On the 11 April 1996, the Prime Minister of Fiji, Mr. Sitiveni Rabuka, officially launched the United Nations prepared report, Time to Act : the Pacific Response to HIV and AIDS in Fiji. In his address, Mr Rabuka said, ĎAIDS is not just a threat to life but to the whole make-up of development prospects of a nation'. He emphasised the importance of educating the people in understanding the impact of HIV and AIDS : the consequences that the illness will have on society, the country's economy and especially the burden on the family in terms of extra medical bills and social alienation from the community. He also said that AIDS was everyone's concern and responsibility and not just that of the medical profession.
Time to Act has been produced through the collaborative effort of the UN agencies in Fiji, namely UNDP, UNFPA, UNICEF and WHO, with the assistance of the South Pacific Commission and numerous individuals who provided research papers, other information, and comments. The main purpose of the report is to increase awareness about the HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome) epidemic and its potential consequences in the Pacific region, and to highlight the types of action that can help contain the epidemic and its impact. HIV has now become a pandemic, affecting people in all parts of the world, including the Pacific. This report can help Pacific island leaders and policy-makers to develop specific strategies and plans for their individual countries.
HIV and AIDS are under-reported in the Pacific - because the statistics are so incomplete, the HIV epidemic is hidden even as it spreads throughout the region. The report notes that several social, cultural and economic factors make Pacific island communities vulnerable to contracting HIV.
The report notes that, in the face of this vulnerability, over the next decade or two, AIDS could become the leading cause of death in some Pacific island countries. The economic costs of HIV and AIDS include the loss of labour and skills, absenteeism from work, and lowered productivity. The potential economic cost of the loss of life to AIDS is 15 to 20 times greater than the present per capita GNP of Pacific island countries. The costs of medical care for people with AIDS are enormous, averaging around US$4,600, a very much higher figure than the US$20 to US$40 per person that Pacific island governments now spend on health care.
The spread of HIV can be contained by Pacific island communities and governments. An essential first step is to remove the stigma of infection and discrimi-nation against people who have HIV or AIDS. A second essential step is to develop a supportive environment in which there are no barriers to people receiving and understanding information about how to prevent the spread of HIV, and no barriers to people acting on this information.
Time to Act notes each country needs to develop specific strategies and plans to suit their particular situation. In every case, however, a multisectoral approach would encourage more effective action.
Mrs Konai Helu-Thaman, an academician, and Dr. Mridula Sainath, a medical practitioner, were elected as Chairperson and Vice-Chairperson of the Advisory Council of the newly instituted Regional Training and Operational Research Centre on Reproductive Health and Family Planning in the Pacific (RTRC) at its inaugural meeting on 23 April 1996. Mrs. Konai, who holds a Ph.D. in Education from the University of the South Pacific (USP) and hails from Tonga originally, is currently Reader in Education and Acting Head of the School of Humanities, USP. Dr. Sainath, of the Fiji Women's Rights Movement (a prominent women's NGO), runs a private medical practice.
Other Council members include Dr. Jimione Samisoni, Head of the Fiji School of Medicine; Dr. Lepani Waqatairewa, representing the Ministry of Health, Fiji; Ms. Fuliasi Aiavao, Ministry of Health, W. Samoa; Ms. Suzie Yoma, Department of Health, Federated States of Micronesia; Dr. Junilyn Pikacha, Ministry of Health, Solomon Islands; Ms. Kesaia Seniloli, Coordinator Population Studies, USP; and Dr. Mesake Biumaiwai, WHO. Additional members may be co-opted into the Advisory Council.Strengthening Capacity
The RTRC is a project, based at the Fiji School of Medicine, funded by the UNFPA to promote regional training and operational research in reproductive health and family planning. With funding for implementation in 1996 from UNFPA and support in principle for two additional years, the RTRC project is executed by WHO and implemented by the Fiji School of Medicine under a memorandum of understanding signed by the Ministry of Health for the Government of Fiji.
The project is aimed at strengthening regional capacity in reproductive health programmes, including family planning and sexual health. This is to be achieved through training interventions targeted at key health-care providers in the Pacific region and the promotion of operational research. It is aimed to train at least 200 health professionals in reproductive health, including family planning and sexual health, from various Pacific island countries during 1996-1998. To promote the development of in-country training and operational research activities, the RTRC expects to organize specialized skill-development courses for selected national personnel in training and operational research management.Training Courses
At its two-day inaugural meeting, 23-24 April, the Advisory Council identified priority areas for regional training and research and proposed topics for the first three regional training workshops to be held in 1996. These training initiatives are "Training for Trainers in Safe Motherhood and Reproductive Health"; "Safe Motherhood and Reproductive Health "for middle and higher-level health personnel; and "Research Methods in Reproductive Health" for middle level professionals. In addition to faculty from the Fiji School of Medicine, the Advisory Council recommended that regional resources available at the University of the South Pacific, the UNFPA CST, and cognate programmes at Australian universities, such as the University of New South Wales, be utilized in the course programme of the RTRC.