Guyana's fight to contain the AIDS epidemic has been reinforced by the Declaration of Commitment on HIV and AIDS adopted last month by the UN General Assembly's 26th Special Session (UNGASS) in New York.

And the country's struggle with the epidemic is in line for significant international support.

This follows from the recognition of the Caribbean as the region with the second highest rate of HIV infection after sub-Saharan Africa and the commitment to "cancel all bilateral official debts of Heavily Indebted Poor Countries (HPIC)" - (Paragraph 87 of the Declaration).

However, certain obligations must be fulfilled before poorer countries will be eligible to benefit from "increased international development assistance" (Paragraph 84) and the HIPC initiative.

Paragraph 84 stipulates the need for developing countries to "commit increased national funds to fight the HIV/AIDS epidemic"

before development assistance becomes available whilst the HPIC debt cancellations require "demonstratable commitments to poverty eradication" and "the use of debt service savings to finance poverty eradication programmes, particularly for HIV/AIDS prevention, treatment, care and support" (Para. 87).

Minister of Health, Dr Leslie Ramsammy, indicated yesterday that part of the debt service savings from the HPIC initiative would be funnelled into health spending, of which a percentage would be directed at tackling the epidemic. This would constitute the required increase in spending on the epidemic, allowing Guyana to benefit from the recommended "increased international development assistance".

"Our focus will be on treatment and care," he stated, listing obtaining drugs, improving care facilities and human resources.

Merle Mendonca, member of the National AIDS Committee (NAC), hailed the caucus and declaration as an "extraordinary step forward" in which developed countries had "agreed and committed themselves" to aid the developing countries worst afflicted by the epidemic. She described the declaration as a "valuable blueprint for all our work in the future."

According to an NAC release, "with regard to the final declaration itself, the General Assembly had to adopt a consensus document, as unanimous agreement could not be reached."

The main bone of contention was the naming of certain vulnerable groups in the document. According to the release, men who have sex with men, commercial sex workers and their clients have been grouped under the phrase "identifiable groups."

Some 189 member states had representatives at the landmark Special Session with over 1,200 government officials and 700 others representing some 500 NGOs and civil groups.

According to Guyana's UNGASS representatives, the occasion provided an excellent opportunity to learn how other countries were tackling the epidemic, but they remarked that the event was marred by a lack of opportunity for discussion and a heavy bias towards the African continent.

"At the round table discussion," the release stated, "we expected it to be participatory, but instead, almost all the countries that participated read prepared statements."

"Not much came out of that round table," explained Dr Morris Edwards, programme manager of the National AIDS Programme Secretariat (NAPS), at an NAC/NAPS press conference at the Guyana Human Rights HQ, Georgetown, yesterday. Dr Edwards represented Guyana in the official delegation in support of Dr Ramsammy.

"The entire mood was the plight of Africa," Dr Edwards continued. "Most of the other regions were not given prominence."

The epidemic has swiftly become a world crisis affecting Africa heavily, other regions such as the Caribbean have been lost in the sheer numbers of deaths and infections in Africa.

However, Caribbean countries face the risk of similar problems with the second highest infection rate in the world. Dr Edwards estimated that Guyana's infection rate lies between 3.5% and five per cent of the population.

Part of the blame for the severity of infection rates in poorer regions has been the high price of effective treatment such as anti-retroviral drugs.

Paragraph 24 of the declaration recognises that "there is a need to reduce the cost of these drugs" and acknowledges that "the lack of affordable pharmaceuticals ... continue to hinder an effective response to HIV/AIDS in many countries."

Dr Ramsammy remarked that steps were underway to secure cheaper drugs, explaining that a deal was being brokered with Indian pharmaceutical company, CIPLA to provide drugs at an estimated cost of US$250 per year per patient. The usual price of such treatment per year can cost up to US$10,000.

The UN World AIDS fund is also expected to be set up and much-needed funds to be initially dispersed by the end of this year to support poorer countries in addressing the crisis.

However, it remains to be seen whether this and other proposed subsidies along with national budget allocations will be enough to enable "low and middle-income countries" to achieve the HIV/AIDS annual spending target of "between US$7 billion and US$10 billion" by 2005 as stipulated in Paragraph 80 of the Declaration.