On November 30, 2011, the Ministry of Health and Environment issued a press release just in time for world aids day to be observed on December 1, 2011. In the release stated that AIDS related deaths and cases among the adult population has decreased from 665 in 2004 to 333 in 2010. This represents a 50% decrease in annual AIDS deaths since univeral access to anti-retroviral (ARV) medicine has been granted in 2004. According to Dr. Nicola Skyers, Acting Director of the national HIV/STI programme, the results can be ascribed to the improvement in the monitering, care and support of persons living with HIV (PLHIV).

This information comes at a great time as the theme for world AIDS day is getting to zero.i applaud the Ministry of Health and Environment for the progress that they have made in our efforts to get the HIV and AIDS death rate down to zero.

There have been speculations that climate change will result in changes in agricultural production, an increase flooding, typhoons/hurricanes, earthquakes and other problems. This claim has prematurely borne these catastrophic events as we have been continuously experiencing these events within the last ten years. According to Population Action International “Unfortunately, most solutions to climate change have focused on restricting emissions of greenhouse gases and supplying the governments of poor countries with another alleged consequence of climate change is the spread of vector-borne and bacterial diseases. As with climate in general, these diseases are a problem today and they affect the poor far more than the wealthy. Vector-borne diseases, such as malaria and dengue, are essentially diseases of poverty.

Many countries that are today wealthy once experienced levels of vector-borne diseases similar to those now experienced by poor countries. In the fourteenth century, one-third of Europe’s population died from the Black Death, which was spread by fleas that thrived on rats living in the sewers of medieval towns. Wealthy countries have largely eliminated such diseases through a combination of environmental interventions (such as the use of pesticides), improved water and sanitation systems, and the development of vaccines and medicines.

Every year, between one and three million people die from malaria. A similar number die from dehydration as a result of diarrhoea. Around 2 million people die from respiratory infections. Most of these 6 million total deaths are children, all of them are poor, and most of their deaths are preventable. Some of the factors that affect disease transmission include:
Malnourishment: Poor people tend to be less well-nourished than wealthy people. They often eat a diet based on staple foods, and lack essential vitamins and minerals. The effect is that their defense systems are weaker and less able to fight off disease. Paradoxically some rich people also suffer from malnourishment, but this is a consequence of the voluntary consumption of inappropriate types and quantities of food, rather than lack of access to nutritious food. The dietary mishaps of the rich can be simply rectified by choosing to eat a better diet; this is not an option for the poor.

I decided to write this blog post in response to comments made by the Ambassador of Korea Mr. Geun-hyeong Yim yesterday at the Rio+20 on sustainable development briefing. During his presentation Ambassador Hyeong Yim outlined the 7 key priority areas to be focused on at Rio, however within these areas there was no mention of health. As a SRHR/HIV&AIDS youth activist I was personally disappointed on how little the UNFCCC and RIO organizers regard the issue of Health specially SRHR as a key component of their sustainable development advocacy and work. The sustenance of a healthy population will no doubt result in a growing, sustained, progressive and developed society.

The World Bank reported in 2009 that average age of life expectancy is 69.4 with some countries averaging as low as 32.1%. Many of these countries are continuously plagued with health related issues such as an increase HIV/AIDS cases, Malnutrition, starvation among others. While many of these epidemics are not as a result of climate change there are those that are direct results of famine, floods, migration caused by climate change, lack of potable water, relocation caused by hurricane/typhoons and diarrhoea. In regions and countries that predominately depends on agriculture as their main source of income the increase in temperature will negatively affect the mode of income and as such will result in the loss of crops, and loss of income, livelihood. The perpetual health related deaths caused by climate change have and will continue to negatively affect the sustainability of our individual, regional and international communities.

