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HIV/AIDS in Sri Lanka: Free of cost doesn't mean free of charge

Stigma, discrimination and lack of awareness, main challenges
Lanka Plus celebrates the International AIDS day for their first time in its story

Lanka Plus, the only registered HIV/AIDS positive people's forum of Sri Lanka, has celebrated for the first time in its thirteen years of history the International AIDS Day. Stigma and discrimination are still very strong in the country where the lack of awareness and accurate information is one of the main risks for the spreading of the epidemic.

"We would have liked to have commemorated the International AIDS Day much earlier but people living with HIV and AIDS (PLWHA) in Sri Lanka can't still speak up and share their experiences", affirmed T.W. Princey Mangalika, President of Lanka Plus, during the event.

"HIV prevalence in Sri Lanka is still very low but we can't afford to be complacent. Although medical treatment for HIV is available in Sri Lanka today, still need a social vaccine to combat stigma and discrimination", affirmed David Bridge, UNAIDS representative for Sri Lanka and the Maldives. "Let's bring HIV/AIDS out of the shadows", Bridge stated.

More than 70 people joined Lanka Plus members during the event. UNAIDS, UNDP, ILO, National HIV/AIDS control programme and ActionAid, members of their Advisory Board, participated in this first gathering. "It is a very happy day for all of us but the challenge remains among us as well. We need to create the appropriate environment to facilitate PLWHA to come out and speak up. It is our responsibility to make the society to get rid of many myths and misconceptions and advocate governments to fulfill their commitments", Rangapali Ranaweera, Team Leader HIV/AIDS ActionAid said.

During the event, Lanka Plus presented an appeal to the Government of Sri Lanka which aims "to share, not to challenge the on going HIV response in Sri Lanka, but to make it more effective and adequate for all citizens, particularly for the families who are infected and affected from the virus".

One of the main appeals was "to extend the services for positive people at least in other three major hospitals around Colombo and provincial hospitals as well. So that, more people can get access to free treatment," Lanka Plus states in their appeal.

Having more medical facilities in Colombo for positive people will also reduce the economical burden that the illness represents for most of them. Though the drugs for the treatment for PLWHA are provided by the Government for free, other treatment related costs are not covered. "The Government made the access to ant retro viral (ARV) drugs free of cost in 2004, but not free of charge. Large numbers of positive people leave outside Colombo and to get free medicine they have travel to Colombo from different provinces. Some times they had to stay in here for two or tree days and they pay for their travel, accommodation and food," affirmed T.W. Princey Mangalika.

That is why Lanka plus has proposed the Government to conduct a "need assessment towards developing a comprehensive treatment package which should make provisions of covering costs related all kind of tests, treatment for opportunistic infections, travels and accommodation, nutrition, alternative food for the positive babies."

Lanka Plus, in their appeal already handed to the Ministry of Health has made the following recommendations for developing a better-coordinated, comprehensive and sustainable HIV and AIDS National policy for 2007- 2010:

  • National AIDS Council should be activated to provide policy guidance and regularly review the progress of national response.
  • HIV should be considered as a development and human rights issue in which health (treatment) is an important component along with other components like prevention (awareness), care and support.
  • A National HIV/AIDS Commission should be set up for policy implementation, programme monitoring and inter agency coordination.
  • To comply with "three ones" policy, following arrangements should be made in the strategy. All funds should be placed in one basket from all sources for allocation against national intervention plan.

There are an estimated 39.5 million people worldwide who are living with HIV and AIDS, 8.6 million in Asia and 5.7 million in India (UNAIDS 2006). Sri Lanka's estimated 4,500-5000 cases (UNAIDS 2005) and 750-800 actual reported cases (National AIDS Council) might seem insignificant. But the country gathers a series of factors which could easily fuel the epidemic. Besides the lack of proper knowledge, Sri Lanka has a large number of migrants living in regions with a higher prevalence of HIV and the percentage of young people becoming sexually mature is important as well. Commercial sex is also increasing and the prolonged conflict and the impact of the tsunami has increased the level of vulnerability.

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