Press release 64/2004
(29 April 2004)

Honorable Secretary-General of CARICOM, Distinguished Ministers and Country Representatives, Colleagues from Regional and International Organizations, Ladies and Gentlemen:

First and foremost, I would like to express our gratitude to the organizers of this meeting for giving us a chance to sign the Grant Agreement between CARICOM and the World Bank to support the implementation of the Pan Caribbean Partnership Against HIV/AIDS.

As it is well documented, the Caribbean Region is facing a major challenge as it now has the highest HIV prevalence rate of any Region in the world outside of sub-Saharan Africa. And the total number of new AIDS cases, reflecting limitations in the care and treatment of HIV infected individuals, has continued to increase in the Region over the last 10 years.

As it claims the lives of more and more workers, AIDS poses an increasing threat to various sectors in the economy and to society as a whole. Today, 83 per cent of AIDS cases in the Caribbean are in the most productive age group, from teens to adults in their early 30s. These are today's and tomorrow's parents and labor force. And as they become infected with the virus, the consequences are more children without parents, classrooms without teachers, farms without workers, and hospitals without doctors and nurses. All the infected persons not only suffer from the disease, but also from the distress caused by the fear and stigma still associated with the disease in many countries of the Region.

In most of the Caribbean, the epidemic has spread beyond vulnerable population groups to the general population, and it has the potential to reverse the hard-won gains in development and to cause turmoil more devastating than any hurricane.

In the face of this challenge, several Heads of State, such as Prime Minister Douglas of St. Kitts, Prime Minister Arthur of Barbados, President Mejia of the Dominican Republic, and Prime Minister Manning of Trinidad and Tobago, has shown extraordinary leadership. The Caribbean countries are fighting back, mounting a strong and coordinated regional response, involving international organizations, regional bodies such as CARICOM, CAREC and the University of the West Indies, international foundations such as the Clinton Foundation, and community organizations such as the Caribbean Regional Network of People Living with AIDS, and the Caribbean Council of Churches.

The Pan Caribbean Partnership, under the leadership of CARICOM, is already an international best practice that influencing other Regions to adopt similar arrangements. For example, the Central American leaders are starting to emulate the Caribbean example.

The World Bank, my friends, has a clear mission "Our dream is a world free of poverty." But we know that until the AIDS epidemic is reversed, that mission will remain precisely that, only a dream, since AIDS is a major impediment to development in many countries around the world.

As we announced in three years ago, the World Bank is committed to support the Caribbean efforts to address in an effective manner the HIV/AIDS challenge. Under the US$155 million dollars Multi-Country HIV AIDS IN THE CARIBBEAN HIV/AIDS Prevention and Control Program for the Caribbean that was approved by our Board of Directors in June 2001, we are already supporting the national efforts in Barbados, the Dominican Republic, Jamaica, St. Kitts and Nevis, Grenada and Trinidad and Tobago, Guyana and now the regional efforts under the Pan Caribbean Partnership Against HIV/AIDS.

The overall commitment of World Bank resources to support the struggle against HIV/AIDS in the Caribbean has now reached US$109 million. And, if the counterpart funds of the countries are added, the total amount already allocated under the program amounts to more than US$115 million.

The preparation of projects in Saint Lucia and St. Vincent and the Grenadines is well advanced, and we expect that they will be approved by the end of this year or at the beginning of 2004.

The US$9 million dollars grant allocated to support the Pan Caribbean Partnership Against HIV/AIDS will support regional institutions such as CARICOM, the University of the West Indies and the Caribbean Network of People Living with AIDS, to undertake research on region-wide policy issues, establish communication networks between people living with AIDS, and provide assistance to national Governments in policy formulation and program implementation. Also, support would be provided to the Caribbean Epidemiology Center (CAREC) to expand and upgrade its regional laboratory capacity to conduct CD$, Viral Load and Tuberculosis testing to assist in the scaling up of AIDS treatment in Region, and its information systems to improve the regional surveillance capability.

The program that the World Bank is supporting since 2001 is already giving the Caribbean countries tools to make an immediate impact on the AIDS epidemic. This assistance is allowing the countries to explore new institutional arrangements, to educate people about the epidemic, to reduce risky behaviour associated with the onset of AIDS, and to scale up treatment and care activities.

For instance, in the Dominican Republic, different line ministries are now implementing multisectoral action plans under COPRESIDA, the Presidential Commission on HIV/AIDS established by President Mejia in early 2002. A similar arrangement has been put in place in Jamaica, Grenada, Guyana, St. Kitts and Nevis and Trinidad and Tobago. Also, the Punta Cana Group, the largest hotel and resort consortium in the Dominican Republic, is involved as part of the project in the fight against AIDS; this is a good example of corporate social responsibility in the Caribbean that needs to be replicated throughout the Region.

With the support of the World Bank-financed project, the Government of Barbados put in place in 2002 all the necessary building blocks for scaling up its treatment program with anti-retroviral drugs. Among them are investments for establishing the Lady Mead AIDS treatment facility that includes space for voluntary counselling and testing, laboratory, pharmaceutical, and nutrition services benefiting more than 600 patients already. Laboratory equipment in place in this facility and staff training was provided for HIV ELISA testing, management of opportunistic infections, and CD4 count and Viral Loan Testing. Procurement processes have been established for increased quantities of anti-retroviral drugs, treatment protocols have been adopted, and an increased allocation of budgetary resources in real terms to support the operation of the program has been agreed with the Government of Barbados.

Finally, we believe that a comprehensive regional approach led by countries themselves with support from the international community is key to curbing the spread of the epidemic in the Caribbean. The overarching goal of the international community should be to assist every country in their efforts to implement comprehensive and multi-sectoral programs that include prevention, treatment and care and institutional development.

To conclude, my friends, I would like to quote the President of the World Bank, Mr. James Wolfenshon, as the guide for our work in the Caribbean Region.

"There is simply no reason why generations of people should disappear as a result of AIDS. AIDS is an international security problem, and as such it needs a war chest and a rigorous strategy for achieving results."

The challenge, therefore, in the years ahead is that each of us must get actively involved to win the fight against AIDS in the Caribbean.

The best advocacy is action.

Thank you.