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Tackling the difficulties faced by young people in the Pacific is such a mammoth task that health workers in the region are calling for all hands on deck.

By Mona Matepi

AVARUA, Rarotonga, Cook Islands (February 23, 2000 – Cook Islands News)---Education for all is what a report from UNDP and Fiji School of Medicine sees as the key to youth and health difficulties. The report, released only a week ago, is calling on key decision makers outside of the health sector to help in efforts to educate youth on the causes and possible impact of the human immuno-deficiency (HIV) virus. It says such a move would advance a "more effective multi-sectoral response in the region."

The joint report was based on the findings of UNDP's Linda Petersen and Dr. Ayoade Olatunbosun-Alakija of the Fiji School of Medicine Reproductive Health Training Program.

A statistical profile of Pacific Islands showed there are 1.4 million young people aged between 15 - 24 years, around 20 percent of the region's population.

According to the paper, "This youthful structure of Pacific Island populations is posing critical development challenges to governments of the region as it is becoming increasingly apparent that the needs and aspirations of these young people are not being met."

Petersen quoted examples such as "high rates of youth unemployment, youth crime and formation of youth gangs, consistently high rates of sexually transmitted infections (STIs) among young people, teenage pregnancies, an increasing incidence of drug use and teenage suicides" plaguing many countries of the region.

She said a "key cause for concern in relation to the development impacts of HIV is that many people are or will be dependent on this particularly vulnerable group (youths)."

The report acknowledged that "male infections outnumbered female and that heterosexual contact is the main route of transmission in the region. The prevalence of other STIs may also encourage the spread of the virus."

The disparity between sex, age and mode of transmission suggests more education is needed for youth in regards to reproductive health, family planning and HIV awareness.

The movement of people within, out and around the region was also highlighted as a key factor in the spreading of the HIV virus in the wider Pacific region. The paper pointed out that economic reasons play a large part in the movement of large numbers of people to other regions of the Pacific, Australia, New Zealand and the United States.

It said "mobility often means an increase in sexual partners and therefore greater vulnerability to contracting HIV."

Also related to this is the high dependence on the tourism industry in most countries in the region and its contribution to the spread of HIV with the movement of visitors to and around the region from other parts of the world.


The report also touched on the state of the region's economies, concluding that "most countries of the region can be characterized as slow growing or, in the case of some countries, stagnant or regressive." State of the economies also factor in the conditions of economic hardship in which HIV/AIDS flourish.

So what is being done?

According to Petersen's report, the response to the spread of HIV has been mainly health sector led, with emphasis on advocacy and information, which includes education on the prevention of infection, promotion of a multi-sectoral approach which encourages governments, NGOs, churches, business sectors and professional organizations to educate their members and the public on STIs and HIV prevention and care, and solving social problems that contribute to and are consequences of the spread of the epidemic.

However, these strategies have had their shortcomings. For example, most of the national AIDS strategies were deemed to be isolated to only the health sector, with policies confined to the upper echelons of the health ministries.

Public Health Information Services’ Edwina Tangaroa confirmed this to be true in the Cooks. She said a multi-sectoral approach to the awareness of drugs, alcohol and tobacco, for example, should be taken up by all sectors instead of the job being left only to the health department.

This one-band-led approach, according to the report, defeats the purpose of a multi-sectoral policy formation.

Another grey area has been the setting up of an effective structure that would see the policy through.

Again, this area is either centered around the health sector or non existent. For example, Samoa and Kiribati were the only countries that acknowledged their governments’ efforts in coordinating activities between government and NGOs.

In other countries of the region, governments and NGOs operated independently.

The paper concluded that Pacific Island countries need to learn from the experiences of Africa and Asia and work towards a strategy which encourages a multi-sectoral approach towards HIV policy implementation, steps up advocacy and education for youth and formulates legislation that will ensure that people living with HIV/AIDS are not discriminated against.

One-third of the estimated 33 million people living with HIV (at the end of 1998) are young people between the ages of 15 and 24. About half of all new HIV infections occur in the 15 - 24 years age group. 510,000 children under 15 years old were among the 2.5 million people who died of AIDS in 1998. More than 8,500 young people are infected everyday.

Some might say that such figures are worldwide figures and so do not exemplify the situation in the Pacific. Here is some data from the Western Pacific (from Fiji to Mongolia) region. The World Health Organization estimates that there are 35 million new cases of curable sexually transmitted infections (STIs) each year, the majority of which are among 15-30 year olds. The 17 percent of reported AIDS cases and 43 percent of reported HIV infections in the region have occurred in the 13-29 age group.

It is obvious from the figures that reproductive health/STI/HIV/AIDS issues are affecting this region. One of the countries with an increasing HIV prevalence in the Pacific is Papua New Guinea. This increase is attributed to heterosexual transmission, thus breaking the myth that STIs/HIV is only transmitted via homosexual contact or intravenous drug use.

The figures for individual Pacific Island countries with regard to HIV/AIDS are low, but not just cause for complacency. The Pacific region is highly susceptible to an outbreak of the virus on a scale similar to that of the outbreak in Sub Saharan Africa.

Peter Piot, Executive Director of UNAIDS, in his opening address at the 5th International Congress on AIDS in Asia and the Pacific (ICAAP 5) stressed that low rates can change with "frightening speed." He said given what is known about the AIDS epidemic, any "naivete is unforgivably shortsighted.

"Discrimination and stigma are seen as a major obstacles in breaking myths about HIV/AIDS. Malaysia's Prime Minister Mahatir has called on heads of government to help in reducing discrimination towards people living with HIV/AIDS."

He said prevention can take place only if people with HIV/AIDS are willing to come out into a stigma-free society which did not discriminate against them.

"People's lives cannot be extended by care and treatment if they are afraid to come to the hospitals. They cannot afford to provide for their families and for their own medical expenses if they have no work. Their families suffer just as much -- the stigmatization extends even to the next generation," he said.

"What is most disconcerting is that more than 95 percent of all HIV infected people live in the developing world and 95 percent of all deaths occur in the developing world. This is largely among young adults who would normally be in their peak reproductive years," Mahatir pointed out.

The conference organizers also recognized people living with HIV/AIDS (PLWHAs) as the "invisible sector" of society, who could still contribute to the economy but are denied this chance through discrimination in the workplace and business sectors.

The 5th ICAAP, at which the Pacific region was well represented, was hosted by the Malaysian AIDS Council at the Putra World Trade Center, Kuala Lumpur, October 23-27, 1999.

It was the last and largest AIDS conference for 1999, and provided a launch pad for the concerns of a region which makes up about a third of the world.

For additional reports from the Cook Islands News, go to PACIFIC ISLANDS REPORT News/Information Links: Newspapers/Cook Islands News.

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