Speech by The Honourable Terrence Deyalsingh

FEATURE ADDRESS BY
THE HONOURABLE TERRENCE DEYALSINGH
MINISTER OF HEALTH
4TH MEETING OF THE NATIONAL AIDS PROGRAMME MANAGERS AND KEY PARTNERS
HYATT REGENCY
TUESDAY 15th MARCH, 2016
8:30 A.M.
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SALUTATIONS

• CHIEF MEDICAL OFFICERS OF CARICOM MEMBER STATES

• MR. DERECK SPRINGER, DIRECTOR OF THE PAN CARIBBEAN PARTNERSHIP AGAINST HIV AND AIDS(PANCAP)

• DR. DONALD SIMEON, VICE CHAIR

• DR. BERNADETTE THEODORE -GANDHI, PAHO/WHO REPRESENTATIVE, T&T

• DR. SHANTI SINGH, NATIONAL AIDS PRPOGRAMME MANAGER REPRESENTATIVE, • REPRESENTATIVE FROM THE CENTRES FOR DISEASE CONTROL, US

• DR BEVERLY ANDREWS, DIRECTOR, HIV/AIDS SECRETARIAT

• DR. AYANNA SEBRO, DEPUTY DIRECTOR, HIV/AIDS COORDINATING UNIT

• OTHER NATIONAL  AIDS PROGRAMME MANAGERS

• REPRESENTATIVES FROM OTHER UN AGENCIES

• SPECIALLY INVITED GUESTS

• LADIES AND GENTLEMEN

• MEMBERS OF THE MEDIA

Good Morning,

• It is with great pleasure that I welcome you all to our twin island republic. To those of you visiting our shores for the very first time, I say welcome and hope you are able to see some of our lovely island while you are here. To the rest of you I say bienvenidos, welkom, bienvenu, Namaste to the Fourth National AIDS Programme Managers Meeting.

• I have noted the objectives and expected outcomes of your Fourth meeting. I am pleased to report to you all that since the last meeting held in October 2015 at which it was announced that the National AIDS Coordinating Committee (NACC) will be returned to the Office of the Prime Minister (OPM), the Cabinet of Trinidad and Tobago led by our Prime Minister has approved the re-establishment of the NACC and its Secretariat in the OPM. Currently, the OPM is engaged in setting up the structure for the multisectoral committee and recruiting staff for the Secretariat. The NACC will review its operations after six months.

• With respect to the 2015 WHO Guidelines and the new WHO recommendation to test and treat all, we are currently looking at this new recommendation and we acknowledge the international guidelines to 500 (CD4 count falls to 500 cell/mm2), which suggest that persons should begin treatment immediately upon diagnosis of HIV.

•   Given the prevailing economic climate and in order to ensure sustainability, we are adopting an evidence based approach which entails conducting some economic analyses such as National AIDS Spending Assessment, the Modes of Transmission Study and the HIV Investment Case. In this regard we are receiving support from the United Nations Development Programme (UNDP) to assist in some of these activities. We would also be approaching other partners such as PEPFAR for assistance in these projects. These activities along with treatment 2.0 mission, the pharmacy mission, programme and procurement systems assessments would give an indication of our country’s readiness to adopt these guidelines.

• The new guidelines would imply the need for  establishing additional testing sites, creating more opportunities for testing, purchasing more medication which is freely available in TNT, acquiring more staff as well as laboratory supplies and infrastructure. The testing and treating of all guidelines would also necessitate the need for increased psychosocial support mechanisms. The need for a strong multisectoral mechanism such as the NACC would be a fundamental prerequisite for the implementation of these guidelines.

• With the Elimination of Mother-to-Child Transmission our national programme data shows that from 2011 to 2014 there has been a consistent decline from 2.3% in 2011 to 0.6% in 2014. We are awaiting confirmation from PAHO with respect to this country’s status on elimination of mother-to child-transmission.

• The PAHO Action Plan for the control of HIV/STI 2016-2021 for Latin America and the Caribbean has engaged the attention of our stakeholders at the national response level as well as at the Central Statistical Office and public sector ministry level as many of them would have provided feedback on the plan.

• However this presents another opportunity for the regional plan to be strengthened further as additional inputs are solicited. We support this approach to dialogue as it only serves to make the plan more robust and ensure that issues and concerns of the Caribbean are included.

• We at the Ministry of Health are concerned about the risk behaviours displayed by our youth both in and out of school. For example, children and youth under 24 years accounted for 13% of all new HIV diagnoses in 2014.  Just over more than a quarter of students aged 13-15 years reported ever having sex while 35% of males and 20% of females reported same according to the 2011 Global School Health Survey. Moreover 17% of students reported that they had sex with 2 or more partners during their life time. According to the last Multiple Indicator Cluster Survey of 2006, 15% of young women who had sex in the last 12 months, had sex with a man 10 years or older.

• We are also concerned with gender based violence and how this affects HIV transmission. This is recognized globally as one of the main drivers of the HIV and AIDS epidemic. Youth especially young women are vulnerable to HIV through sexual violence such as sexual abuse, coerced sex and intimate partner violence. Empirical research conducted in North America shows that young people who have experienced sexual abuse are more likely to engage in sexual or drug related risk behaviours (CDC, Dec 2011, HIV Among Youth). Fear of violence can also be a barrier to disclosing one’s status as well as seeking counselling and testing and getting treatment.

• I hope that in your deliberations you will also address some of these structural issues and share good practices on how to reduce them.

• I indeed look forward to learning of the contributions which will be garnered over the next three days. I encourage you all to participate fully and work assiduously towards achieving the elimination of HIV by 2030.

• I wish you a successful two days ahead.

Thank you.