Source: Johnson D, D´Agostino M, Marti M, de Cosio FG. Knowledge management strategy for advancing the

national health agenda in Dominica. Rev Panam Salud Publica. 2017;41:e3. 

ABSTRACT: The Ministry of Health and Environment (MoHE) of the Commonwealth of Dominica identified the need for a knowledge management strategy to advance the country’s national health agenda.  The Pan American Health Organization and the MoHE conducted a rapid situation analysis of knowledge management in July 2015. The findings, analysis, and recommendations were developed
jointly with a core team of the MoHE within the context of the strategic plan for health, “Investing in Health – Building a Safer Future.” The situation analysis described the overall status of the understanding and implementation of information and knowledge management
activities, projects, products, and practices. The analysis also aimed to identify what critical knowledge is needed to support overall organizational goals and individual and team activities.

The MoHE expects patient outcomes and quality of care to improve as a result of having a knowledge management strategy that boosts the Ministry’s efficiency and productivity.
Dominica, the largest and most northern of the Windward Islands, is only 29 miles long by 16 miles wide and has 91 miles of coastline (1). The Government of Dominica has a Westminster-style parliamentary government. The executive branch includes the president, who is elected by parliament for a 5-year term, and the prime minister, who is appointed by the president. Dominica’s legal system is based on English common
law, with three magistrate courts that may appeal to the Eastern Caribbean Court of Appeal, and ultimately, to the Privy Council of London (2).
The local government consists of councils with the majority of representatives elected by universal suffrage. Supported by property taxation and governmentgrants, the councils are responsible for the regulation of markets and sanitation and the maintenance of secondary roads
and other municipal amenities. The island is also divided into 10 parishes whose governance is unrelated to the local governments. The Carib territory has its own ruling council with greater autonomy.
According to the Central Statistical Office (Roseau, Dominica) the country’s population grew from 70 121 in 1991 to 70 340 in 2011,4 virtually no change in 10 years. During that same period, the natural increase (the excess of births over deaths) was 9 300. The population is predominantly (almost 80%) of African descent. Just over 4% are Carib, the only concentration of indigenous people in the Antilles.
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Messages from The Secretary-General, CARICOM 
                          Director, PANCAP Coordinating Unit, CARICOM Secretariat
                             The Secretary General - The United Nations
                             UN Secretary-General Special Envoy for HIV in the Caribbean 
                          Executive Director of UNAIDS, Under-Secretary-General of the United Nations
The Caribbean Community (CARICOM) joins the rest of the world in commemorating World AIDS Day 2016, which is being observed under the Theme ‘Hands up for #HIV Prevention’.  This Theme calls attention to the crucial need for us to refocus our efforts on combination prevention that includes treatment, behaviour change, communication, and provision of social protection to address individuals’ vulnerability.
The CARICOM Strategic Plan 2015-2019 articulates as a strategic priority, Building Social Resilience - Equitable Human and Social Development - with a goal of improved quality of life for all people.  This is targeted through, among other things, improved education and health, reduced levels of poverty, equitable access to opportunities by vulnerable groups, and enhanced citizen security.  In so doing, CARICOM acknowledges the critical importance of providing the requisite social protection to address vulnerability. 
While the Caribbean Region continues to see increased numbers of persons being placed on treatment, 52 percent in 2016 compared to less than 5 percent in 2001, the recent 2015 UNAIDS Prevention Report highlights an increase in new infection in the Caribbean.  This is a cause for concern given that the 2014 UNAIDS Global AIDS Report lauded the Caribbean for achieving the sharpest regional reduction in HIV incidence by 49 percent.  This calls for increased focus to be placed on combination prevention of HIV. 
We are all aware that external donor funding to support both our regional and national response to HIV continues to decrease amid the call for greater emphasis on ‘test and treat’, in accordance with the WHO 2015 Treatment Guidelines which states that people who are diagnosed HIV positive should be placed on treatment early.  Evidence shows that the earlier people living with HIV start antiretroviral treatment, they have better health outcomes. 
With that evidence in mind as well as the reported increase in new infections, I urge the international donor community to support the regional response to HIV and AIDS.  It is a matter of urgency that we fill remaining gaps in funding to assist in ending the AIDS epidemic in the Region as we seek to achieve the UNAIDS goal of ending AIDS by 2030. 
Let us therefore intensify our efforts to increase national HIV investment and prioritise policies and activities aimed at HIV prevention in the years ahead.

