Guyana Chronicle
Georgetown, Guyana
February 16, 2004

PAHO expects Global Fund to boost Guyana's TB programme --- says it's vital to curb AIDS spread

By Shirley Thomas

Impressed with Guyana's programme for responding to the HIV/AIDS epidemic, Dr. Pariago, who met with journalists in Georgetown last week, referred to the programme as 'very structured'. The PAHO official arrived here last week to attend the PAHO Sub-Regional Managers Meeting at Le Meridien Pegasus, from February 9-12.

Noting that PAHO supported Guyana's HIV/AIDS and malaria projects, which both succeeded at the level of the Global Fund, she was optimistic that the outcome of the fourth round of meetings of the Global Fund to be held in Geneva, Switzerland, in July will yield good for Guyana's tuberculosis (TB) programme, so vital to controlling the spread of AIDS.

Commenting that malaria and tuberculosis (TB) go hand in hand in relation to compounding the HIV/AIDS problem, the PAHO Director said that her organisation is hopeful that Guyana can have a joint intervention into the two.

Malaria and tuberculosis (TB) and malaria - prevalent in Guyana, are two opportunistic infections to which HIV-infected persons quickly fall prey. Once such persons become infected with these two illnesses, their immune system becomes further weakened and the virus that causes AIDS (HIV) multiplies in the body much more rapidly. Therefore a combined approach towards fighting HIV/AIDS and malaria and tuberculosis becomes crucial, she said.

Said Dr. Pariago: "We have just finished a new proposal that is going to the fourth round of the Global Fund, and that will be on tuberculosis, and so we hope that the country will have a more level resource base for addressing the question of tuberculosis."

While admitting that Guyana is not one of the countries with the highest rate of tuberculosis, the PAHO Director nevertheless held the view that Guyana's case be taken on its merit, because of the high incidence of HIV/AIDS infection here, and the link between that and the two infections - tuberculosis and malaria.

The PAHO Director observed that, with the wider migration of population, tuberculosis has been spreading widely. Noting that two of Guyana's projects (HIV and malaria) have already been approved by the Global Fund, she conceded that the quality of Guyana's health projects is very good.

Dr. Pariago asserted: "We hope now, that the country will be more successful in its fourth round...and we hope that will bring about $15million or $20 million more exclusively to make interventions in tuberculosis."

In this regard, she noted the importance of laboratory testing and the requisite drugs.

Commending Health Minister, Dr. Ramsammy's blueprint for a programme which will cater specifically to the needs of hinterland communities (primarily peopled by indigenous peoples) and plagued by tuberculosis and malaria, the PAHO official asserted: "It is very good that the government has been able to put up a specific proposal... That was something that Minister Ramsammy was pushing very hard to have - a specific project for the Amerindians." She said that with grant resources from the World Bank being assured, the programme can see success.

Dr. Pariago said that, in the case of malaria, PAHO is also working with the Amazonian countries to expand the health services, and to ensure that they have coverage of treatment for all.

Meanwhile, Guyana and Haiti said to be the two countries most affected by HIV/AIDS in the hemisphere, and outside of Sub-Saharan Africa, are on the list of the priority countries benefiting from assistance from the Pan American Health Organization (PAHO), the PAHO Director reported.

And PAHO Resident Representative to Guyana, Dr. Bernadette Theodore Gandi, earlier outlined that, the fundamental purposes of PAHO are to promote and co-ordinate efforts of the countries of the Americas to combat disease, extend life, and promote the physical and mental health of the people.

Dr. Gandi said that PAHO's efforts will be directed at mounting a vigorous response aimed at combating re-emerging diseases such as tuberculosis and new health issues like HIV/AIDS.

According to PAHO reports, in the 1960s malaria was almost eradicated in Guyana. Cases were confined to the North West District, but the 1980s saw the resurgence of the disease, and today it remains a major public health problem in Regions 1,8,9 and 10. PAHO continues to work with the Ministry of Health to improve and strengthen its response to the incidence of malaria in Guyana through a number of strategies, some funded by USAID.

Examples of such response programmes include: studies to ascertain the level of resistance of the malaria parasite to anti-malarial drugs, funded by USAID; implementation of multiple prevention strategies; technical support for resosurce mobilization; promoting a Pan American approach - supporting Guyana's participation in the Amazonian Basin Initiative in the Roll Back Malaria Programme.

And in the case of tuberculosis, following the 1993 World Health Declaration that TB is a re-emerging disease, PAHO supported Guyana's plan to re-organize its TB programme.

In order to assist Guyana in combating TB, PAHO has provided assistance in the following areas:

* Development of the National Plan for the Control of Tuberculosis

* Promotion and support for the establishment of the use of Directly Observed Treatment Strategy (DOTS)

* Training of laboratory staff in the diagnosis of TB.

* Training of technical staff in the programme management of TB

* Production of the TB control manual

* Development of TB Registries

* Integration of TB diagnosis and treatment into primary health care.

And generally, in Guyana. PAHO's efforts have contributed to the overall improvement of the health of the nation.

Said Dr. Gandi: "The country has seen a significant reduction of some of the communicable diseases, and in some cases, even eradication evidenced by Guyana's Foot and Mouth Disease free status. Maternal and infant mortality have also decreased," she added.

More recently, PAHO has been doing much to control the spread of lympathic filariasis (LF) through the use of Di-ethylcarbamazine (DEC) fortified salts.

Where the World Health Assembly passed a resolution in 1997 to eliminate lympathic filariasis by 2020, Guyana is working to eliminate local cases by 2015.