I welcome you to this meeting in my capacity as Chair of the Planning Committee and wish to let you know that it was my privilege to work with such a dedicated Team. On behalf of the Team I wish to acknowledge the role played by the Honourable Denzil Douglas, Prime Minister of St. Kitts and Nevis who initiated the idea of such a Conference at a Breakfast meeting with Prime Minister Tony Blair who in turn fully supported the activity which manifested itself in the funding for the Conference and the collaboration and active participation by the DFID staff in this venture.

This Conference is a significant landmark in the fight against HIV/AIDS in the Caribbean. We are gathered here to address one of the major factors contributing to the spread of HIV in the region and in the world. Tonight and for the next two days the Region is showing gumption by taking the initiative to address the issues of stigma and discrimination.

Modern society has not experienced such high levels of stigma and discrimination associated with a disease until the advent of HIV. The mere mention of HIV engenders fear; fear of being infected, fear of death; but more, so fear of being stigmatized and discriminated against; and fear of being ostracized. Stigma devalues and discredits people, generating shame and insecurity, which manifest themselves in behaviour that exacerbates the spread of the infection. For example, infected individuals may not use condoms or lactating mothers may not wish to stop breastfeeding.

HIV/AIDS related stigma and discrimination have a negative impact on prevention, care and treatment measures instituted in the National HIV/AIDS Programmes. People infected with the AIDS virus are apprehensive of interacting with the Public Health Services for fear that their HIV status will be disclosed. Consequently, they deny themselves of critical medical care and attention.

Our Public Health Services in the region need to provide a level of service that recipients feel comfortable with and have confidence in. A large percentage of HIV positive persons lack confidence in the Public Health Service. Controlling the HIV epidemic would require the active utilization of the Public Health Services. In order for this to happen, there is need for a restructuring and reorientation of the Public Health Services and reorientation of the related systems of care and support. The Public Health Services need to provide an enabling environment, where clients accessing the services will feel assured that their HIV-status will not be disclosed, nor will they be stigmatized and discriminated against by the health care providers.

Within the Public Health Service there is need for training and retraining of the health care workers to deliver services in a non-discriminatory manner. In this regard we need a cadre of champions for change: a change of attitude, a change of values, a change of behaviour both on the part of the affected and the infected. In reorienting the health services, particularly at the primary health care level, consideration needs to be given to the employment of PLWHAs. It is important to note that one of the lessons resulting from the discussion of experts earlier today is that some of the most powerful efforts to curb HIV/AIDS - related stigma and discrimination are driven by the involvement of people living with or affected by, HIV/AIDS.

It is my fervent belief that emanating from this conference will be champions for change at all levels of society and sectors: champions that truly make a difference. This is by no means a veiled assumption. It is one is made against the backdrop of the multi-sectoral and multi-disciplinary nature and high calibre participants engaged in this venture.

Stigma and discrimination are not new phenomena. They have existed since biblical times. Many would recall how lepers were treated then and until recently, in the Caribbean. It is significant to note that there has been a change in the attitude of Caribbean people towards Hansen's disease and those infected with it. The name of the disease has changed. People infected are no longer referred to as unclean or lepers. It is important for us to reflect on the factors contributing to this societal attitudinal change and to apply some of the lessons learnt to reduce HIV/AIDS related Stigma and Discrimination.

During the next two days of deliberation, the meeting will seek to achieve the following objectives: 

• Identify culturally appropriate tools to reduce stigma and discrimination that policy makers can develop and political leaders can endorse. 
• To present progress to date and to set out the challenges for the Caribbean. 
• To define the role of leadership in advocacy and implementation; and 
• To define the framework for an action - oriented programme.

Earlier today a group of experts met to deliberate on some of the more technical aspects of our topic. They will help us to focus on the lessons learned, on the models by which our parliamentarians may advance legislation to protect the human rights of PLWA; on the modules by which our educators may socialize our youth into patterns of behavioural change; toolkits of factual material around which our pastors and religious leaders may shape their sermons to stir their congregations into active engagement to alleviate the fear and suffering of infected brothers and sisters and to relate to HIV/AIDS as an affected group. 

The lessons, too, evolve for the business leaders, for whom the workplace must become a supportive environment, sponsoring opportunity rather than rejection. They also are bountiful for our cultural icons and the media that must utilize the instruments of their trade to advise, counsel, scold, and transmit a message of hope tempered by behaviour change, of love accompanied by meaningful community support, and of compassion based on respect and a believe in human dignity for all. 

If this Conference merely produces a critical mass of champions for change in the fight to reduce Stigma and Discrimination, it would have satisfied the minimum requirement. 

But I am confident that as champions you would go the extra steps. This involves not only the development of plan of action, but also of making concrete commitments to implement the action plan by ensuring that it becomes road map that encompasses a broader and broader band of champions within your group, among your stakeholders in the community, in the country where you live in the region where we share a common bond and in the world for whom we can yet be a role model in this noble challenge of champion the reduction of stigma and discrimination against PLWAs willing to fight stigma and willing to stamp out discrimination. 

I implore you that the time to act is now.