Message by Director, PANCAP Coordinating Unit

CARICOM Secretariat 

Dereck Springer 

on the ocassion of World AIDS Day 2016




As the World commemorates World AIDS Day 2016, its does so under the theme ‘Hands up for #HIV prevention’. This theme calls attention to the crucial need for us to refocus our efforts on combination prevention that includes treatment, behavior change communication, access to condoms and provision of social protection to address individuals’ vulnerability.


We must be reminded that a new generation of young people are growing up without the education, knowledge and tools to protect themselves. We must therefore advocate for renewed emphasis to be placed on HIV prevention education among our young people and evidence informed strategies to enable them to protect themselves from HIV. Let us be cognizant of the vulnerabilities that people continue to face and which put them at risk to contracting HIV. There is an urgent need to collaborate with all sectors including human services, social protection and education to address the underlying causes of vulnerability and risk: poverty, inequality and social exclusion.


We must be mindful that in spite of the many successes of PANCAP, stigma and discrimination continue to serve as barriers to individuals’ access to much needed prevention services. PANCAP is using its Justice for All (JFA) Programme to affirm human rights of all and to advocate for reducing stigma and eliminating discrimination. We believe that synergies between the JFA programme and other efforts would result in increased numbers of persons from key population groups coming forward to access prevention, treatment care and support services.


Let us recommit to placing prevention high on our agenda and doing all we can to enable this new generation to achieve prevention. 






Message by The Secretary General of the United Nations
Ban Ki-Moon
On the occasion of World AIDS Day 2016




Thirty-five years since the emergence of AIDS, the international community can look back with some pride but we must also look ahead with resolve and commitment to reach our goal of ending the AIDS epidemic by 2030.



There has been real progress in tackling the disease. More people than ever are on treatment. Since 2010, the number of children infected through mother-to-child transmission has dropped by half. Fewer people die of AIDS-related causes each year. And people living with HIV are living longer lives.



The number of people with access to life-saving medicines has doubled over the past five years, now topping 18 million. With the right investments, the world can get on the fast-track to achieve our target of 30 million people on treatment by 2030. Access to HIV medicines to prevent mother-to-child transmission is now available to more than 75 percent of those in need.



While there is clear progress, gains remain fragile. Young women are especially vulnerable in countries with high HIV prevalence, especially in Sub-Saharan Africa. Key populations continue to be disproportionately affected by HIV. New infections are on the rise among people who inject drugs as well gay men and other men who have sex with men.



The AIDS epidemic is increasing in Eastern Europe and Central Asia, fuelled by stigma, discrimination and punitive laws. Globally, people who are economically disadvantaged lack access to services and care. Criminalization and discrimination foster new infections each day. Women and girls are still especially hard hit.



The 2030 Agenda for Sustainable Development was adopted with a promise to leave no one behind. Nowhere is this more important than in tackling AIDS. Supporting young, vulnerable and marginalized people will change the course of the epidemic. The UNAIDS strategic framework is aligned with the SDGs, which highlight how the work against HIV is linked to progress in education, peace, gender equality and human rights.


I am proud to see how the United Nations and UNAIDS, under the leadership of Michel Sidibé, are committed to finding new and better approaches to end this epidemic.



During its first decade, affected groups refused to accept inaction, mediocrity and weakness in the AIDS response. Their courage drove progress on securing women and children's health, lowering the costs of lifesaving drugs and giving voice to the voiceless. We must all join together in that same uncompromising spirit. On World AIDS Day, I salute the tireless effort of leaders, civil society, colleagues in the UN and the private sector to advance this cause.



As I prepare to complete my tenure as Secretary-General, I issue a strong call to all: let us recommit, together, to realizing our vision of a world free of AIDS.




Message by UN Secretary-General Special Envoy for HIV in the Caribbean
Edward Greene
On the ocassion of World AIDS Day 2016
'Let's raise Hands and voices for Prevention'

World AIDS Day provides the ideal occasion to join scientists, activists, practitioners and people living with and affected by AIDS around the world in celebrating the successes that we have achieved. Yet it is a time for caution against complacency that will contribute to reversing these gains. Prevention must therefore be the flagship for sexual and reproductive health and rights, age appropriate sexual education, access to condoms and pre exposure prophylactics. It must also be a standard bearer for reducing violence against women, girls and adolescents and eliminating AIDS- related stigma and discrimination.


