Cover Story
AIDS Crisis Looms
AIDS Could Devastate Most Pacific Island Nations.
In 1996, the United Nations predicted that all 22 Pacific Island countries would be devastated by an AIDS epidemic in the not too distant future unless intense counter-attacks against the spread of the disease were begun immediately. The predicted epidemic has now begun, according to Pacific Island non-government organizations (NGOs) engaged in trying to fend off a disease that has already killed nearly 22 million people worldwide.
At the United Nations special General Assembly on AIDS in New York in July, the 12 Pacific Island members put a powerful case for persuading the UN to direct some of the hundreds of millions of dollars being allocated for a global battle against AIDS to the Pacific. They argued that while, except for Papua New Guinea, AIDS has not hit them catastrophically as in Africa, it has to be stopped in the region before becomes an overwhelming disaster. The NGOs say that an intense campaign could avert a horror that could cut the populations of some countries by 10 per cent or more and cripple them economically for decades.
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They argue bluntly that much of the money destined for Africa will be wasted since, for some African countries, it is too late to halt the spread of a disease now killing more than 30 percent of local communities. It is not too late to do that in the Pacific Islands, but money is needed for the job, they say.
Surprisingly, the Pacific Islands Forum of heads of government have not yet discussed AIDS at the top level. It was barely mentioned in March at a conference of the region’s health ministers, where the big topic was diabetes.
At a preliminary UN meeting in New York in May, Pacific Island delegates arrived poorly prepared for the AIDS debate, held to draft resolutions for the top-level meeting in June at which at least 20 heads of government were expected to be present. According to Jane Keith-Reid, director of the AIDS Task Force in Fiji, which operates now in eight countries, at the May UN meeting the Pacific Islands were able to catch attention there mainly thanks to an intervention by Nauru and with backing from Malaysia. Like the Pacific Islands, Malaysia feels that the UN has put emphasis on Africa at the cost of giving adequate support for work in areas where the disease is just beginning to set in.
Keith-Reid said the strong Pacific Island showing at the July New York meeting demonstrated the region’s commitment to act urgently in fending off the disease before its grip became fatal. “It was very important we were there,” she said. “The Australians were very supportive of where do we go next in the region. There are going to be discussions on implications for the region. The work really begins now.”
Australia will host the next Asia/Pacific conference on AIDS in October with 38 countries to be invited. Tuvalu’s health minister, Amasone Kilei, told the UN meeting that although his tiny country hadn’t yet recorded a single case of the disease, AIDS was a “new and alarming source of vulnerability to many small countries in our group, further exacerbating existing economic and environmental variables.”
Papua New Guinea’s health minister, Tommy Tomscholl, said his badly infected country was one of the most difficult battlegrounds for fighting AIDS compounded with a low literacy rate and more than 800 languages that makes communication “daunting.”
“We estimate that of the 5.2 million population of the country about 10,000 to 15,000 people will fall ill from the disease in the next few years.”
Vanuatu’s health minister, Clement Leo, said while his country had yet to have a case reported, “we have not been complacent. For small island states like Vanuatu we stand to lose even more if we allow the pandemic to take hold of our small population, considering the main constraints we face even before infection is reported.”
Except for Papua New Guinea, the number of AIDS cases reported in the region appears to be small; by the end of 2000 a total of 4,054 cases for seven million people. But that is five-and-a-half times higher than the count in 1995. About 77 percent of all cases have occurred in Papua New Guinea, where one authority as being out of control has described the disease. New Caledonia has 7.3 percent of the total, French Polynesia 6.8 percent and Guam 4.9 percent.
What AIDS experts warn is that experience shows that there could be five to 10 times more than reported. The five countries where the disease has not so far been reported — American Samoa, the Cook Islands, Niue, Tokelau and Vanuatu — probably have some.
Kiribati is said to be in a dangerous position. In a population of about 80,000 people the number of reported cases has grown from four before 1995 to 49 by the end of last year. AIDS appears to have been introduced by the hundreds of Kiribati sailors who crew foreign cargo ships The 1996 UN report warned that AIDS could become the Pacific’s main cause of death, cut population’s drastically and impose health cost burdens impossible for small island economies to bear.
"When future historians look back on the history of the Pacific, the failure to respond to the HIV/AIDS epidemic at an early and determined fashion may be viewed as one of the great tragedies of our time," the UN said. At the end of a meeting held in Suva in April to discuss a draft UN document for the June meeting, delegates from 12 island countries issued a strongly-worded declaration saying that they were “filled with fear” for their islands since they are unable to fight AIDS alone. “This may be because our populations are small but the result is that we are invisible, forgotten and neglected,” the statement said. The declaration attacked as being bland and feeble the UN draft because it treated island countries “as dots on maps rather than countries.” Most small islands were not even mentioned in the UN resolution.
In the Pacific Islands, the Suva statement continued, “the vast majority of health and welfare workers have not been trained in HIV. The few that have are not receiving necessary support to do this work. Pacific Island health systems are unable to cope with existing epidemics. Countries of the Pacific do not have the capacity to cope with a new and bigger epidemic.” Dr. Michael O’Leary of the WHO regional office in Suva, said to use the word “epidemic” to describe the spread of AIDS in the region was a “question of definition” but the position was “definitely worrisome.”
Photo: Robert Keith-Reid
