Aids figures increase - Personal responsibility is best policy

ANY premature death is tragic. It is doubly so if the death might have been prevented.

That is why the report from Dublin’s St James’s Hospital that recorded the highest number of new HIV cases in a year since records began is worrying.

There has been a 20% increase in positive diagnoses in the last year. St James’s Hospital expects that 242 people will be diagnosed with HIV in the hospital by the end of the year. In 2008, 208 cases were confirmed. The number of cases recorded annually has more than doubled in the last decade.

Though this is a startling rise in Irish terms it pales into insignificance compared to the devastation being caused by the disease across regions of Africa.

As we mark World Aids Day this week more than 5,700 people still die from Aids-related illness every day in Africa. An estimated 25,000 people die from hunger-related causes in the same region every day.

Hungry, HIV-positive patients are abandoning their ARV treatment in Uganda, Kenya and Ethiopia as food prices rise. This carries the risk of drug resistance later.

In southern Africa, known as the HIV hyper-endemic region, increasing hunger is hindering treatment and forcing desperate women to take risks to try to feed their children.

Three years ago the United Nations Political Declaration on HIV and Aids — unanimously adopted by 192 member states in New York — committed to integrating food and nutritional support into the responses to HIV and Aids yet there is a stark gap between the 2006 commitment and delivery.

Like so many commitments made before the world economy imploded, delivery of the supports pledged in 2006 is far less than ideal. Even though we are facing challenges we never expected to face again we are relatively comfortable and it is not to our credit that we renege on promises to the very poorest of the poor. Their circumstance and ours are worlds apart and we should recognise that and act accordingly. Comparatively speaking we are rich beyond imagining and we really don’t have an option on this.

Though the response to the crisis in Africa requires an international effort we need to establish why Irish figures have increased and act accordingly.

Dr Fiona Mulcahy, consultant at St James’s department of genito-urinary medicine and infectious diseases, tells us that this rise was due to unsafe sexual practices among young men.

This may be because the great publicity surrounding the disease has diminished; it is no longer a cause célèbre, just another of the deadly traps waiting for the innocent or the careless.

Dr Mulcahy estimated that for every three people diagnosed, one does not know they are infected. More than half of infected women learnt they have HIV through antenatal screening and most men were diagnosed only when screened for other sexually transmitted infections.

She also pointed out that the majority of new patients did not have health insurance and this will have implications for health budgets.

The Irish figures are worrying but it would be foolish to expect that Government is in a position to implement a programme that will take the place of personal responsibility. Minimising risk and recognising the dangers of unprotected sex are the most appropriate response to this growing and dangerous problem.


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