THE Ministry of Health has started sourcing the more than $14 billion dollars it needs to implement a five-year strategic plan to tackle the spread of HIV and AIDS.

Dr Kevin Harvey, co-ordinator of treatment, care and support at the ministry told the Observer that they have already identified almost 40 per cent of the required amount. He also noted that the plan is geared towards achieving universal access to prevention, care, treatment and support for persons living with HIV and AIDS.

“The plan cost about US$200 million ($14 billion) over the next five years,” he said. “So far we have Government of Jamaica resources through a loan from the World Bank and local resources as well as grants from the global fund. The plan is funded to about a little under 40 per cent.”

Dr Harvey is hoping that the private sector will step up to the plate and supply the balance.

“Private sector need to play a greater role in providing support and funding,” he said. They have been our partners for the past number of years and we are looking to them to play a greater role.”

The strategic plan has four components – prevention, treatment and care, enabling environment and human rights, and empowerment and governance.

Its main goals are to reduce the transmission to HIV infections; to mitigate the impact of HIV/AIDS on the people of Jamaica; and achieve a sustained, effective multi-sectoral infrastructure and commitment to support the national response to HIV and AIDS.

It is estimated that 1.5 per cent of the Jamaica’s population of 2.6 million people are living with HIV and AIDS. Almost two thirds of these persons are unaware of their status. At the end of 2006 more than 11,000 people were reported as having AIDS since the disease was first discovered here in 1982, while the cumulative AIDS death was over 6,000 people.

The strategic plan fingers some of the main factors driving the epidemic in Jamaica as behaviour, economic and sociocultural issues. It noted that despite a rapidly expanding prevention programme, risky behaviours such a multiple sex partners, early initiation of sex, involvement in transactional sex and non-condom use continues to impact the spread of the disease.

“Persons who deny or are unable to calculate their personal risk oftentimes get caught in the trap of unprotected sex,” said the final draft of the ministry’s HIV and AIDS in Jamaica Strategic Plan 2007-2008. “This fuels the inconsistency between HIV prevention knowledge and behaviour.”

It also pointed out that stigma and discrimination drives those most at risk of contracting HIV underground. Continuing, it said men are more frequently the decision maker as it relates to condom negotiation, which leaves women vulnerable to sexually transmitted infections and HIV. The plan also highlighted the fact that widespread homophobia affects condom distribution in prisons and hinder intervention among men sleeping with men (MSM).

Data among the MSM population is sparse because many of those who are HIV positive refuse to disclose their sexual practices. However, a UNAIDS survey indicated that between 1994 and 1996 the HIV prevalence in major urban areas amongst MSM ranged from 30 per cent to 67 per cent. It is also estimated that the population of MSM range between 9,000 and 27,000.

Meanwhile, speaking to the four main priority areas of the strategic plan, Dr Harvey explained that the prevention component will seek to target vulnerable groups such as sex workers, adolescents, inmates and MSM.

“We are going to be making a major thrust in collaboration with the Ministry of Education which accelerates the health and family life education in schools,” he said.

Additionally, under the prevention component, the ministry also sets out actives aimed at reducing the transmission of new HIV infections. This includes increasing quality prevention services, to strengthen the prevention efforts for sex workers and others engaging in transactional sex and strengthening prevention efforts for inmates in correctional facilities.

Meantime, in implementing the enabling the environment and human rights component of the strategic plan, which will focus on decreasing stigma and discrimination toward people living with HIV and AIDS, Dr Harvey pointed out that stakeholders will have to look at developing anti-discriminatory legislations or reinforcing the existing ones.

“We are looking at amending the Public Health Act to make it more meaningful to provide protection and a resource for health care workers to take action in particular areas,” he said. “So we are looking at providing an enabling environment through policy and legislation.”

The treatment and care component, Dr Harvey added, involves the provision of anti-retroviral (ARV) drugs to persons living with HIV and AIDS, enabling access to quality care services and social support.

Dr Harvey also pointed out that the strategic plan which will be presented to Parliament for approval, will seek to use a research-based approach to implement all four components.