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'Shining Example'

Cuban Lessons on Fighting AIDS

by Peter McKenna
29 July 2004 The Toronto Star

Revolutionary Cuba is hailed by some as a shining example of how to combat successfully the HIV/AIDS pandemic. Today, Cuba has an HIV infection rate of less than 0.1 per cent, in a region that has one of the fastest growing infection rates in the world.

Not only have Cuban authorities virtually eliminated the transmission of the virus through blood transfusion and intravenous drug use, but they have also halted transmissions involving newborns at birth. In April 2003, Peter Piot, the executive director of UNAIDS, declared: "Cuba was one of the first countries to take AIDS seriously as a problem, and provide a comprehensive response combining both prevention and care."

Of course, this was not always the case. Back in the mid-1980s, Cuba was widely condemned by the international community for its harsh treatment of AIDS sufferers.

Indeed, it sought to isolate or quarantine people with HIV (remember the SARS outbreak in 2003?) in sanatoriums –far away from the "collective" population. Their sexual partners were subsequently traced and tested. Pregnant women and those who had travelled to Africa were also tested.

By the late '80s, however, Cubans were more knowledgeable about the epidemic, and they humanely allowed patients to leave the sanatoriums for extended periods of time.

A few years later, the Cuban government introduced its ambulatory care treatment program, which enabled AIDS patients to choose between living within the sanatoriums or convalescing at home with family members.

In Cuba today, people with HIV are guaranteed access to free medical care. And nobody can be fired from their jobs because they are carrying the virus.

There is clearly a strong commitment on the part of the political leadership in Cuba to undertake a wide-ranging and comprehensive HIV/AIDS action plan –domestically as well as internationally, as part of Cuba's activist foreign policy.

As early as 1983, Cuba had already set up a National Commission on AIDS, before any cases had even been diagnosed, to educate its 11 million people. Sex education programs were subsequently introduced in the schools and TV ad campaigns informed Cubans about AIDS and the need to promote safe sex.

Over the years, the government began compiling a comprehensive database of those infected with HIV, along with their chain of sexual partners. While HIV testing is no longer compulsory, Cuban health authorities recommend it for pregnant women and those in high-risk categories. Those who do contact HIV are required to attend an eight-week education and drug support program in a sanatorium.

Last year, Dr. Byron Barksdale, the director of the American charity, Cuban AIDS Project, was quoted as saying: "I don't know if six weeks or eight weeks are the magic numbers, but that is certainly a longer time than is given to people in the U.S. who receive such a diagnosis. They may get five minutes' worth of education."

Because of the 40-year-old U.S. economic embargo against Cuba, no anti-retroviral drugs were initially available on the Caribbean island.

By 2001, however, Cuba's growing biotechnology sector was beginning to manufacture generic versions of several HIV/AIDS inhibitors.

Cuba is now one of the few developing countries that actually provides its HIV/AIDS patients with a full supply of free drugs.

From an international standpoint, Cuba has sent thousands of doctors and nurses to almost every part of the world to help in the valiant struggle against HIV/AIDS.

In Botswana, which has the highest proportion of people living with HIV in the world, Cuban medical professionals work in several clinics and hospitals to treat AIDS sufferers and to offer suggestions for prevention. Two weeks ago, the Cuban government offered to train –at no cost– nurses and doctors from other Caribbean countries to fight the pandemic.

More strikingly, Cuba has promised to provide anti-retroviral drugs to its Caribbean friends for a cost well below market prices. It won't be long before countries in Latin America and Africa will also come calling.

This is even more impressive when you realize that Cuba is largely a poor, developing country locked in an undeclared war with its superpower neighbour only 145 kilometres away. As a comparatively rich and industrialized country, where is Canada's leadership on this critical issue?

Cuba's approach to the HIV/AIDS pandemic is a major success story. There is much that the rest of the world can learn from the compassionate Cuban experience.

No one is saying that Cuba has all the answers to the AIDS epidemic.

But as Nina Ferencic, a UNAIDS program development adviser for the Americas region, recently confided: "Cuba has lots of potential and lots to offer."

Peter McKenna is an assistant professor in the Department of Political Studies at the University of Prince Edward Island in Charlottetown.



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