Mr. Chairman
Hon. Rudyard Spencer, Minister of Health, Jamaica
Hon. John Fabien, Minister of Health and the Environment, Commonwealth of Dominica and Chair of the Regional Coordinating Mechanism of PANCAP
Ministers of Government and Parliamentarians of other Caribbean States
Dr. Edward Greene, Assistant Secretary-General, CARICOM Secretariat
Dr. Kevin Harvey, Chair of the Caribbean Coalition of National Programme Coordinators
Members of the Diplomatic Corps
Members of PANCAP
Members of the Media
Distinguished Ladies and Gentlemen

It is for me a profound honour and privilege to be afforded the opportunity to address this august gathering on the occasion of the official opening of the Eighth Annual General Meeting of the Pan Caribbean Partnership against HIV and AIDS (PANCAP) that will unfold here over the next two days in this beautiful resort town of Montego Bay, Jamaica.

It is my understanding that more than 160 participants registered for this event making it the largest-ever Annual General Meeting convened by PANCAP in its eight year existence and I am particularly pleased to be associated with this flagship event.

To my mind, the theme of the Meeting “Leadership: Uniting Vision and Purpose” lies at the heart of a successful national and regional response to the stern developmental challenges posed by HIV and AIDS. For if indeed, HIV infection has now taken firm root in the general population as evidenced by the growing feminization of the epidemic; and if in fact, AIDS has evolved has the leading cause of mortality among the most productive sector (15-44 years) of our population; and if in reality, the cost of responding to the AIDS crisis in the Caribbean is in excess of US$200 million a year as postulated by our health economists; then I submit that visionary and purposeful becomes a most crucial and inescapable ingredient in the pursuit of a successful national and response.

The creation of PANCAP by the Heads of Government of the Caribbean Community in 2001 is a telling example of proactive and visionary political leadership and the very positive results are well documented. Indeed, I was fascinated to learn that while still in its fledgling stage, PANCAP won the acclamation of UNAIDS as an “International Best Practice” and that the experiment has been replicated in many other regions of the world, as far away as Central Asia. By itself, this type of recognition of PANCAP by the international community must be a vindication of the vision of our political leadership whom we sometimes love to hate.

It is said that comparisons are odious and I attempt none on this occasion. However, I do crave your indulgence to make allusion to a few persons who I believe have demonstrated the finest qualities of vision and purpose and leadership in the Caribbean regional dynamic against HIV and AIDS.

I refer first of all to the indefatigable Prime Minister Denzil Douglas of St. Kitts and Nevis who, perhaps more than any other, blazed the trail for the successful evolution of PANCAP from the day of its birth in 2001. At another level, the dexterity and commitment shown by Dr. Edward Greene, Assistant Secretary-General, CARICOM Secretariat, in nurturing PANCAP through the uncertainties of infancy and the vagaries of early childhood must qualify as an award winning performance in organizational engineering.

The name of Dr. Carol Jacobs is not only a household one in the Caribbean but her exploits in leading the Global Fund to Fight AIDS, Tuberculosis and Malaria through a challenging period of its existence have been recognized internationally as well and deserve our applause. Of course, you would know that Dr. Jacobs has been the first and only recipient to date of the Gold Award for highest national achievement offered by the Government of Barbados and this for her stalwart leadership in the field of HIV and AIDS.

Add to that list Ms. Yolanda Simon of Trinidad and Tobago, advocate par excellence for people living with HIV and AIDS for more than a decade, consider the driving force in transforming the HIV and AIDS landscape in Jamaica that is Prof. Peter Figueroa, and contemplate the pioneering work of Dr. Perry Gomez of the Bahamas and one begins to appreciate the embodiment of true Caribbean leadership in full bloom in the field of HIV and AIDS.

These men and women have been some of our true “Champions for Change”. Put in biblical language they are “the salt of the earth” or if you prefer the Jamaican vernacular, they “tallawah”.

It is this type of leadership, pregnant with vision and purpose, that has provided the platform for the successes that have been achieved in the region in the past and will take us to the next plateau.

The recently published evaluation of the first-ever Caribbean Regional Strategic Framework on HIV and AIDS confirmed a number of very significant areas of advancement in the Caribbean regional dynamic against HIV and AIDS over the past five years. For example, it evaluation report confirmed that:

• The prevalence of HIV infection had stabilized across the region and, in fact, had shown early signs of decline in at least three countries;
   
• Mother-to-child transmission of HIV infection had declined in all countries of the region, with no exception;
   
• Although much remained to be done, moderate progress had been made in aspects of treatment, care, and support; while
   
• The level of knowledge about the cause and consequences of HIV infection had risen exponentially across the region, although significant gaps remained in translating such cognition into desirable attitudes and behaviour.

So we do have much to celebrate and we must not be inhibited in doing so. At the same time, we must not forget and the region must not be allowed to forget that our HIV prevalence rate is still 1½ times that of the global average, twice that of North America and Eastern Europe, and more than five-fold that of Western and Central Europe.

