Dennis Zulu and Richard Amenyah | Taking the rights path to end AIDS in Jamaica

Today, December 1, we commemorate World AIDS Day, remembering those that we have lost to the epidemic and celebrating the resilience of those living with HIV.

This year’s theme, ‘Take the Rights Path’, draws our attention to the urgent need to promote and protect human rights to achieve the goal of ending AIDS as a public health threat by 2030. For Jamaica, this theme is particularly timely as we navigate the challenges of our national HIV response, ensuring that no one is left behind, especially those who are most vulnerable.

URGENCY OF HUMAN RIGHTS-BASED APPROACH

Human rights are fundamental to ending AIDS as a public health threat. Ensuring the full realisation of human rights is essential for preserving the dignity of every individual. . Their universality, indivisibility, interdependence, and interrelatedness are critical to achieving our collective development goals to achieve sustainable development, making Jamaica a place of choice to live, work, do business and raise families.

Jamaica has made notable strides in its HIV response, including achieving WHO certification from the World Health Organization (WHO) for eliminating mother-to-child transmission of HIV and syphilis IN 2024. However significant challenges remain that include the putting of more people on treatment and the reduction of new HIV transmission among individuals who are most at risk of contracting HIV such as young people and key populations.

To achieve epidemic control, Jamaica must continue to prioritise a rights-based approach that ensures equitable access to HIV prevention, testing, treatment, and care. Evidence shows that when rights are respected, health outcomes improve. It is not enough to focus solely on clinical interventions; we must address the social, cultural, policy and legal barriers that prevent people from accessing the care they need.

ADDRESSING THE GAPS

Despite progress in scaling up treatment, only 15,000 of the estimated 26,000 people living with HIV (PLHIV) in Jamaica are on antiretroviral therapy (ART). This leaves a significant proportion of PLHIV without the treatment they need because they are yet to be identified or, for those identified, have not been successfully linked to care and treatment, or have simply dropped out of treatment for various reasons. By the end of 2023, Jamaica had an estimated 1,200 new infections and 700 AIDS-related deaths. This clearly shows that AIDS is not over, and a lot of work needs to be done to get Jamaica back on track.

The Draft National Strategic Plan (2023-2030) outlines ambitious targets to ensure 95 per cent of PLHIV know their status, 95 per cent of those diagnosed are put treatment regimes, and 95 per cent of those on treatment achieve viral suppression by 2030. Current data however indicates that we are falling short of these targets, especially in reaching and retaining people in care and treatment. Key challenges include a) late case finding with high rates of late diagnosis, with 35-40 per cent of newly initiated patients in 2023 presenting with advanced HIV disease; b) high loss to follow up with about 4,000 people classified as treatment interrupters; c) reluctance to access services due to fear of breaches in confidentiality, stigma, and discrimination, particularly among young PLHIV and key populations and d) inadequate immunological and viral load monitoring among others.

LEVERAGING STRATEGIC INVESTMENTS

The resources from the Global Fund and the President’s Emergency Fund for AIDS Relief (PEPFAR) and, importantly, the Government of Jamaica co-financing commitments, provide a timely opportunity for Jamaica to scale up its HIV response, particularly for underserved communities. It is therefore imperative that these resources are used to quicken the pace of treatment, strengthen health and community systems. The goal is to build resilience and responsiveness at the primary healthcare level, expand prevention services—particularly scaling up pre-exposure prophylaxis (PrEP), enhance access to HIV self-testing, and strengthen outreach in underserved areas. Crucially, we must prioritize addressing human rights barriers

The Government of Jamaica has demonstrated its commitment to health equity through initiatives like the “Know Your Numbers” campaign and the Patients Charter of Rights as well as its complaint mechanism and partnership with the network of people living with HIV, Jamaican Network of Seropositives. We must build on these initiatives to dismantle structural barriers, ensuring that everyone can access HIV services without fear of stigma or discrimination. The establishment of the Enabling Environment in Health and Client Services Division within the Ministry of Health & Wellness is a clear demonstration of the government’s commitment to quality, equitable health care access. This patient-centred approach champions human rights and ensures health care delivery is inclusive, protecting the dignity and rights of all Jamaicans, regardless of age, economic status, gender identity, sexual orientation, religion, geography, or social status.

CALL TO ACTION

On this World AIDS Day, the United Nations calls on all stakeholders to take bold action and to take the rights path to end AIDS in Jamaica:

1. Strengthen Human Rights Protections: Repeal discriminatory laws that hinder access to HIV services and promote inclusive policies that protect the rights of vulnerable and marginalized key populations.

2. Invest in Community-Led Solutions: Strengthen the partnership with communities by providing civil society organisations more resources to lead HIV prevention, testing, and support services. These organizations have proven effective in reaching key populations and fostering trust within communities through peer-led initiatives to support adherence and retention and to bring people back to care and treatment.

3. Integrate HIV Services into Primary Healthcare: Expand access to comprehensive HIV prevention, testing, and treatment services, including pre-exposure prophylaxis and HIV self-testing. Strengthen the integration of HIV services and non-communicable diseases at primary healthcare level to enhance holistic care as well as sustainability and resilience.

4. Ensure Sustainable Financing for the HIV Response: The Government has increased domestic resources for the HIV response, but continued investment is crucial to protect gains made and achieve long-term sustainability. Explore innovative financing mechanisms, such as public-private partnerships and debt-for-health swaps, to sustain health interventions.

In the words of the UN Secretary General António Guterres, “Ending AIDS as a public health threat by 2030 is achievable. But reaching this goal requires breaking down the barriers keeping people from vital services.” By committing to these actions, we can accelerate progress towards ending AIDS in Jamaica by 2030, in line with Sustainable Development Goal 3. Now is the time to take the rights path, not just for those living with HIV, but for all Jamaicans who deserve a future where health, dignity, and human rights are upheld.

Dennis Zulu is The United Nations resident coordinator in Jamaica, The Bahamas, Bermuda, The Cayman Islands and the Turks and Caicos Islands. Dr. Richard Amenyah is an international public health specialist from Ghana and the UNAIDS Multi-Country Director for the Caribbean. Send feedback to @UNJamaica and @UNAIDSCaribbean on X (formerly Twitter).