Let us raise our hands in support of PREVENTION -- to signal Justice for All. And Let us raise our voices in a global chorus for PREVENTION -- "ending the AIDS epidemic by 2030"




Message by Executive Director of UNAIDS

Michel Sidibé
Under-Secretary-General of the United Nations

on the ocassion of World AIDS Day 2016


UNAIDS EXD Michel Sidibe Hi


Today, we commemorate World AIDS Day—we stand in solidarity with the 78 million people who have become infected with HIV and remember the 35 million who have died from AIDS-related illnesses since the first cases of HIV were reported.


The world has committed to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals. We are seeing that countries are getting on the Fast-Track—more than 18 million people are now on life-saving HIV treatment and many countries are on track to virtually eliminate HIV transmission from mother to child.


We are winning against the AIDS epidemic, but we are not seeing progress everywhere. The number of new HIV infections is not declining among adults, with young women particularly at risk of becoming infected with HIV.


We know that for girls in sub-Saharan Africa, the transition to adulthood is a particularly dangerous time. Young women face many challenges—for HIV, they face a triple threat: a high risk of HIV infection, low rates of HIV testing and poor adherence to HIV treatment.


Coinfections of people living with HIV, such as tuberculosis (TB), cervical cancer and hepatitis B and C, are at risk of putting the 2020 target of fewer than 500 000 AIDS-related deaths out of reach. TB caused about a third of AIDS-related deaths in 2015, while women living with HIV are at four to five times greater risk of developing cervical cancer. Taking AIDS out of isolation remains an imperative if the world is to reach the 2020 target.


With access to treatment, people living with HIV are living longer. Investing in treatment is paying off, but people older than 50 who are living with HIV, including people who are on treatment, are at an increased risk of developing age-associated noncommunicable diseases, affecting HIV disease progression.


Whatever our individual situation may be, we all need access to the information and tools to protect us from HIV and to access antiretroviral medicines should we need them. A life-cycle approach to HIV that finds solutions for everyone at every stage of life can address the complexities of HIV. Risks and challenges change as people go through life, highlighting the need to adapt HIV prevention and treatment strategies from birth to old age. 


The success we have achieved so far give us hope for the future, but as we look ahead we must remember not to be complacent. AIDS is not over, but it can be. Fundamental political, financial and implementation challenges remain, but we should not stop now. This is the time to move forward together to ensure that all children start their lives free from HIV, that young people and adults grow up and stay free from HIV and that treatment becomes more accessible so that everyone stays AIDS-free.







The K4Health-PANCAP project will provide a two-day training and one-day workshop
for Civil Society Organizations (CSOs) and National AIDS Program (NAP) Managers
from November 23-25, 2016 in Port of Spain, Trinidad.


The workshop will focus on:


· synthesizing knowledge of challenges
and best practices around Test and Start into products that have a clear,
concise narrative


·creating and adopting standard tools
and templates for information analysis, organization, and packaging


·utilizing newly acquired knowledge
synthesis skills to enhance the reporting, documenting, and sharing of best
practices specifically in regard to integration of CSOs into national programs
more reliably and effectively to regional stakeholders


Capitalizing on a knowledge sharing
opportunity – The LAC Forum


The proposed knowledge synthesis training and best practices workshop will build
participants' capacity to synthesize and share knowledge and also help prepare
PANCAP members for more effective participation during The Third Latin American
and Caribbean (LAC) Forum on sustainability of the HIV response.


The Forum will provide a space for sharing information on national progress and
preliminary results towards the achievement of the agreed "90-90- 90" and the
prevention and zero discrimination targets, challenges and unmet needs from the
2015 Rio Call to Action, as well as sharing new scientific data following the
International AIDS Society meeting in Durban, South Africa, to support the
implementation of cost effective and efficient interventions across the HIV
continuum of care.


The Forum will also facilitate a discussion of how
strategies and mechanisms transition into nationally sustainable responses in
the Latin America and the Caribbean engagement to halt and eventually eliminate
HIV as a public health threat by 2030.


Since the knowledge synthesis training and best practices workshop will be conducted
before The LAC Forum, participants will be able to capitalize on the
opportunity to meet face-to-face, improve and enhance messaging and
representation for the Forum, and develop specific outputs from the workshop to
present to their Latin American counterparts at the LAC Forum.





- Stigma and Discrimination a major barrier to accessing HIV Prevention tools and education


Net mapping CSWC SWIT workshop


Thursday October 20, 2016, GEORGETOWN GUYANA: The Pan Caribbean Partnership against HIV & AIDS, PANCAP, participated as a key stakeholder at the Caribbean Sex Work Coalition SWIT (Sex Worker Implementation Tool) Meeting held from October 16 to 20, 2016 in Georgetown, Guyana.