Coupled with the issue of health is that of population, the UN celebrated the 7th Billion person in October of this year, however there are reports coming out UN that some areas are too populated. The scarcity of resources will no doubt lead to limited and unbalance distribution creating an even greater gap between the rich and the poor. Population growth is already putting a strain on the world’s limited supply of freshwater. According to the Food and Agriculture Organization on the UN more than 45 countries are currently experiencing water scarcity, this situation will no doubt leave many at greater risk of poverty or disease especially our vulnerable population: those living with disabilities, women and children.
It is evidently clear that there is little cohesion among the UN agencies as simple areas of cohesion and correlation would not have been ignored. I therefore call upon the United Nations, its member states, international civil society to acknowledge the interconnectivity of all social, economic and politic issues and approach each not as a separate issue but as a result of or cause of.

UN Secretary General Ban Ki Moon mentioned in his presentation yesterday that “UN must continue to deliver as one” it’s time we begin to practice what we preach!!

December 1, 2011, a day recognized world wide as World AIDS Day, saw youth and policy-makers at the 2011 International Conference on Family Planning (in Dakar, Sengal) gathered for an event titled "Realizing Promise: A dialogue between policy makers and youth."

This event essentially was geared towards provided a space for meaningful discussions between young people and policy makers on issues related to adolescent and youth sexual and reproductive health and rights (AYSRHR). The discussions were led by the nine panellists three of whom were youth  who were voted by all the young people who attended a pre-conference workshop hosted by the Population Reference Bureau (PRB) to represent the youth voice. The other 6 panellist were all policy makers representing different ministires and organizations including Kenya's Ministry of Health and Ministry of Youth and Sports, the Ministry of Health and Social Welfare in Tanzania, USAID and UNFPA. As moderator for the session I used the opportunity during my opening remarks to stress the need and importance of partnerships as we move forward...

In sum the event provided a great platform for the discussion of several key areas. The youth statement which had been prepared and presented at this event highlighted several issues including the need for you engagement and participation in decision making, ensuring youth have access to information and services and support for youth led programs.

Essentially we all agreed that there is a need for greater collaboration between youth and decision makers as we move forward to advance adolescent and youth sexual and reproductive health and rights.

Coming out of the session:

Some strategies/ best practices that we should employ as continue to work in field of AYSRHR that were highlighted are:

1. Continous engagement of adolescent and youth in the design, implementaion, monitoring      and evaluation of AYSRHR programs.
2. Set funding for youth programs.
3. Provision of leadership training for youth.

Additional areas for further exploration and development that were noted include:

1. the developmwent of youth policies, national youth councils.
2. further exploration of how to reach youth who are most in need/ marginalized youth.
3. How to encourage greater civil society participation.
4. How to change the mindset of persons who seek to undermind our progess.

As we move forward from this event and from the staging of the conference I must highlight that each and everyone of us has responsibilties and roles to play in realizing the promise.

Learn, Engage, Change!!!

Many strides have been made over the last thirty years to control the spread of HIV. In the 1980s, HIV was a death sentence for people right across the world. People, at least those who were compassionate and empathetic not to stigmatize and scorn people living with the disease, could do nothing but sit and watch their loved ones die in agony.

Thankfully this is no longer the situation. Financial commitments made by several developed countries, political leadership by many governments and the passion and dedication of many people, there are effective methods to preventing infection and there is life saving drugs to keep people living with HIV alive. In fact, HIV and AIDS research have advanced, so much so that this year the National Institute of Health announced that antiretroviral drugs used to treat people living with HIV is also effective in preventing HIV infection.

As I pen this blog, I am forced to reflect on the first time I knowingly met someone living with HIV in 2002 at my church. I too had my fears, like many persons I knew. I was astounded that I sat in a workshop with a man, whose name I have forgotten, and couldn’t tell he was “one of them”. He looked just as healthy as the rest of us, despite being diagnosed for more than 10 years at the time. I am forever grateful to him for having disclosed his HIV status, sharing his experience and knowledge and being so patient with my hesitation to hug him after this revelation.

The AIDS response has enabled many people infected and affected by HIV to speak out about their realities - hardships, successes, you name it. It has challenged us in so many ways to care for people as people and not put a veil over our faces because of who they are or what they do. Personally, I never imagined that I would have known so many sex workers and love them so dearly. I never imagined that I would have been so comfortable with people living with HIV. I never imagined that I would have become a human rights advocate for these people. 7,000 people worldwide become infected with HIV daily. 3000 of them are young people. These 7000 people often put themselves at risk because of our prejudices. Our prejudices deny them information, access to prevention commodities such as condoms and lubricants, services and even lifesaving treatment.

