treatment and care, and the development of sustained and well targeted prevention programs. Increased focus is also being given to access to medications, their cost, and the support services needed to successfully administer them.

The Bank’s HIV/AIDS initiative presented in Quebec focused on four areas: prevention, access to medications, support to the networks of persons living with AIDS, and increasing private-public sector partnerships.

The IDB, the Pan American Health Organization, and the World Bank signed in 2000 an agreement and are developing a Shared Agenda for Health in the Americas to coordinate efforts to improve health conditions and public health services in the region through joint actions, including disease prevention and control.

The IDB has supported the development of the health infrastructure in Latin America and the Caribbean with almost $2 billion in financing during the past decades. This resources, in addition to grants and technical cooperation, were key for the treatment and care aspects of HIV/AIDS programs. Together with PAHO/World Health Organization and bilateral donors, the Bank has also supported the strengthening of epidemiological surveillance systems that have improved knowledge on how the epidemic has spread.

The IDB answered the mandate from the 2001 Summit of the Americas by preparing a program aimed to support activities in 3 areas: public policy dialogue, strengthening of non-government organizations that provide services to persons living with HIV/AIDS, and involvement of the private sector.

A series of dialogues will be initiated that focus attention on the economic and social aspects of the disease. The dialogues will focus on four main areas: (1) Improved Access to Comprehensive Prevention, Treatment and Care; (2) Economic Impact, Resource Needs and Allocation Patterns; (3) The Effect of Discrimination, Stigma and Gender in HIV/AIDS Programs and (4) The Impact of HIV/AIDS on Public Policy.

Advocacy work with policy makers will be supported by research studies that focus on the economic and social aspects of the epidemic. The focus will be on examining, implementation needs and best practices, resource allocation patterns and prioritization in resource poor environments. These studies will provide national HIV/AIDS programs and lenders an estimate of the level of resources needed to mount comprehensive programs.

In the area of behavior change, a pilot operation will test newly developed behavioral surveillance methodologies to monitoring changes in HIV/AIDS-related behaviors and evaluating the impact of behavior change programs. The project will support the collection of data on indigenous populations in Bolivia and among youth in Uruguay.

This program is expected to generate greater information and understanding of the factors leading to the successful design, operation, and evaluation of policies and projects designed to fight the spread of HIV/AIDS.

Enhancing an expanded response requires still more attention to building NGOs capacity, particularly that of NGOs of people living with AIDS, which are in a unique position to reach out to persons and families affected. In many countries, one of the first responses to the epidemic came from the NGO sector. However, there is need for greater coordination among NGOs to ensure that limited resources are used more efficiently.

Working with UNAIDS, the Bank will support the institutional strengthening of umbrella HIV/AIDS NGO groups (Foros Nacionales) in Paraguay, Uruguay, Chile and Argentina. The objective of these groups will be to help consolidate the response from the NGO community.

The forums will be involved mainly in the analysis of relevant policy and the provision of information and improving access to health and social services for persons living with HIV/AIDS. With UNAIDS, the Bank will support the strengthening of linkages between the four national bodies and the evaluation of the impact of this model for coordinating the NGO response.

The program will seek to encourage the private sector to develop prevention programs and appropriate HIV/AIDS work-place policies. The project will support the development of pilot projects in Barbados and the Bahamas. In the Bahamas, this initiative will seek to build on existing Bank support for HIV/AIDS Business Councils and to foster technical exchanges between the two countries.