The Colombian Plan on HIV/AIDS 2008-2011 demonstrates substantial Colombian engagement with the Millennium Development Goals (MDGs). In fact, the Plan, prepared by the UNAIDS-Colombia and the Ministry of Social Protection with the active participation of civil society organizations and groups of people living with HIV, aims to provide universal access to appropriate treatment, including antiretroviral treatment.

According to the MDGs, by 2015 Colombia has to maintain the prevalence of the HIV infection under 1.2%, reduce the AIDS-related mortality rate as well as prenatal transmission, and increase the use of protection methods, including the condom, particularly among youth.

“The prevalence of the HIV infection and AIDS is not as significant as in other countries; however, AIDS is still a challenge for the Colombian State and its society,” says Diego Palacio Betancourt of the Ministry of Social Protection. “Every new case of infection is the result of a number of factors, many of them avoidable, which have to be addressed not only from the health sector, but from other sectors involved under the leadership of the Ministry of Social Protection.”

The sectors Palacio Betancourt refers to include cultural, political and social factors, such as: the difficulties women face in negotiating condom use, the myth that HIV/AIDS only afflicts gay men, and the high number of displaced people — resulting from the Colombian armed conflict — who represent a new vulnerable-to-HIV group of almost three million.

From 1983 to 2007, 57,500 people have been registered as infected by HIV or as people who have developed AIDS, and 24,000 of them have died. However, the authorities recognize that this data does not show the complete picture, and estimate that 171,500 people could have become infected over that time span.

These numbers still fall within the Millennium Development Goals. But for Colombia it does not mean that the task is done. In fact, the Plan is a demonstration of long term engagement to reduce the prevalence of the epidemic and to stop its propagation.

For that purpose, the Plan establishes 23 outputs and 53 goals to be reached through prevention and health care, and defines relevant target groups – teenagers and young adults.

Nearly 60% of the cases recorded represent people ranging in age from 15 to 34 years old. Although most of them are male (77%), there is a clear feminization trend. In fact, from 1985 to 2004, the proportion of men infected in relation to women infected drastically changed from 11 men for every 2 women to 2 men for every 8 women.

As a consequence, the Plan calls for a gender perspective insertion in all the prevention and intervention programs. The strategy “Abstinence, Fidelity and Condoms” does not make sense for many women, whose husbands do not practice one or more of these three recommendations. However, the Plan does not elaborate on the gender perspective, which remains a challenge.

Colombia has excellent coverage for HIV/AIDS treatment. Evaluation reports established that 72% of HIV/AIDS cases received treatment through the National Health System. This is one result of important efforts made over the last four years to ensure adoption of all the medicines (including antiretroviral) and diagnostic proceedings under the Mandatory Basic Health Plan, whose coverage is a requirement for every Colombian working person.

Another successful advancement has been achieved in preventing transmission from mother to child. From 2003 to 2007, nearly 600,000 pregnant women were included in the prevention strategy. According to official data, no fewer than 200 cases of this kind of transmission were avoided as a result of the prevention strategy.

The Plan proposes to spread such a prevention strategy to all the health care providers which offer prenatal services.

This is a four year plan with a budget of over sixty million dollars, without including the retroviral medicines and health care costs, which are covered by other sources.

Despite the advancements, the Plan states that there are still obstacles to HIV/AIDS prevention and treatment in Colombia:

“Universal access to health care and retroviral treatment
will only be attainable once we achieve universal access to social security;
as for prevention, we need a strong engagement of those in charge of
massive health activities and from other sectors, in order to impact
the groups more touched and more vulnerable.”