● <B>Mauritius used to boast about being one of the African countries with the lowest prevalence of HIV-aids. Today, the number of infected people seems to have increased dangerously. How have we come to such a situation?</B>

Mauritius can still be considered as a “low prevalence country”. If we look at the registered number of people infected, we reach a 0.5% rate compared to other countries in Southern Africa where the rate is more than 20% - and close to 40% in countries such as Swaziland. We can’t really compare but there is relatively low infection in Mauritius.

● <B>But the number of infections has increased?</B>

What has happened over the last three years is that HIV has pervaded the drug addict population. We know that this is a very fast way of spreading the disease. The sharing of needles sends the virus directly into the blood. In some countries, like India or in Eastern Europe, the rate of infection among drug users has gone from 60 to 90%. According to figures we have, about 15% of drug users in Mauritius are infected. This is why the rate of infection has gone up.

● <B>Associations, like Pils, recommend the provision of needles to drug addicts to prevent the disease from propagating even more. What do you think about it?</B>

This is a personal view. I read a lot about the provision of needles and the way this has been implemented in other countries. I firmly believe that, if it has to be implemented, then it should not be a programme that is implemented in isolation. It has to be part of a comprehensive package of services provided to drug users. This package would include a phase of education and counselling to reduce risky behaviour, then a substitution therapy to remove them from the use of injected drugs. Finally, the programme should involve the treatment of all the ailments caused by aids (which is already being given to some extent).

● <B>Don’t you think the increase in the infection rate is not only due to the fact that there are more cases but also that more people are prepared to admit they are HIV- positive than they were a few years ago?</B>

No, I don’t think so. I believe it is partly due to the surveillance system implemented by the authorities. At our level, we follow the trend very closely. We examine where the virus is going and reinforce our activities with people who need it. We are constantly in the field; if we hadn’t been in contact with these people, then we wouldn’t have known how many cases they were. I mean, there are 5 to 10 people a month who are being contaminated through sexual intercourse. On top of this there are those infected by intravenous drug use. We would not have known about them had we not been in the field. We realised that we had to see these people to really know what was happening. We see them and try to convince them that they should be tested.

● <B>Convince them… Would you be in favour of forcing people with risky behaviour to be tested?</B>

No. I am more in favour of counselling and explaining to people why they should do the test. This is actually what we’re doing when we go and see them. We explain to them that, if they are tested negative, they will be relieved and can then take all necessary precautions to remain negative. If they are positive, they can go to our day care centre and have the anti-retroviral drugs free. These drugs can not only prolong their lifespan but also give them a better quality of life. If we tell them the benefits of being tested, then they will accept. But we first have to be convinced ourselves to be able to convince them.

● <B>Is the disease less taboo than it was before?</B>

Not really. They are still afraid of disclosing their status because of the social stigma. The problem is that the population at large does not feel concerned; they think “aids is for others and not for them”. This is why we have launched a media campaign to take the population on board, especially the community and religious leaders. But it is a very slow process…

● <B>Do you feel that religious leaders are preventing you from doing your job?</B>

No. We have to reach a consensus in such situations and I believe we have achieved it. When we talk about prevention, we talk about the 'ABCD' prevention. A means abstinence, B means being faithful, C stands for condoms while D means drug addiction. That means that we do not only talk about condoms. We give people the choice between these four avenues. The main objective is to protect themselves. We are not concerned that religions do not want to talk about condoms as long as they do not prevent us from doing so.

<I>Aids is transmitted through risky behaviour, like sex and drugs. What people search for in those two areas is “nisa”. How can you prevent people from having pleasure? We can give someone a condom but we can’t be sure he/she will use it.</I>

● <B>Do you consider that the authorities have done their utmost to reduce the propagation of aids?</B>

The authorities have called upon technical assistance from an international consultant of the UNAIDS/UNODC. Suresh Kumar has been in Mauritius since October to train doctors, hospital staff and social workers to provide services to drug users. He has done an analysis of the situation after going to treatment centres and meeting drug users and sex workers in the field. He has sounded out their feelings and found out their needs to finally make some recommendations. Among them, he advocated that outreach activities be set up. This means that we will not wait for these people to come to us but rather go to them. In that context, the ministry of Health is thinking of putting a mobile caravan at our disposal so that we can go and give services in the field – including counselling, testing and treatment, if needed. He also recommended the provision of substitution therapy within a comprehensive package that would include the exchange (provision) of needles on a pilot basis.

● <B>So, will the ministry implement such measures?</B>

It is being studied at ministry level; it has to go through the cabinet before any decision is made.

● <B>But, despite all campaigns and recommendations, the virus continues to spread…</B>

If, in mathematics, you can say that 1+1=2, in medicine, there is no such equation. What works for one patient can fail to work on another. Sometimes a medicine prescribed according to the symptoms of a disease will not treat its root cause. Aids is transmitted through risky behaviour, which are sex and drugs. What people search for in those two areas is “nisa” (pleasure). How can you prevent people from having pleasure? The virus is still propagating throughout the world. Among 5 million new cases, 70% have been transmitted through sexual intercourse. Of course, people know about the disease and the prevention methods. We can give somebody a condom but we can’t be certain that he/she uses it. We can give people the means but we also have to change their behaviour and mentalities. And this is even more difficult with drug users; when the latter are craving for drugs they do not even think of taking a clean needle. They just need their dose. But this is what we are striving to do… It will take time. The authorities must continue working in collaboration with NGOs and social workers. We have the same objective – preventing new infections and treating those already infected – so we need to coordinate the work of all partners and work together, as advocated by the UNAIDS.