In a region as small as the Caribbean, the occurrence of as many as 17,000 new HIV infections and the demise from AIDS of more than 11,000 persons per year must keep us sober, and the projection that life expectancy at birth would have declined by as much as 9-10 years in some countries by 2010 attributable to the disease must keep us honest.

In the objective circumstance, the statistics remain grim and must serve as the impetus for even greater dynamism in leadership and more commitment to high-value actions as we aspire towards the achievement of universal access to HIV and AIDS-related prevention, treatment, care and support services in the Caribbean.

In this regard, the newly-developed Caribbean Regional Strategic Framework on HIV and AIDS, 2008– 2012 is a quantum leap forward and provides the authentic basis for such action and I would like to cite a few areas which I believe could bring high-value rewards for effort. In general terms, I will posit that placing renewed emphasis on prevention of HIV infection, enhancing and sustaining anti-retroviral therapy, dismantling the blight of stigma and discrimination, halting the increasing feminization of the epidemic, ensuring sustainable financing and building a culture of evidence-based decision making will pay huge dividends in accelerating universal access. However, I would like to focus more closely on a few areas that I consider to be ripe for political and community leadership in making a difference.

I invite you to consider with me the role of what I call “compassionate leadership” in advancing human rights and human dignity and human welfare around HIV and AIDS. Each one of can testify to the role of stigma and its sinister companion discrimination in driving the HIV and AIDS epidemic in the Caribbean.

In our Caribbean societies, the evidence of HIV/AIDS-related stigma and discrimination is stark. An indeterminate number of people living with HIV/AIDS opt not to seek treatment, even when within their grasp, immobilized by their palpable fear of stigma and discrimination. People living with or suspected to be living with HIV/AIDS, all too often must suffer the thinly veiled indifference of our health care systems and health professionals, are shunned by friends and colleagues, evicted from their homes by their own families, abandoned by their spouses, ostracized by their communities, denied employment and access to other social benefits, turned down for insurance coverage or refused entry into other countries.

The litany of intolerance is unending, and is an area that cries out for strong political and community leadership in the adoption of affirmative policies, modern legislation and inclusive action to reverse the trend. Perhaps this coming World AIDS Day that will be observed on 1 December under the theme of Stigma and Discrimination will present a golden opportunity for Caribbean political and community leaders to step up to the plate and perform some deed that will be a legacy in this area. Certainly, persons affected would love them for it.

I would also like to address the emotive issue of societal response to the so-called vulnerable groups and, in particular, men who have sex with men, sex workers and substance abusers and in doing so to situate them in the context of the epidemiology of the disease in the Caribbean.

The evidence is incontrovertible that the prevalence of HIV infection is several fold higher among these groups of persons than among the general population. In fact, while general prevalence rates are between 1 and 2% in most countries of the Caribbean, prevalence rates among some of these sub-groups rampage to as high as 30%. These are grim statistics that are irresistible and although I offer no prescription of my own, I certainly implore strong and urgent political leadership, balanced technical and professional guidance and non-pejorative community dialogue as the foundation for responsible action. For act we must and time is not on our side.

I am advised and, as noted before, that the estimated cost of responding to the HIV and AIDS epidemic in the region is in the order of US$200 million annually. Clearly, this is an impossible burden for the Region to bear alone, especially in the face of the many other stern social and economic challenges.

This means that the Region must continue to rely on support from international partners in the form of grants or very concessionary loans, if it were to continue to battle this global threat successfully. I am pleased that so many of our development partners are with us today and I plead the case loudly for your continued empathy and support for the Caribbean cause.

Chairperson, I note with more than passing interest that one of the main agenda items of the Meeting speaks to innovative approaches applied to the HIV and AIDS response in the Caribbean. I must let you know that I am a convert to the imperative of innovation and change in building bridges, challenging frontiers and solving difficult problems. I am therefore very pleased to note this emphasis. My hope is that through careful research and bold innovation the Caribbean will continue to find new answers to this most difficult problem that affects all of us.

As I close, I wish for us to remind ourselves that the race in which we are engaged is one that calls for endurance. There is no quick fix and no magic bullet and none appears to be looming on the horizon. This race is not like the one in which Usain Bolt has excelled and brought so much pride and glory to his native Jamaica and the rest of the Caribbean.

This one requires stamina and resolve, visionary leadership and purposive action, and the marshalling of all the forces at every level to breast the tape and win the prize.

The people across the Region - from Back River and Yallas in Jamaica, to Vielle Case and Grand Bay in Dominica, to Port-au-Prince Haiti and the the Bateyes in the Dominican Republic – depend on us to guide them to the promise land of universal access to HIV and AIDS-related prevention, treatment, care and support services. Let us not fail them.

I thank you.

CONTACT: pancap@caricom.org; 
                 piu@caricom.org