As Guyanese observe World AIDS Day today they must face the grim fact that 5.5% of the country's population is infected with HIV, the virus that causes AIDS. This means that at least one in every 20 persons is infected.

These statistics are for the age group between 15 and 49 years and are said to be extremely high and unsustainable. Minister of Health, Dr Leslie Ramsammy, is expected to make an announcement today on where Guyana would access its anti-retroviral drugs to treat people living with HIV.

"At the moment, I would reiterate that I have access to all of the drugs that one uses in an effective treatment programme. I have access to what is called NRTIs and NNRTIs, drugs which are used in initial treatment of HIV infected persons," the minister told reporters yesterday at a press conference.

It was disclosed that initially $100 million would be invested on the first batch of drugs while other ways were sought to fund a universal programme in Guyana.

This would provide a glimmer of hope for all those infected by the virus and their families as they observe World AIDS Day, which is marked on December 1 every year. The first observance was in 1988, at a time when Guyana had not yet acknowledged that it had a problem with the virus. Guyana's first documented case of AIDS was in 1987.

Another glimmer of hope for those infected is the news that the Ministry of Health is in discussion with the Sisters of Mercy about establishing a hospice. The minister said that this would be a collaborative effort between the government and the Sisters of Mercy. In addition, the minister said, the ministry was looking at what could be done in the interim and was working on reinforcing the manpower in the AIDS Ward at the Georgetown Public Hospital. But it has not been decided as yet, whether the drugs would be given free to infected persons

There is still a grim story to be told, Ramsammy said, as the number of persons diagnosed with AIDS this year has surpassed last year's figure. Further the number of HIV positive persons has exceeded the number for last year.

But, as the minister pointed out, even though it seemed that there was a rapid increase this year, it was not just that, but also that a better job in testing persons was being done and the programmes were becoming more effective. "So some of these cases are really old cases that we did not pick up before, " the minister said.

Ramsammy said he was hoping to make the announcement about where the drugs are being accessed yesterday, but he was unable to get the go ahead from President Bharrat Jagdeo.

From all indications the drugs would be made in Guyana as the minister has hinted at this on more than one occasion.

Earlier this week, the minister had said that Guyana was seriously considering making the drugs here as even though the drugs were being made available to countries like Guyana at a low cost, they were still too expensive.

The minister yesterday told Stabroek News that even though pharmaceutical companies were offering the drugs at US$250 and US$350 per person per a year, this was still too expensive.

Questioned yesterday, the minister said that should the drugs be made in Guyana the country had in place the technology to test the quality of raw materials and the facility to test the quality of the end product. "We have access to technology for the anti-retroviral drugs. If I want to manufacture anti-retroviral drugs today I can do so now," the minister said. He disclosed that the New Guyana Pharmaceutical Corporation (GPC) had the facilities to manufacture anti-retroviral drugs.

He said that Guyana's strategy would be to use the initial drugs, but to keep the protease inhibitors -- drugs which are used in 'salvage therapy' in reserve. This takes cognisance of the fact that HIV could quickly develop resistance to certain drugs, rendering them useless. This is when the salvage therapy is used. The minister said that the protease inhibitors, which have been found to be extremely effective, would be given to persons who are not responding to the initial treatment. Ramsammy said that the reason for this strategy "is that we do not want to use our best drug up front so that the virus gets resistant to these drugs quickly." The minister pointed out that this meant that "willy-nilly" use of the drugs would not be permitted in Guyana.

He said that while the drugs would be available to the private sector they would only be accessed through the Ministry of Health in order for the ministry to keep tabs on what was going on and who was using the drugs. "We don't want the drugs to be just distributed on the streets willy-nilly," the minister stressed. He said that the medications would have to be used in accordance with the guidelines provided by his ministry.

In early January, training would be provided for all doctors who are desirous of treating HIV/AIDS patients. The minister disclosed that his ministry will have a database of doctors who would be treating infected persons so that the public would know who these doctors are. He said that doctors would only be given access to the drugs if they have been trained.

Between February 4 and 15, 2002, two doctors will undergo advanced training in HIV therapy in Mexico and on their return they will be the focal point so that other doctors will continue to have training through them. Ramsammy added that the ministry would ensure that all the public hospitals had at least one doctor who was trained in the use of anti-retroviral drugs.

The health minister stated that drugs would also be made available to treat the opportunistic infections that affect persons who are infected by the deadly virus.

He described the steps to be taken in an attempt to curb the virus as bold steps ".....these are steps that would cost us a huge amount of money but we have no choice we got to do it now."

Ramsammy yesterday admitted that not all the public hospitals had facilities for the treatment of HIV/AIDS patients, but said that there would be a doctor who would make the relevant referrals. "There will be a programme that is designed so that we can move the patients to a doctor who would take over," the minister said.

The inclusion of all stakeholders in society in the fight is something the Ministry of Health is working on in celebration of this year's World AIDS Day and so the National Strategic Plan for HIV/AIDS, which was introduced in 1998, has been revised and will be implemented as the 2002- 2006 programme. The minister said that the programme will be released shortly.

Ramsammy noted that whereas previously the emphasis was entirely on education and awareness, the programme now will be more balanced since it would continue to enhance education and awareness, but would "now be aggressive in our approach in terms of treatment and care." The minister said that the programme would include research with patients taking the drugs.

"Whether the patients are paying for the drugs or not we are not going to lose control of the process, because we want to know whether the drugs are effective," the minister said.

As to what the government will present to the World Trade Organisation to receive a waiver for the importation of drugs or the chemicals to make the drug, Ramsammy told Stabroek News that he would present the fact that Guyana was ranked second in the Caribbean as the country most affected by the virus.