The stark realities of HIV show us, in so many ways, the harmful effects of stigma and discrimination, laws, violence, etc against minorities and vulnerable people. Across the Caribbean young people, men who have sex with men (MSM) and sex workers are among the most vulnerable to HIV infection. Arguably, MSM have the strongest representation in our response. Sex workers are becoming more organized and young people continue to challenge the status quo and mainstream their issues. Sadly, despite many campaigns, people living with HIV can hardly be found and as a result, we still have to be talking with and for them.

What will happen now that the Global Fund to fight AIDS, Tuberculosis & Malaria (GFATM), which has put over 3 million people on treatment in the last ten years or so, has announced the postponement of its next round of funding? Regrettably, this has happened despite commitments made at the High Level Meeting on HIV in June 2011 by member countries of the UN to increase funding and sustain the gains made over the last 30 years. Now, the progress we have all made together may begin to reverse in the coming years because of a lack of funding. This postponement will have the most devastating impact on people living with HIV. People who are not already on treatment may have to pay, but many of them cannot afford this. Can we continue to speak for people living with HIV? Can they continue to hide in the shadows others who are coming out and fighting for their own needs?

So will the people who are most affected stand up?

Delsie-Ann Bailey unavoidably missed out on an important part of her teen life -- senior year. She was unable to celebrate like other teens her age. She missed her senior prom because at age seventeen she became pregnant.

When I leave College and return home to be a mother, “I stop to think how my life could have been different,” Delsie-Ann said to a group of young environmental and reproductive health activists at the One Voice Summit on October 28, 2011 in Washington DC. There were no sex education classes in her high school. Delsie-Ann like many other teens have suffered as a result of the absence of comprehensive sex education, which teaches children, adolescents and youth about abstinence, faithfulness and using condoms and other modern effective contraception.

Delsie-Ann was born in St Catherine, Jamaica. She moved to North Carolina in the United States at an early age. Many people in the developing countries would expect that sex education would be standard for American teens. Today, Delsie-Ann works part-time and attends college full-time. All this she manages while being a teen mom and she still finds time to volunteer with other teens in North Carolina to advocate for comprehensive sex education as well as train teachers how to teach sex ed to teens.

Comprehensive sex education is desperately needed to encourage adolescents to delay sexual debut, reduce sexual partners and teach young people to communicate and make safe decisions about sex.

“No one should have to go through the things I had to go through,” she said. “I advocate because I realize that not only does my work affect people now but also my daughter’s generation.”

Over $1.5b has been wasted on abstinence only until marriage programmes in the USA. Thanks in part to the work of many people, including Delsie-Ann and her colleagues; there is now a Teen Health Act so hundreds of thousands of young people in North Carolina can learn about and safeguard their sexual and reproductive health.

This is remarkable because two young people become infected with HIV every hour in the United States. The rates have stabilized over the years but it is increasing rapidly among young people, particularly among young men of colour who have sex with men, especially young black men.

There is also more good news. About 21 States and the District of Colombia mandate that schools teach sex education, 32 States teach HIV and STD education and 23 States request that abstinence be stressed.

It is important for Christians and other people of faith to learn about their sexual and reproductive health and rights. This is especially important, given the dominant role institutions of faith, such as the Church, play in many countries (even where the Church is said to be separated from the State). After all HIV does not exclude an individual based on their socio-economic status, location or religious belief.

Last week, August 15-21, 2011, I was in Madrid, Spain with a group of other activists from several countries, including Ireland and Poland where the Catholic Church has a great deal of influence. Every four years, Catholic young people from every Diocese across the world meet for what is called “World Youth Day.” This time it was in Spain (one of the most beautiful cities I have ever visited). We were there (as a coalition) to bring the message that “Good Catholics Use Condoms” and “Condoms Save Lives” as well as thank the Pope for acknowledging that condoms are effective in preventing the spread of HIV.

