New PAHO Plan Seeks to Reverse HIV Epidemic by 2015

The Pan American Health Organization (PAHO) has presented a new regional plan aimed at helping Latin America and the Caribbean halt and reverse the spread of HIV by 2015, as called for in the United Nations Millennium Development Goals.

If successfully implemented, the effort could help prevent some 1.4 million new HIV infections between now and 2015 and help save some 300,000 lives.

The new Regional HIV/STI Plan for the Health Sector 2006–2015 outlines a comprehensive strategy to scale up HIV/AIDS care in the region, with three general targets:

• Universal access in the region to comprehensive HIV care, including prevention and antiretroviral treatment, by 2010
• A 50 percent reduction in new HIV infections between now and 2010, and another 50 percent decline between 2010 and 2015
• A reduction in the incidence of mother-to-child HIV transmission to less than 5 percent by 2015 and reduction in congenital syphilis to fewer than 0.5 cases per 1,000 live births.

The plan calls on health officials in PAHO Member States to exercise strong leadership in developing and implementing national HIV policies that are clearly defined, evidence-based, and adequately financed; that fully address the needs of people with and at risk of HIV; and that work to eliminate stigma and discrimination in the health sector and society as a whole.

The plan emphasizes that a wide-ranging approach is key to reversing the HIV epidemic. "A comprehensive national response to the HIV epidemic requires a multisectoral development approach.Therefore,the health sector should continue advocating for the full participation and involvement of other relevant sectors (education, labor, finance, and social services)." The document also notes the importance of participation by civil society, especially people with HIV.

The plan outlines more than a dozen interventions and services that it says any comprehensive HIV program should have. These include voluntary and confidential HIV counseling and testing services, peer education and counseling to change behaviors and develop negotiating skills, promotion of condoms and behavior change for vulnerable and at-risk people, protection from sexual abuse, prevention of mother-to-child transmission, linkages between tuberculosis and HIV programs, prevention of HIV transmission in health care settings, harm reduction services for injecting drug users, and uninterrupted supplies of HIV diagnostics, medicines, and other essentials.

The plan also notes the importance of integrating HIV prevention into larger efforts to promote and protect sexual health, especially among younger people. PAHO estimates that roughly half of those infected with HIV globally are between the ages of 15 and 24.

"All these activities must be based on open discussion of sexuality, gender, and relationships in general," says Carol Vlassoff, head of PAHO's HIV/AIDS/STI program.

PAHO's role will focus on providing technical support to member countries in their implementation of the plan, facilitating technical cooperation between countries, advocating for the plan, strengthening regional alliances and partnerships, and mobilizing resources to fill gaps in financing for HIV/AIDS activities.

The plan notes that financing for HIV prevention, care, and treatment has risen significantly in recent years. The Global Fund for AIDS, Tuberculosis and Malaria alone has provided some $480 million to the region. Negotiations have reduced prices on antiretroviral drugs notably, putting universal access to HIV treatment within reach of the region's countries.

The development of the new plan was a participatory process involving the ministries of health and national AIDS programs in PAHO member countries, as well as other development partners, people with HIV, and PAHO's country offices.

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