9311: AIDS: First Lady Mildred Aristide at launching of Interim Plan on HIV/AIDS (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: MKarshan@aol.com

TRANSLATION FROM FRENCH TO ENGLISH

SPEECH DELIVERED BY MADAME MILDRED T. ARISTIDE
The First Lady of the Republic of Haiti

Delivered at the ceremony launching the Interim Plan on HIV/AIDS
Jacmel, Haiti
October 4, 2001

Minister
Honorable members of Parliament
Mayor of Jacmel
Representatives of the Government
Ambassadors
Representatives of National and International Organizations
Health Professionals
Dear Citizens of Jacmel

Last June 25, on the occasion of the extraordinary session of the United 
Nations on HIV/AIDS, Mr. Kofi Annan, the General Secretary of that 
organization, said that the world response to the AIDS epidemic did not meet 
the challenge. That the efforts already being deployed were not sufficient to 
fight AIDS. 

Here in Haiti we knew this.  To help increase our ability to fight AIDS the 
elaboration of a global plan was necessary.  For that the Health Minister 
accelerated the process of elaboration of the Strategic Plan for 2002-2006 
officially launched last 
May 7th by President Jean-Bertrand Aristide, which represents an important 
step within the context of this fight that concerns all of us.  Diverse 
multi-sector consultations have been held in view of finalizing the Strategic 
Plan.

Today the Interim Plan that the Ministry is presenting 
responds to a timely need to increase and immediately reinforce the actions 
against AIDS. This is an
operational plan that must bridge the gap with the 
strategic plan for 2002-2006.  This inevitably implies an articulation and 
continuity between the interim and strategic plans.  

I know that this document was created with the 
participation of national and international agencies that are working to meet 
the AIDS challenge 
and better respond to all those who are affected and those at risk of 
contracting AIDS.  We welcome this cooperation with fraternity and a spirit 
of 
solidarity.

As you already know, I am neither a doctor nor a specialist in AIDS. I am a 
lawyer by profession.  So I will let the Minister and the other technical 
experts 
explain in detail and in depth the Interim Plan.  

But I would like to emphasize two points in the plan.  First the multi-sector 
aspect in the fight against AIDS.  Global statistics clearly show the 
correlation between AIDS and poverty:  90% of the people living with the 
disease live in developing countries where the healthcare infrastructures are 
poor, access to potable water difficult and the rate of literacy and 
education are low.  In countries where if you are a woman you have a greater 
chance of suffering from discrimination.  We know well, that fighting AIDS is 
more than a medical war, it is also a war against social injustice; it is a 
war against poverty.

But what are we doing concretely to advance this social justice in the 
context of the fight against AIDS in Haiti?

Last weekend we visited the department of Artibonite, 
the largest of our nine departments. There 1,091,374 inhabitants live on 
4,983 square kilometers. 
Artibonite is often called the bread basket because it 
is the greatest producer of food for Haiti.  The President chose this place 
to commemorate the 10th anniversary of the bloody coup d’etat of September 
30, 1991; an event which, with the forced migration of approximately 300,000 
people and the introduction of rape as a new instrument in the political 
repression, surely increased the number of persons and children exposed to 
HIV.  The fight against AIDS from now on must be one of the responses to the 
injustices suffered by these victims.

A broader vision of the challenges posed by AIDS will lead us further in the 
fight.  It will lead us to the necessity to better organize or re-organize 
the 
national healthcare system. To this end, the government last May finalized a 
loan of 22.5 million
dollars with the Inter-American Development Bank to 
reinforce the healthcare structures in four departments, with the possibility 
to train health 
workers and purchase basic medicines, etc.

Unfortunately, instead of taking one step forward 
toward social justice with such an initiative, the freezing of these funds 
are limiting our efforts aimed 
at improving the health conditions of the population. We sincerely believe 
that this is unjust.

Back to the Artibonite.  In the commune of Grand 
Saline, it is not a health center that the population is missing.  It exists. 
 But what is missing is an 
access road to get there.  So even when there are healthcare services, 
without a road sick people cannot
get the health care that they need. Infrastructure, 
like social justice, is an integral part of a healthcare program prepared to 
face this plague that AIDS represents.

Now moving from road systems to other systems 
apparently independent from health, it is the same thing. The agricultural 
system for example: 
approximately 60% of the employed population works in agriculture and 
contributes to supplying food to the
country.  But many people don’t have access to irrigation, fertilizers or 
even land.  The result is a drop in the production of food and an increase in 
prices – with the disastrous consequences on nutrition and consequently on 
the population’s health.  And it is not only in Haiti.  Nearly one-third of 
the children under age 5 throughout the world suffer from malnutrition.

While the government has the obligation to take care of all our citizens who 
have AIDS, the strategy elaborated in consultation with different partners to 
combat AIDS must go beyond the medical field. Satisfying the fundamental 
needs of the people –
nourishment, potable water, education – are important points of this 
strategy. Our laws, our educational system, our campaign for literacy, are 
tools which are essential to this struggle.

In all actions undertaken by the government, the participation of the people 
is the key element to achieving success.  

The same is true for AIDS.  The second point I want to underscore within the 
context of the Interim Plan is the participation of the population in the 
fight 
against AIDS.  At the heart of the Interim Plan, are plans to develop in all 
of the state operated
healthcare facilities voluntary testing and counseling centers to reinforce 
the capacity of the population to fully participate in the fight against 
AIDS.  How?

First, by making information about AIDS available to the population.  Second, 
by giving people the opportunity to be tested to find out if they are 
infected or not and how to protect themselves and others.  Women in 
particular will be encouraged to
make informed and rational decisions on matters of 
family planning.  Infected persons will be cared for, with priority given to 
pregnant women, they will 
receive necessary social services, medications and nutritional support. 
Because throughout the world and not only in Haiti, people living with 
HIV/AIDS are the most determined and the most passionate advocates in this 
war, and in this war we need all our citizens.

Here, at St. Michel Hospital in Jacmel, the state is 
making a great effort in this regard by officially announcing the opening of 
the first voluntary testing 
and counseling center inside a state facility. I encourage the Minister and 
all of you to continue the
implementation of the 9 other departmental sites as 
quickly as possible.  

Starting with the city of Jacmel, I believe that the 
government chose to pursue the vision of decentralization that is at the 
heart of its published 
program, Investing in People. Emphasizing the reinforcement of public 
institutions, the state is
fulfilling its obligation to provide healthcare for 
all Haitians, as mandated by Article 19 of the Constitution.  That is the 
real work of a democratic 
and responsible government.

Last August, I took part in a conference on health and 
human rights at Partners in Health, a medical project in the Central Plateau. 
 Among the diverse 
interventions and debates by patients, one said to us, “We hear much about 
the negotiations which are
strangling the country.  But for us, the real negotiations that should be 
held are those which will lower the cost of medicine, increase the number of 
Haitian doctors and nurses and increase the number of hospitals in the 
country.”

I propose that we begin these negotiations within the 
context of the fight against AIDS.  It is up to each actor to clearly 
identify her role in this context and
assume their responsibilities, and together we will be able to stop this 
plague.  

Thank you.

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