Article: USAID Health Expert Reports on Effects of HIV/AIDS in Caribbean

18 April 2002

Article: USAID Health Expert Reports on Effects of HIV/AIDS in Caribbean

Anne Peterson relates how virus brings out best, worst in people

By Eric Green
Washington File Staff Writer

Washington -- The dilemma posed by the global HIV/AIDS crisis is revealed not only in its grim health consequences, but in the fact that those who contract it are often discriminated against and made to feel ashamed and guilty, which serves to perpetuate the epidemic, says Anne Peterson, assistant administrator in the global health bureau of the U.S. Agency for International Development (USAID).

But at the same time, Peterson said in an interview April 17, the virus can also bring together families and communities to care for those infected with the virus.

The stigma attached to HIV/AIDS victims, said Peterson, is a huge problem in the Caribbean, which has the world's second-highest occurrence of the virus after sub-Saharan Africa.

Peterson, a medical doctor herself, will be attending an April 20 U.S.-Caribbean health ministers' meeting in Georgetown, Guyana, on the Caribbean's HIV/AIDS crisis. Peterson said the stigma attached to those with HIV/AIDS causes people to refuse testing to determine if they carry the disease. This means, she said, that those with HIV/AIDS may continue to infect others without even knowing it. This results in an increasing number of orphans who have lost parents because of the epidemic. That, in turn, can lead to orphans being "cast out" instead of receiving proper care by adults.

Peterson said the problem of stigma related to HIV/AIDS emerged as one of the biggest issues at a U.S. "chief of [embassy] missions" meeting held in Haiti in mid-April, and will probably be on the agenda at the regional health ministers' meeting in Guyana.

Health experts expect the world to have 44 million orphans by 2010, primarily because of the HIV/AIDS epidemic, Peterson said. "That's a huge increase in the number of healthy older kids who have lost their parents, and thousands and thousands of them" are going to be in the Caribbean, which becomes a cultural, social, and humanitarian issue, she said.

The magnitude of the problem is such that U.S. Secretary of State Colin Powell has said that if "humankind is to realize the great potential that the 21st century holds for prosperity and for peace, the global response to this crisis must be no less comprehensive, no less relentless, and no less swift than the AIDS pandemic itself." In sub-Saharan Africa alone, Powell said, 6,000 people die of AIDS every day. Powell said Africa now has more than 13 million orphans, mostly as a result of AIDS, and that infection rates are rising in the Caribbean, Asia, and Eastern Europe.

Peterson said unless the world can get a grip on the epidemic, countries with high rates of HIV/AIDS are going to be economically devastated, causing declines in the gross domestic product. This will have negative social and workforce ramifications, she indicated. In the Caribbean, especially, HIV/AIDS' destructive effect on national economies could turn the region into a less viable tourist destination.

Her agency, Peterson said, is helping finance a number of HIV/AIDS prevention projects globally and in the Caribbean, with the greatest amount of money earmarked for the region going to Haiti, which has an estimated 7.5 to eight percent of its population suffering from the disease. USAID estimates that about 1.4 million people in the Caribbean and Latin America have HIV/AIDS.

USAID Administrator Andrew Natsios announced in February that 29 community organizations in 20 nations, including those in Jamaica, Ecuador, and Brazil, had been selected to receive grants from his agency to engage in HIV/AIDS prevention programs and patient-treatment initiatives. The grants, Natsios said, "can go a long way toward helping local communities in the fight" against the epidemic. The war on AIDS "will be a long and arduous one," but "it is a war we ultimately will win," he said. The Bush Administration budget proposal for fiscal year 2003 calls for spending a total of more than $16 billion ($16,000 million) to combat HIV/AIDS at home and abroad.

Peterson said Haiti represents an example of how USAID is extending its work beyond just trying to prevent the spread of HIV/AIDS, to overcoming discrimination and stigmatization and caring for those with the disease.

The truth about HIV/AIDS is that it can bring out both the good and bad in people, she suggested. While those with the virus can sometimes be stigmatized and ostracized by their families and friends, others will band together to offer support and to care for those afflicted with HIV/AIDS, as is happening in the port city of Jeremie, on the southwest end of Haiti.

Peterson said during her trip to that city in April, she met with people living with AIDS who were receiving supplemental nutrition aid from the Catholic Relief Services, which contracts with her agency to help victims of the disease. Peterson said she found the experience "fascinating" because these AIDS victims were overcoming stigma to a degree she did not see in other places she has visited. The AIDS patients, she said, were receiving support from volunteers, families, and neighbors in living with the disease.

Peterson described how impressed she was by the initiative of people in Jeremie who had gotten together to launch micro-enterprise businesses, with the support of USAID. Micro-enterprise business owners use the income earned from their products to pay the school costs for orphans of HIV/AIDS victims. In some cases, the children themselves are HIV-positive, Peterson said. Peterson said she encountered one mother who had four children of her own, but had taken into her home four orphans who had lost their parents to the virus.

Jeremie is an area afflicted with very severe malnutrition, high HIV/AIDS rates, and poverty, but the adults were not letting that stop them from taking in the orphans and putting them in school, Peterson said. Forming micro-enterprises, with the help of USAID and its subcontractors, allowed this to happen, she said.

Peterson indicated that HIV/AIDS programs funded by USAID spread a prevention message on how behavior can be changed so people will not contract or transmit HIV/AIDS. The programs provide treatment to prevent the population from getting "opportunistic diseases," such as tuberculosis, a big killer in developing countries.

USAID has been able to establish, through hard data, that its HIV/AIDS programs are showing "really good success" in such African countries as Zambia. But even in Jeremie, she said, it was clear that patients with the virus are doing much better, because they were staying healthy, receiving food, and not being shunned by their neighbors. These people, in fact, were able to both speak out and educate others about behavior that can result in contracting HIV/AIDS.

Peterson said the April 20 meeting in Guyana, another country with a high HIV/AIDS infection rate, is designed to enable U.S. and Caribbean health officials to better coordinate their work against the epidemic. The meeting, she said, is being arranged by U.S. Health and Human Services Secretary Tommy Thompson, so that the region's health ministers can look "more seriously" at a problem that is taking a deadly toll on the Caribbean and the world.