Health
The Dots on the Map Fight in Battle for AIDS Frunding.
Islands put their hands up at United Nations.
In 1996, the United Nations predicted that all 22 Pacific Islands 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 Islands non-government organisations (NGOs) engaged in trying to fend off a disease that has already killed nearly 22 million people worldwide.
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At the United Nations special General Assembly on AIDS in New York in July, the 12 Pacific Islands members put a powerful case for persuading the United Nations 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 percent or more and cripple them economically for decades.
They argue bluntly that much of the money destined for Africa will be wasted. This is 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 has not yet discussed AIDS at the top level. It was barely mentioned in March at a conference of the region¹s health ministers, where the big topic was diabetes.
At a preliminary United Nations meeting in New York in May, Pacific Islands delegates arrived poorly prepared for the AIDS debate, held to draft resolutions for the top-level meeting in June at 20. According to Jane Keith-Reid, director of the AIDS Task Force in Fiji, at the May United Nations 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 United Nations 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 Islands showing at the July New York meeting demonstrated the region¹s 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 United Nations 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 Guinea¹s 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."
Vanuatu¹s 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 has described the disease as being out of control. 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 and territories 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 United Nations report warned that AIDS could become the Pacific's main cause of death, cut populations 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 United Nations said.
At the end of a meeting held in Suva in April to discuss a draft United Nations document 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 United Nations draft because it treated island countries "as dots on maps rather than countries."
Most small islands were not even mentioned in the United Nations 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 Islands 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 O¹Leary, 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."
