A recent visit from a UNAIDS Programme Coordinating Board (PCB) delegation to El Salvador stressed the importance of addressing stigma and discrimination in the response to HIV in the country and commended the government of El Salvador for its leadership on these issues.
"We congratulate the efforts by El Salvador in its national response to HIV under the leadership of the government with active participation by civil society," said Dr Marijke Wijnroks, AIDS Ambassador from the Netherlands, the current PCB Chair. “We are particularly impressed with the openness on sensitive issues such as comprehensive sexuality education for young people and stigma and discrimination of key populations like MSM, transgenders and sex workers”.
The field visit, that took place from 10-14 May 2010, coincided with the launch of a Presidential Decree that prohibits any discrimination based on sexual orientation and gender identity in the public sector. The Secretary of Social Inclusion, Dr Vanda Pignato, who is also the First Lady of El Salvador, officially opened the National Directorate for Sexual Diversity during the visit, and stressed that “this Presidential Decree represents the obligation of the State in addressing the issue of discrimination."
The PCB field visit provided an opportunity for Board members to be exposed to the realities of the epidemic and the work undertaken by UNAIDS, together with its national and international partners, on the ground. Dr Menna Ould Tolba, Delegate of the PCB and Coordinator of the AIDS Response in Mauritania said "After participating in this field visit, I am now convinced of the importance of working with and supporting populations at higher risk of HIV infections."
During their visit, PCB delegates met with the Minister of Foreign Affairs, Mr Hugo Martínez; Minister of Health, Dr. Maria Isabel Rodriguez; the Chief of HIV/AIDS Department, Ana Isabel Nieto; and Chief of the Tuberculosis Department, Dr. Julio Garay. They also met the Vice President of the Republic of El Salvador and Minister of Education, Salvador Sanchez Ceren and discussed with Ombudsman Oscar Luna various human rights issues in the context of the country’s HIV response. The delegates also met with representatives of civil society, including people living with HIV, MSM, sex workers and transgender communities.
Participants in the field visit took the opportunity to explain the ten priority areas under the UNAIDS Outcome Framework (2009–2011), highlighting the tenth area related to men who have sex with men (MSM), sex workers and transgender populations. According to UNAIDS, El Salvador has the highest HIV prevalence rate amongst men who have sex with men (MSM) in Central America at 17.8%
Minister of Health Dr. Rodriguez said, “HIV in our country is an important cross-sectional issue and we must explore every option in order to produce tangible results.”
PCB delegates also stressed the importance of linking sexual and reproductive health with the HIV response in meetings with the Ministers of Health and Education. Cases of HIV positive adolescent mothers with babies born with HIV were particularly highlighted during their visit to the Maternity Hospital of San Salvador. They also watched how an HIV prevention training guide is being implemented at the Canton Milingo School. Some key HIV prevention issues such as sex education in schools and stigma and discrimination have traditionally encountered resistance in the Salvadorian society. Delegates witnessed country efforts to implement programmes that address such issues while respecting the sensibilities of communities and individuals based on their religious views. "Education is the vaccine we already have against HIV,” said Delegate Dr Ibra Ndoye, Executive Secretary of the National AIDS Council, Senegal.
Whilst overall impressed with the quality of the programmes, delegates expressed concerns about the sustainability of HIV prevention programmes targeting key populations. Most of these programmes are implemented by NGOs and are heavily reliant upon external financing. With donors increasingly moving away from the region, sustainability could be at risk.
The delegates asked the government to ensure follow-up and implementation of the Ministerial Declaration that was adopted at the first meeting of Ministers of Health and Education to Stop HIV and STIs in Latin America and the Caribbean in July 2008 in Mexico City during the XVII International AIDS Conference. "We encourage El Salvador to share its experiences widely and hope to see the country play an even stronger leadership role in the regional response to HIV" said Dr César Antonio Núñez, UNAIDS Regional Director for Latin America.
UNAIDS is guided by a Programme Coordinating Board which serves as its governing body. The PCB has representatives from the five regions of the world, the UNAIDS Cosponsors, and nongovernmental organizations, including associations of people living with HIV.
El Salvador, which is currently the Vice Chair of the PCB, will assume the Chair for the year 2011. This move comes at a vital time for the AIDS response when stakeholders will come together to assess progress made towards achieving universal access to HIV prevention, treatment, care and support.
