Speech by Mr Micheál Martin T.D., Minister for Health and Children at the Ministerial Conference “Breaking the Barriers -Partnership to fight HIV/AIDS in Europe and Central Asia”
Good morning Taoiseach, Ministers, distinguished guests. It is a great honour to be here today on a platform with such distinguished speakers. This conference – HIV/AIDS – “Breaking the Barriers -Partnership to fight HIV/AIDS in Europe and Central Asia” is an important one and I am delighted to be the co-host with the Minister for Foreign Affairs.
HIV/AIDS in Ireland
The epidemiological development of HIV and AIDS in Ireland is similar to that experienced in other Western European countries. From 1982 to 1985 the condition was seen as a largely imported virus. When seroprevalence monitoring became possible in 1985 it was apparent that the HIV virus was indigenous in the country and that a particular problem existed in relation to the spread of HIV infection amongst IV drug users.
In 1992, the first report of the Irish National AIDS Strategy Committee (NASC) was published in response to the prediction that Ireland and the rest of the world faced an AIDS epidemic. Indications at that time were that the incidence of HIV would continue to grow. Right from the start the Irish Government took the view that what was required was a multi-agency approach, which incorporated statutory and voluntary organisations and people who were HIV positive. A National AIDS Strategy Committee was established in 1991. The National AIDS Strategy Committee produced its strategy document in 1992, which compromised the recommendations of four sub-committees namely, Education and Prevention, Surveillance, Care and Management and Discrimination.
For the next 8 years this was the framework upon which Irish policy for dealing with HIV/AIDS was built. Central to this policy were specific initiatives for injecting drug misusers, whose numbers were increasing at an alarming rate. In 2000 “AIDS Strategy 2000” was published which is the policy from which we now operate. The principle of partnership remains and all the various stakeholders were included in the development of this policy document. Because of robust equality legislation it was possible to disband the discrimination sub-committee in 2000 and the three remaining sub-committees work to implement the recommendations of this strategy.
The number of new HIV cases reported in Ireland has been increasing in the last number of years. The latest statistics published by the National Disease Surveillance Centre (NDSC), and which have been published today, show that in the first two quarters of 2003, 207 new cases of HIV were reported. For the whole of 2002, 364 new cases of HIV were reported. These figures compare with 299 in 2001 and 290 in 2000. The total number of HIV infections in Ireland is now at more than 3,000. The issue of HIV remains a concern and we can never become complacent.
Like many other countries in Europe a significant change in these figures is that heterosexual transmission accounts for a high proportion of new cases reported. This transmission category has replaced injecting drug use as the main route of transmission of the virus. With greater mobility of populations there is a more urgent need to ensure that everyone, particularly young people, are aware of the facts about HIV and AIDS, so that they can minimise the risk of becoming infected with the virus.
186 of the newly diagnosed cases (51.1%) in 2002 were among people born in sub-Saharan Africa. The number of diagnoses mirrors the epidemiology of HIV in other Western European countries and is not unexpected, given that 70% of the worlds HIV cases are found in sub-Saharan Africa.
There were 12 cases of AIDS reported to the NDSC in 2002, bringing the total number of AIDS cases in Ireland to date to 731. This figure is likely to be an underestimation as there is a delay in reporting AIDS cases in Ireland. There were four AIDS related deaths reported in 2002, bringing the total number of AIDS related deaths in Ireland to 369.
Education and Prevention
In relation to HIV our first line of defence must be education. My Department produces a range of materials and literature and runs awareness campaigns to inform the public, about the dangers of HIV/AIDS. Specific messages have been placed in third level colleges, nightclubs and pool halls. The Department of Health and Children is also a partner with the Department of Education and Science in the implementation of Social, Personal and Health Education (SPHE) at post primary school level. The Relationship and Sexuality Education Programme is an integral component of SPHE. The 10 regional health boards fund voluntary organisations that provide education and prevention as well as counselling and befriending services. A National Survey of Sexual Knowledge, Attitudes and Behaviours (KABS) in Ireland in relation to HIV and STI´s will commence shortly.
Routine antenatal HIV testing
During 1999 a system of routine linked antenatal HIV testing was introduced in antenatal clinics nationwide, with the aim of identifying women who are HIV positive at an early stage in pregnancy in order to provide appropriate treatment so that the risks of newborns being infected are greatly reduced. This is an ethically important step since it has been clearly shown that the perinatal transmission of the virus can be dramatically reduced or prevented by antenatal treatment of HIV positive women with anti-retroviral drugs and by careful management of the delivery. I am pleased to say that since its introduction, when the positive HIV status of the mother is known antenatally, the perinatal transmission rate has so far been less than 2%.
Links with drug misuse
As I mentioned earlier, intravenous drug misusers were most at risk of becoming infected with HV. Since 1992 additional funding has been provided each year to health boards to address the problem of drug misuse and HIV/AIDS. To respond to the strong links between HIV and drug msisue health board services include methadone treatment and needle exchange in the range of services for drug misusers. These services have seen significant expansion in recent years, particularly in the health boards in the East where the majority of drug users reside. In addition health boards have developed a range of interventions among the gay community aimed at lowering the incidence of HIV cases among men who have sex with men.
We were and still are faced with many challenges, however, in relation to HIV/AIDS. There is still no cure for this illness. Highly Active Antiretroviral treatment (HAART) has had a dramatic impact on the overall health and wellbeing of people with HIV, but as we have heard and will continue to hear there is a global pandemic, with millions of people, particularly in the developing world, unable to access any form of treatment.
I´d like to conclude now by wishing everyone a very successful and informative conference. I look forward to the hearing the remaining speakers at this mornings session and I have no doubt that the panel discussions over the next two days will generate lively debate.
Thank you for your attention.