It was an interesting, fun and tiring week to say the least; but it was also very instructive for my own work in Jamaica.

Do Good Catholics Use Condoms?
There were hundreds of thousands of young people clad in bright coloured shirts carrying and waving their country flags, singing and routinely shouting ‘Papa’ --the Spanish word for Pope.

I couldn’t understand what there were singing about or what they were saying and I had very little idea about what they --the pilgrims as they are called, at the World Youth Day 2011 were doing in Madrid. Much of it appeared to be a big gathering of Catholic youth in an organized chaos. Despite my ignorance or perhaps the ambiguity surrounding the events, I had one mission -- give as many people as possible a sticker and a post card. I wanted them to know they have and will not defy the “moral code” if they have use a condom. Additionally, encourage people, irrespective of age, to use a condom if they are in circumstances that they must be sexually active.

I knew the Catholic Church (or perhaps it is just the hierarchy and a few “blind” followers) does not support the use of condoms or any other form of contraceptive for that matter. Interestingly, despite their leadership in treatment and care for people living with HIV (PLHIV) their position about condom usage does not change.

Clad in my red shirt marked “condoms save lives” I stood with my friends in Puerta de Sol --the heart of the city-- in the early morning and late afternoon bringing and sharing this wonderful message to Catholic youth, the Bishops and nuns (at least those who would take our materials) and people who live in Madrid.

“How can you be Catholic and use condoms,” some would whisper as they passed us.

“Abstinence!” a few would shout.

More...

Sex is one of the farthest things from the Christian ethos, except when you are constantly reminded that fornication and adultery are sins. So much so that many of us are raised to believe that a relationship is for the man and woman to procreate. Forget about variances in relationships and that the vast majority of people, even Christians, do enjoy sexual intimacy.

There was no talk of sex in our children and youth groups at church. There were one or two lessons in secondary school about sexual and reproductive health but I was hardly attentive, as I didn’t see the need for all this adult talk.

I grew up with strong Christian values. I got baptized at age 11, in July 1998. I knew very little about sex and the reproductive system. I would cover my eyes when there were kissing or sex scenes in movies. I guess you could call me a “true Christian.” I was very uncomfortable talking about my body parts and issues related to sexuality. I have overcomed those long ago, but there are still many young people who undergo siginificant discomfort in this regard.

In the “Pairability” episode of The Glee Project, an American reality television series which serves as an audition for the FOX TV musical series Glee, Cameron, one of the contenders, broke down in tears when Lindsay (another contender) kissed him during the music video recording of "Baby, It's Cold Outside" by Frank Loesser. I am sure many fans of Glee and now the Glee Project were alarmed at his reaction. Many may think he is just plain stupid. So many guys out there would die for a beautiful girl to kiss them voluntarily, but not Cameron.

Why would a teenager be so terrified at something many of us do so casually without any thought? Cameron is from a Christian home in Texas. He admitted that he is not comfortable with kissing girls and talking about sex in the episode called "Sexuality". There are many young people across the world like Cameron who have similar fears about sexuality. There are many reasons for this. However, much of this is because of their Christian upbringing and the absence of comprehensive sex education lessons at school.

Human Rights Watch, in a publication entitled Unaccountable: Addressing Reproductive Health Care Gaps (2010), notes that there are many obstacles, including cultural, religious and financial, that act as ‘barriers to services and information, inadequate care, [and] discrimination’.

Why is it that religion and culture has had such a big influence on issues related to sexuality? How many church in your community has a space for young people to learn about sex and reproductive health? Do churches even have a policy on this? Why is the church so silent, except in instances where they feel a need to protect the "morals" of society?

I strongly believe the church must do more to ensure young people can safeguard their sexual and reproductive health. To prevent unplanned pregnancies. To prevent the transmission of sexually transmitted infections, including HIV. The church must ensure their young people are being given condoms and other safe sex commodities, but they are not doing that.

