The following is a Call to Action which emanated from the three-day Caribbean Strategy Meeting on Domestic and Innovative Financing for HIV, Tuberculosis and Malaria. The Developing Country NGO Delegation to the Global Fund Board (DCNGO) will convene a webinar with civil society organizations (CSOs) on the Call to Action on a date to be announced.  Please bookmark the PANCAP Current and Upcoming Events page for the date and time.

Tremendous progress has been made in the response to HIV and AIDS, Tuberculosis and Malaria in the Caribbean. An estimated 310, 000 persons are living with HIV with Jamaica (10%), Cuba (8%), Dominican Republic (22%), Haiti (48%) and the Republic of Trinidad & Tobago (4%) accounting for 92% of the total disease burden at the end of 2016. New infections among children 0-14 years decreased by 44% from 1800 in 2000 to fewer than 1000 in 2016 and 55% reduction in AIDS-related deaths from 21,000 in 2000 to 9400 in 2016. The number of people accessing ARVs doubled in the last seven years with access among expectant mothers increased to over 90%. Much of this progress is due, in large part, to increased investments by stakeholders, including the private sector and government, greater involvement of civil society, strengthening of health and community systems, and a more coordinated approach among stakeholders to improve the health and well-being of all persons, including key and vulnerable populations across the Region.

The Caribbean has relied heavily on donor funding over the years to finance its response to the three diseases. However, dwindling resources and heavy dependence on foreign assistance negatively impact the Region’s ability to meet SDGs and national targets which will reverse gains in the response if Caribbean leaders do not continue to increase domestic investments.

More resources are needed to finance, sustain and scale up programmes for prevention, treatment, care, support and human rights as well as for gender equality across the Region towards ending the three diseases. The situation requires that additional attention be placed on efficient use of resources, including utilization as well as exploring new revenue sources. Mobilizing resources domestically is critical to this thrust. It is an imperative we cannot ignore given our shared responsibilities to improve the health outcomes and quality of life of people in the Caribbean.

We, representatives from non-governmental organisations, academia and government, call upon our leaders to undertake the following in partnership with us and in keeping with the 2016 UN High-Level Political Declaration HIV, UNAIDS Fast Track Initiative, the 2017 Latin America & Caribbean Call to Action for the Acceleration of HIV, and the Caribbean Strategic Framework on HIV/AIDS:

1. Increase the allocation of national health budgets each year over the next three years to the HIV, Tuberculosis and Malaria response in order to fill the funding gaps which arise as a result of the reduction in donor funding;

2. Scale-up prevention, treatment, care and support as well as human rights and gender equality programmes for HIV, Tuberculosis and Malaria;

3. Acknowledge the value-added of partnership with civil society and community systems and Implement the WHO recommendations to strengthen and sustainably support civil society’s role in the response through mechanisms such as subventions, social contracting and other forms of technical assistance and support;

4. Explore innovative financing approaches for health where HIV, Tuberculosis and Malaria are prioritized;

5. Establish a regional funding mechanism that can/will attract support to mobilize, manage and disburse funds for country-level initiatives for the three diseases, including the strengthening of health and community systems and improvement of the human rights situation in countries;

6. Accelerate and/or strengthen the integration of the HIV response into primary health care to encourage better health-seeking behaviours and make services more accessible;

7. Minimize out of pocket payments (OPP) for medical expenses by accelerating, introducing and strengthening commitments to universal health coverage (UHC); introducing and/or strengthening National Health Insurance Schemes and include HIV services in the minimum package of services;

8. Honor commitments to implement activities per treaties and agreements related to the protection and promotion of human rights in partnership with civil society;

9. Engage development partners around the impact of upper middle-income country status on the availability and accessibility of donor funding as well as cost of services and commodities and advocate for the development and use of other criteria to determine eligibility for funding; and

10. Reaffirm commitments to SDG targets of increasing health financing while ending AIDS, TB and Malaria by 2030, towards meeting SDG targets and to ensure healthy lives and promoting well-being for all across the life cycle.