AIDS Emerges as a Major Threat for Small Islands, Especially in the Caribbean and Pacific
3 April 2004

(New York, April 2004) - The Caribbean now ranks second only to sub-Saharan Africa among the regions that are hardest hit by HIV/AIDS, with a 2.3 per cent adult HIV prevalence rate. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), the national prevalence levels in Haiti are at 5 to 6 per cent. It is estimated that 30,000 lives are lost to AIDS every year in that country, leaving 200,000 children orphaned thus far. With a national prevalence rate of 2.3 per cent for a population of 8.2 million, in the Dominican Republic HIV/AIDS has become the leading cause of death among women of reproductive age. In the Pacific region, the known prevalence has remained relatively low, but the levels of risk factors for HIV transmission are high.

'The AIDS epidemic in the Caribbean has shifted to younger populations, especially females,' writes United Nations Secretary-General Kofi Annan in a recent report on small islands. 'It has already begun to have an impact on Caribbean societies and economies in terms of loss of human potential and productivity and economic costs. Most HIV/AIDS cases occur among people aged 15 to 39, the prime productive and reproductive age group,' the report notes.

'Small island developing States must address the issue of HIV/AIDS, which is increasingly prevalent in many countries', the Secretary-General states, 'since HIV/AIDS is particularly devastating for countries with limited skilled workforces, taking a severe toll on their economies as the economically active succumb to AIDS- related illnesses, income levels are reduced and the social fabric is undermined.'

Although in most Pacific countries known prevalence has remained relatively low, the prevalence of risk factors for HIV transmission is considered high. 'The stage is set for an expanding and widespread HIV epidemic in the (Pacific) region due to a dramatic increase in sexually transmitted infections and risky sexual behaviour among young people aged 15 to 25,' Dr. Peter Piot, Executive Director of UNAIDS, said recently.

Papua New Guinea has the highest reported rate of HIV infection in the Pacific, with an estimated HIV prevalence of over 1 per cent among pregnant women attending antenatal clinics in three urban sites around mining areas in Port Moresby. Elsewhere in the region, the great majority of the reported HIV infections have been from French Polynesia, Guam, New Caledonia and Fiji, a country where cases have also begun to rise significantly in the last two years.

Malaria affects Pacific Islands Small island nations have decided to make the fight against HIV/AIDS a priority, as well as the fight against malaria, which has particularly hit tropical islands of the Pacific region. The islands have proposed that health-related challenges to sustainable development appear on the agenda of the Mauritius International Meeting (30 August - 3 September 2004) to review the 1994 Barbados Programme of Action for small island developing States. The original programme contains several references to health issues but did not highlight health as a separate priority area.

Malaria is a major health problem in Papua New Guinea and the Solomon Islands, and this disease is also endemic in many other small islands. In Papua New Guinea, where the World Health Organization (WHO) declared the disease to be a serious health problem in the coastal and inland regions, malaria is the third leading cause of hospital admissions. Malaria transmission is particularly sensitive to weather conditions. In dry climates, heavy rainfall can create puddles that provide good breeding conditions for mosquitoes, and in very humid climates, droughts may turn rivers into strings of pools, preferred breeding sites of other types of mosquitoes.

In the Asia-Pacific region, medical experts and doctors were puzzled by the cycles of malaria in some countries, peaking roughly every five years. They collated anecdotal evidence in which these cycles were strongly linked to climate change phenomena like the El Niņo cycles, which seem to modify the incidence of epidemic diseases transmitted by mosquitoes, such as malaria and dengue.

Dengue is also a mosquito-borne infection found in tropical and sub-tropical islands. In recent years, when it has become a key international public health concern, the highest prevalence has been observed in South-East Asia and in the Western Pacific. WHO reported that since 1994, dengue incidence has been rising steadily in Singapore, with 5,258 cases observed during a major regional outbreak in 1998, the highest number of cases reported over the last decade. During another outbreak in 2001, Singapore reported 2,372 cases, though the casualty rate in the region has remained low. But a 2001 World Bank study of the costs of climate change to Fiji and Kiribati found that while Fiji would be able to cope with a major outbreak, a dengue epidemic in Kiribati would pose challenges beyond the capacity of its health system or governmental financing. Kiribati can simply not afford to face such an outbreak.

Along with infectious diseases, new 'lifestyle' diseases relatively unknown in the past in small islands, such as nutritional diseases and diabetes, have also emerged. A WHO study has revealed that diabetes imposes a very high economic burden on SIDS in the Caribbean. The direct cost to the economies of eight small islands has been estimated at $1.2 billion. Similar figures are also found in the Pacific.

Press Contact:
Frances Coutu, UN Department of Public Information, Development Section
Tel.: (212) 963-9495, Fax: (212) 963-1186, E-mail: mediainfo@un.org
For more information, see www.un.org/smallislands2004