One of the most well known opponents to this liberal approach to sex and sexuality is perhaps the Catholic Church. Many know the Pope for his strong views on using condoms. And if you have been to a HIV related meeting, you most definitely would have been upset by the Holy See's statements during UN Meetings for example. Beginning August 13, 2011, observed as International Youth Day, I would be a part of a coalition Catholics and non-Catholics alike to challenge the Catholic hierarchy during the World Youth Day Conference in Madrid, Spain.

Stay connected to this space, as I will be focusing on religion, particularly Catholicism, and its impact on the sexual and reproductive health and rights of young people.

Follow me on Twitter: @jaevionn

While reading the daily paper on Monday of last week I came across a letter to the editor entitled “Stop HIV Pre-Employment testing” which immediately drew my attention. Dr. Rattray a well-known physician wrote the letter complaining of an ordeal a patient of his had to face for job-required physical, Dr Rattray wrote that the female patient had to submit herself to blood tests that included mandatory HIV-antibody screening and sign a document agreeing that the results should go to her new potential employer (a well-known international company), this was later confirmed by the human resource manager of the company through a telephone call with Dr. Rattray. The Human resource Manager reported that it was company policy for the HIV-antibody test to be included in the 'routine' physical and explained that the patient was on probationary employment.

Now I found this occurrence as not only disturbing but also as a setback for treatment, care and support for those infected within the Jamaican society. After many attempts by International and national legislation it is shocking to learn that companies still require mandatory testing for employment. Are you serious, let’s be reminded that HIV/AIDS cannot be transferred through sharing simple office supplies such as pens, papers, desk chairs.
I had the privilege of taking a Labour and Employment Law course at the UWI and was fortunate to write a paper on the nature and scope of the HIV/AIDS Workplace Policy by the Ministry of Labour that was passed in Parliament in February 2010. The policy visibly stipulates that there should be no workplace HIV-antibody testing (whether for pre-employment screening, pre-contractual screening, for promotions or renewal of work contracts). The Ministry of Health is currently in the process of finalising its HIV policy from the perspective of the workplace.

In addition there is the ILO Code of Practice on HIV/AIDS and the World of Work states, "HIV/AIDS screening should not be required of job applicants or persons in employment." The Caribbean Tripartite Council/Pan Caribbean Partnership against HIV/AIDS - Model Caribbean Workplace Policy on HIV/AIDS stipulates under HIV screening, recruitment and employment that: "The organisation will not compel an employee or a job applicant to disclose his or her HIV or AIDS status, or that of any other person."

With both national and international legislations prohibiting such actions I still cannot comprehend how and why a company would continue to implement such a policy. This further puts the fight against discrimination and stigmatization a step back which is all too sad. It will no doubt affect PLWHA and their family. I honestly wish one of our many parliamentarians or a good lawyer saw and read this letter and have contacted the victim with the intention of addressing the problem.

Let me try to explain the concept of Universal Access to HIV prevention, treatment, care and support services and the High Level Meeting on HIV/AIDS in June to you in five minutes.

In 2006, our governments made history at the United Nations when they committed to scale up the HIV and AIDS response globally. In the Political Declaration on HIV/AIDS they promised us to move towards universal access to HIV prevention, treatment, care and support services to all those who are in need. This includes sex workers, men who have sex with men (MSM), intravenous drug users (IDU) and people living with HIV (PLHIV). In fact, this commitment has its roots in the Declaration of Commitment on HIV/AIDS, which they agreed to in 2001 (one year after signing the Millennium Development Goals).

However, despite the series of time-bound commitments to expand their efforts to address HIV by 2010, there are still a number of shortfalls in the response at the community, national, regional and global levels. For example, young people, especially girls, intravenous drug users, sex workers and men who have sex with men, account for a significant portion of HIV cases worldwide. Although, UNAIDS data published in July 2010 shows that we are leading the prevention revolution in sixteen of the most affected countries, we account for more than 30% of new HIV infections. In the Caribbean, while there are no readily accessible disaggregated data by age, there are fifty new infections every day. Additionally, new infections are outpacing treatment. For every fifty persons on anti-retroviral treatment there are seventy new infections.