The workshop is supported by the United Nations Development Programme (UNDP) and Global Network of Sex Work Projects (NSWP).

The PANCAP-Knowledge for Health (K4Health) project engaged over 20 participants of the CSWC Sex Worker Implementation Tool (SWIT) workshop in a 'net-mapping' activity to determine how stigma and discrimination affects their ability to advocate for human rights, access to HIV prevention and care, and HIV/AIDS education.


According to Sarah Fohl, Knowledge Management Advisor for the K4Health project, 'net-mapping is a knowledge management tool that allows participants to determine the relationships, actors, barriers and opportunities within their communities that significantly affect their lives'.

The Knowledge Management Advisor further explained that the net-mapping exercise allowed participants to work together and identify barriers and opportunities to adequate access to condoms and education about safe sex and HIV/AIDS.


Knowledge Management Coordinator, K4Health, Dr. Shanti Singh-Anthony who also implemented the net mapping activity stated, 'sex workers face a tremendous amount of discrimination because of their line of work. It was important for the participants of the workshop to clearly identify what prevents them from gaining sufficient knowledge on HIV/AIDS as well as prevention tools so that advocates can identify solutions to remove these barriers with the aim of eliminating the spread of AIDS'.


According to Miriam Edwards, Co-chair and Coordinator of the Caribbean Sex Work Coalition (CSWC), 'the exercise was vital for sex workers and leaders of sex worker-led groups to fully understand the importance of their role in reducing discrimination in order to consistently access HIV/AIDS prevention tools and education'.


The Co-Chair further explained that the net mapping activity complemented the goal of the workshop to educate participants on the Sex Worker Implementation Tool (SWIT) which offers practical guidance on effective HIV and STI programming for sex workers. It provides evidence on the importance of decriminalizing sex work, the involvement of sex workers in developing policy, and the empowerment and self-determination of sex working communities as a fundamental part of the fight against HIV.


The Co-chair concluded 'the aim is for sex workers and leaders of the groups represented to propagate the messages and lessons learnt through the PANCAP – K4Health activity among their peers in their respective countries so that more sex workers are playing an active role in responding to stigma and discrimination barriers to HIV/Prevention tools and education'.


- ENDS -


Editor's Notes:


The idea for the Caribbean Sex Work Coalition SWIT (Sex Worker Implementation Tool) workshop was generated after Leaders of the CSWC participated in the Global Fund SWIT workshop in October, 2015 in Ecuador as well as additional SWIT training activities earlier in 2015 organized by the United Nations Population Fund (UNFPA).


SWIT was created by the World Health Organization (WHO) and is based on WHO's 2012 recommendations on HIV and Sex Work.
Following discussions at the CSWC's last Regional Meeting, an agreement was formed by a consortium network of sex workers from NSWP (Global Network of Sex Work Projects) that increased awareness of SWIT is crucial to the development of sex workers in the Caribbean. CSWC has received the support of NSWP through the Robert Carr Civil Society Networks Fund (RCNF) to convene this 5-day SWIT training in Guyana'.


Director of PANCAP, Dereck Springer, advocates for more attention on the issue of stigma and discrimination within the sex work environment.

'It was imperative that PANCAP be a key part of this workshop since eliminating discrimination against sex workers is a key component of PANCAP's Justice for All (JFA)' initiative, stated the PANCAP Director, 'the JFA advocates for the reduction of stigma and discrimination and the upholding of human rights with particular regard to the right to access HIV prevention, treatment and care'.


'Ending AIDS requires an environment that is free of stigma and discrimination,' stated the PANCAP Director, 'key populations such as sex workers are more likely to receive education on HIV/AIDS, as well as prevention tools when there is no fear or being stigmatized. I fully endorse the objective of the SWIT workshop. Sex workers must be cognizant of their role in creating a stigma free environment as well as what actions are pivotal to eliminating the spread of HIV/AIDS in the sex work industry'.


The SWIT Workshop, which hosted participants from Guyana, Jamaica, Antigua, Suriname, Trinidad and the Bahamas, aims to provide effective training on the use and implementation of the SWIT with the objective of building the knowledge capacity of sex workers in reducing stigma and discrimination.


- ENDS -




PANCAP is a Caribbean regional partnership of governments, regional civil society organisations, regional institutions and organisations, bilateral and multilateral agencies and contributing donor partners which was established on 14 February 2001. PANCAP provides a structured and unified approach to the Caribbean's response to the HIV epidemic, coordinates the response through the Caribbean Regional Strategic Framework on HIV and AIDS to maximise efficient use of resources and increase impact, mobilises resources and build capacity of partners.


