Key note speaker Sir George Alleyne, United Nations Special Envoy for HIV/AIDS in the Caribbean

"There was a fifth horseman of the Apocalypse and his name is AIDS," said Sir George Allyene, United Nations special envoy for HIV/AIDS in the Caribbean as he delivered the keynote speech at the inaugural summit. Allyene said "prophets of doom" predicted the "kiss of death" to the Caribbean economy as the numbers of infected persons continue to rise.

The first Caribbean Summit on HIV/AIDS took place Sunday at the Buccaneer Hotel on St. Croix. A welcome reception was held Saturday evening at Government House, Christiansted. Present were mnisters of Health, government officials and community stakeholders from several Caribbean countries including US Congressman Donald Payne, a member of the International Relations Committee and founding member of the Friends on the Caribbean in Congress and V.I. Delegate Donna M. Christensen, Congressional Black Caucus Health Braintrust chair.

The summit's aim was to explore ways the Caribbean and the US government could collaborate to bring added economic stability to a region which, on the whole, has fewer resources to deal with a growing HIV/AIDS affected population.

During his keynote address Allyene spoke about the relationship between HIV/AIDS and a booming tourist economy suggesting that commercial sex plays an important part in the transmission and spread of HIV/AIDS. He also said using a per capita income as an indicator of the prevalence of the disease is a "fallacy."

Saying that HIV/AIDS is one of the top five causes of death in the Caribbean, Allyene remarked that the rise in adult mortality associated with the disease is causing, among other things, the reduction of work productivity, absenteeism, illness and impaired morale because of the stigma that comes along with being diagnosed with HIV/AIDS. For a society living on the edge of poverty, having to use funds on medical expenses can "drive a family into abject poverty."

"More attention needs to be given to prevention," Allyene said. Another indicator fueling the spread of HIV/AIDS is the "gross inequality in the power between the sexes," according to Allyene. He said although on the whole, women are better educated; they are at a disadvantage when "negotiating sexual relations." To combat this inequality, Allyene advocated more accessibility to the female condom and a reduction in its price.

"The female condom is five times more expensive" than its male counterpart, he said. Allyene pointed out another emerging problem that could potentially increase the spread of the disease in the Caribbean - the free movement of people in the region including those with HIV/AIDS. "Will the countries be able to treat the people?" he asked.

Allyene said he looks forward to the day when "the Caribbean as a whole passes a law to make it illegal to discriminate against people with HIV/AIDS.

Congressman Payne, of the New Jersey district revealed a startling fact – 46 percent of all HIV/AIDS patients living in New York City are from the Caribbean. He said the US government was previously reluctant to send these patients back to their homeland where the ARV drug was not readily available, but with more Caribbean countries having the treatment, more infected Caribbean people will be sent back to their place of origin.

John Maginley, Antigua and Barbuda's Minister of Health, Sports and Youth Affairs said women aged 15 to 29 are the fastest growing population of HIV/AIDS infected persons in his country. Pointing to the plague of commercial sex workers, he said in a country with a population of 75,000 having 4 to 5,000 sex for hire workers is a "huge challenge." Antigua offers free antiretroviral (ARV) treatment "but can we provide it for all undocumented persons?" he asked. Maginley said Antigua is also concerned about the influx of persons from other countries that will come with free movement.

The Caribbean Community and Common Market CARICOM has recently modified the mandate for free movement which gives residents the right to seek employment in any member state eliminating the need for work permits and permits of stay.

Maginley also questioned if the campaign waged to inform residents on HIV/AIDS is reaching their intended population. Additionally, the issue of health care workers leaving Antigua for better pay in the US and Canada is crippling the health care industry. 

Jerome Walcott, Barbados Minister of Health, lightened the mood of conference as he revealed that Barbados has made some progress turning back the tide of the HIV/AIDS pandemic. He said a loan from the World Bank allowed Barbados to embark upon a vigorous program to supply ARV to those who need it. "We can see the immediate benefits," said Walcott. He said he would like to see the reduction in the price of the ARV treatment and the introduction of generic drugs which would reduce the cost even further. The Barbados minister reiterated the sentiments of his colleagues asking if the message of prevention is getting through to the target population. He also expressed that stigmatization prevented people from getting tested and treated. The free movement of people was also of great concern.

Haiti is second only to Africa in reported cases of HIV/AIDS, the region has 190,000 with the disease according to Dr Robert Auguste, Haiti Minister of Health. "The challenge is to have more people on ARV treatment," he said. Presently there are 7,000 persons taking the treatment, according to Auguste, but the goal is 20,000. "With limited economic resources, the future is uncertain," Auguste said.

St Lucia Minister of Health, Stephenson King, listed some startling statistics regarding HIV/AIDS cases in that country. He urged governments to speak out and develop new policies to deal with the crisis and provide free ARV treatment and counseling.

Payne advised the heads of government to apply for the PETFAR program funds to help in the HIV/AIDS fight. PETFAR is a $15 billion initiative of President George W. Bush which uses treatment and education to combat the AIDS epidemic in Africa and other threatened regions.

"CARICOM has to make a bigger and stronger demand for funds," Payne said. "If you stand up and say you have a problem, I believe funds can come."

In the remainder of the one day summit panels held various discussion on issues surrounding HIV/AIDS in the region including private sector and governmental intervention and creating policies and legislation for HIV/IDS treatment and prevention.