Universal access is the culmination of all these commitments and serves as a mid-point to reaching the Millennium Development Goal (MDG) to halt and reverse the spread of HIV by 2015. Universal access is a call for more equitable, affordable and comprehensive HIV services and is a platform for social justice.

2011 marks 30 years since the first case of AIDS was identified, 10 years later since the landmark UN General Assembly Special Session on HIV/AIDS, and five years since the 2006 High Level Meeting where the universal access commitment was made. The impetus for our action is that there are far too many persons who are still in need of services. In addition, many of our governments have allowed themselves to become complacent after recording some success. As such we should use the High Level Meeting in June 2011 as an opportunity to build unprecedented progress in addressing this global health and development crisis and galvanize our countries to a transformative agenda that overcomes remaining barriers to effective HIV services and build inclusive country-owned sustainable responses.

I hope I did it!

Source: UNAIDS Report (2011) Universal Access to HIV Prevention, Treatment, Care and Support: From Countries to Regions to the High Level Meeting on AIDS and Beyond

Is zero new HIV infections and zero AIDS-related deaths by 2015 really attainable?

More than twenty young people from across Jamaica will meet on April 9, 2011 to critically assess that possibility based on the lived reality that they confront on a daily basis. They are expected to do so against the background of rape, incest, lack of condoms, sexual diversity, discrimination, etc. The already brewing militant mood of these youths is expected to be central to their recommendations to the Government in preparation for Jamaica’s participation in the United Nations High Level Meeting on HIV/AIDS in New York in June 2011.

There is steady progress towards achieving Millennium Development Goal (MDG) 6 - to halt and reverse the spread of HIV/AIDS by 2015 globally. UNAIDS Executive Director, Michel Sibide, echoed that sentiment by insisting that the energy of young people must be harnessed for an HIV prevention revolution. “We are well on our way towards an HIV-free generation”, he said. But it is no secret that such a revolution must however be quick in coming so as to reverse the fact that in the Caribbean fifty persons become infected with HIV everyday. Additionally, new HIV infections are outpacing treatment in the Caribbean. In 2009, for every 50 persons starting antiretroviral treatment (ART) in the Caribbean, there were 70 new HIV infections.

According to Dr. Pierre Somse, UNAIDS Representative for Jamaica, “this is of great concern because far too many young people in Jamaica do not know how to correctly prevent HIV transmission while they are having sex from as early as 13 years. That is why UNAIDS is happy to be involved in this consultation”.

The consultation, entitled “Getting To Zero & The Road to Universal Access”, is being convened by the Jamaica Youth Advocacy Network (JYAN) with technical assistance from UNAIDS. JYAN is an independent voluntary youth-led non-governmental organisation (NGO), which represents the interests and aspirations of youth across Jamaica. Participants at the consultation comprise of persons from JYAN, the Jamaica Youth Ambassadors Programme (JYAP), Eve for Life, National AIDS Committee (NAC), Ashe Performing Arts Company, UNFPA Youth Advisory Board, Clarendon College and UWISTAT, National Secondary Students’ Council, among others.

According to Jaevion Nelson, Executive Director at JYAN, the consultation is important because the progress in Jamaica towards achieving the MDGs has not reached every young person between ages 10 and 24, particularly those who are most vulnerable, marginalized and at risk. “We are still in dire need of comprehensive sex and sexuality education. We need access to and availability of condoms and other safe sex commodities. And we need a more holistic mechanism to treat, care and support those of us who are living with HIV/AIDS.” There are still approximately 13,000 people waiting for HIV treatment in Jamaica.

The consultation seeks to identify gaps in the national response to HIV and AIDS and suggest appropriate strategies to create a more enabling environment to reduce young people’s vulnerability to HIV transmission and AIDS related deaths. It will also air the human rights issues around stigma and discrimination preventing access to HIV prevention, treatment, care and support for the nation’s youth.

At the end of the consultation a Call to Action will be developed urging stakeholders to renew their commitment and improve national strategies for moving forward towards reaching universal access to HIV prevention, treatment, care and support and the Millennium Development Goals with respect to young people.