Knowledge for Health (K4Health)


The mission of the Knowledge for Health (K4Health) project is to improve family planning and reproductive health services in low- and middle-income countries. We are working to change the way family planning knowledge is accessed, shared, and used.

For more information visit and


Timothy Austin
Communications Specialist
PANCAP – Knowledge for Health (K4Health)
CARICOM Secretariat
Georgetown, Guyana.

The Global Fund to Fight AIDS Tuberculosis and Malaria logo


MONTREAL – At the launch of the Global Fund's Fifth Replenishment, donors pledged over US$12.9 billion for the next three years, demonstrating extraordinary global commitment toward ending the epidemics of AIDS, tuberculosis and malaria for good.


Hosted by Prime Minister Justin Trudeau, who stressed youth engagement as a key to success in global health, the conference welcomed significantly increased pledges from several donors. Canada increased its own contribution by 23 percent, many new partners pledged for the first time, and private sector contributions more than doubled.


The Replenishment Conference raised nearly $1 billion more than the previous replenishment conference in 2013, and benefitted from participation by leaders from countries all over the world, United Nations Secretary General Ban Ki-moon, and Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation.


The amount raised will save 8 million lives, avert 300 million infections, and help build resilient and sustainable systems for health. The conference is only the beginning of a three-year replenishment period, and the Global Fund will actively work to gain further contributions in the coming months and years, with strong advocacy by civil society and partners worldwide.


Programs supported by the Global Fund have saved 20 million lives since 2002, and averted 146 million new infections since 2012. The Global Fund has also helped stimulate an additional US$6 billion in domestic investments in health by low- and middle-income countries in the most recent three-year period.


"We can end these epidemics for good, if we accelerate our efforts and continue to bring in new partners," said Prime Minister Trudeau.

Prime Minster Trudeau's remarks at the conference embodied a spirit of compassion and commitment to work across borders and find solutions to significant global challenges, like ending AIDS, tuberculosis and malaria as epidemics.


The United States led the pledging with US$4.3 billion, approximately one-third of total funding. The United Kingdom pledged £1.1 billion, the second-largest pledge for this replenishment period; France pledged €1.08 billion, maintaining their position as the second-largest donor to the Global Fund overall.


Germany pledged €800 million, a 33 percent increase; Japan pledged US$800 million, effectively a 46 percent increase when measured in Japanese yen; Canada pledged $804 million CAD, a 23 percent increase; and the European Commission pledged €475 million, nearly a 30 percent increase. The Bill & Melinda Gates Foundation pledged US$600 million.


Sweden Prime Minister Stefan Löfven addressed the closing session of the conference, and pledged SEK 2.5 billion. Norway pledged NOK2.0 billion, a 18 percent increase. Australia pledged $A220 million, a 10 percent increase. All pledges cover the coming three-year period.


Several low- and middle-income countries that are significantly increasing their investments in health also pledged contributions to the Global Fund, to benefit the broader work to end the epidemics globally, including Kenya's pledge of US$5 million.


Pledges from private donors and innovative financing initiatives reached US$250 million for the coming three years, more than double from the previous period.


The Global Fund is committed to achieving maximum impact with available funds, and is constantly evolving to find innovative ways to achieve even better results with available resources. Programs supported by the Global Fund partnership have put 9.2 million people on antiretroviral treatment for HIV, provided 15.1 million people with TB treatment and distributed 659 million mosquito nets to protect families from malaria.


"The Global Fund is one of the most impactful investments a donor can make in global health," said Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation. "The increased generosity pledged by long-standing and new donors is inspiring and will help ensure this unique partnership can continue its critical work to make the world better, safe and more equitable for all."


The Global Fund partnership is committed to removing human rights barriers to health so that everyone can access the health services they need, particularly communities and key populations who are denied access due to stigma or discrimination. The Global Fund invests in many programs that specifically focus on the needs of women and girls, who are particularly at risk from HIV, TB and malaria, and works to address the gender inequalities that are major drivers of the spread of the three diseases. Ending the epidemics requires stronger systems for health, and breaking down the barriers that prevent people from accessing lifesaving health care.


"We have the knowledge and tools to end HIV, TB and malaria as epidemics by 2030, but we need to invest smartly and with focus to make it happen," said Mark Dybul, Executive Director of the Global Fund. "When we work together, we can achieve more than anyone dreamed possible."


Source: The Global Fund