(CARICOM Secretariat, Turkeyen, Greater Georgetown, Guyana) Last year, the global community was confronted with a poignant call from the organizers of the World AIDS Day commemoration to “Keep the Promise: Stop AIDS”. This call found particular resonance in the Caribbean given the high prevalence and increasing incidence of the disease and the dire consequences for the development of the human and social capital.

It is the stark and despairing reality that the number of persons living with HIV infection in the Caribbean today estimated at some 275,000 persons is more than the entire population of many of the Member States of the Caribbean Community. It must be of grave concern to our Caribbean community of nations when, in 2006 alone, more than 27,000 new infections were added to this pool; and when more than 20,000 persons mostly from the most productive age-group of our population succumbed to AIDS-related illnesses. Clearly, this is not a happy situation for the Caribbean especially at this juncture of our history when we are celebrating the launching of CARICOM Single Market January 2006 and now marching forward toward the CARICOM Single Economy.

This year, the organizers of World AIDS Day have retained the tagline to “Keep the Promise and Stop AIDS”, but with a focus on “Accountability”. The emphasis on Accountability is intended to be a forceful reminder to all stakeholders of the imperative of remaining faithful to the commitments in accelerating universal access to prevention, treatment, care and support services for people living with HIV and AIDS.

The call for Accountability comes against the backdrop of a worsening global AIDS epidemic. The 2006 UNAIDS Report indicates that the epidemic not only continues to grow but is showing a resurgence in countries that were previously stable or declining. Indeed, the grim reality today is that infection rates in some of the most populous regions of the world have grown by more than 50% since 2004 and the situation is projected to deteriorate even further in the short term.

During the past year, the Caribbean has enjoyed a measure of success in its response to the epidemic. The rate of vertical transmission of HIV infection from mother to child continues to fall across the region and, in some countries, quite dramatically; the benefits of wider access to antiretroviral treatment have become evident in the lowering of mortality rates; while condom use and other prevention options are on the rise in some of the most vulnerable population groups.

But while these are small successes to be celebrated, we cannot ignore the central fact that the incidence is increasing and therefore so is the enormity of the task that still lies before us. We must in the circumstances all be held accountable to deliver in our dedicated spheres of responsibility.

The establishment of the Pan-Caribbean Partnership against HIV and AIDS (PANCAP) by the Heads of Government of the Caribbean Community in 2001 was a demonstration of unprecedented regional political action in the area of Health (HIV and AIDS); and we are pleased to note the phenomenal successes of PANCAP over the past five years.

The role of PANCAP in negotiating a most substantial reduction in the cost of antiretroviral therapy for the Caribbean; its mobilization of significant resources in support of regional HIV and AIDS programmes; and its recognition as an international best practice are all noteworthy. The work has however only just begun, and PANCAP and all of its partners must be challenged to do more and be held accountable to deliver on commitments.

Without doubt, our greatest commitment in the Caribbean at this time must be to accelerate access to prevention, treatment, care and support of people living with HIV and AIDS. Indeed resulting from national and regional consultations in the Caribbean leading up to the special UN Session on HIV/AIDS June 2006, PANCAP has pledged to move toward the achievement of Universal access to prevention, care and treatment by 2010. This means that we must recommit to the following measures:

o We must continue to advocate and negotiate for the lowest possible prices, not only for antiretroviral drugs, but for all other related commodities as well including laboratory supplies

o Prevention measures must remain central to the national and regional response to HIV and AIDS. Without it, the pool of infection will simply balloon beyond our capacity to respond. This means the implementation of more imaginative programmes aimed at in and out of school youth and more aggressive and targeted condom social marketing programmes.

o We must be bold in confronting the evils of stigma and discrimination and homophobia that are known to be some of the key drivers of the epidemic in the Caribbean.

The Champions for Change process is an attempt by PANCAP to accelerate action by various groups including faith-based organisations, media, youth, parliamentarians, private sector cultural icons and sport persons to contribute toward reduction of stigma and discrimination and toward greater involvement of PLWA in the process of decision-making in the fight against HIV/AIDS.

For its own part, the CARICOM Secretariat remains committed to pursuing its mandate to coordinate the regional response to HIV and AIDS and we will do so with energy and resolve, as we in the CARICOM Community reach out to embrace our partners in the Dominican Republic, Cuba and the Dutch, English and French Overseas Countries and Territories thus giving a truly Caribbean dimension to this venture. In this sense, I call upon all stakeholders and partner agencies to embrace the concept and practice of “Accountability” as we strive together to “Keep the Promise and Stop AIDS”.

CONTACT: piu@caricom.org