Release Type: Communiqué

Opening Ceremony

Canon Garth Minott, Co-Chair, described the dialogue between Caribbean Religious Leaders and Representatives of key populations (sex workers, the LGBT community, Transgender community, etc.) as a historic occasion. He highlighted that it was one of the major outcomes of the PANCAP Conference involving 50 Religious Leaders from across the Caribbean Region held in Trinidad and Tobago February 1-2, 2017. He stated that the aim of the dialogue was to establish how the collaboration between Religious Leaders and Key Populations could contribute to the Region’s quest to end the AIDS epidemic by 2030. He identified the focus as:

• Addressing the gaps in treatment and prevention of HIV with special reference to the 90-90-90 test and treat targets and the strategies for combination prevention
• Promoting the reduction of stigma and discrimination especially in relation to key populations
• Promoting a viable legislative environment while fostering compliance with the principles of human rights, human sexuality, and human dignity.
• Forging partnerships and reconciling overlapping and divergent aspects of secular and religious governance that deal with the sacredness and wholeness of each person and social action to promote their dignity

Mr. Dereck Springer brought greetings from Prime Minister, Timothy Harris, CARICOM Lead Head for Human Resources, Health and HIV and Ambassador Irwin La Rocque, CARICOM Secretary General. He stated that the dialogue is a milestone for PANCAP and is consistent with the goals of the PANCAP Justice for All Programme as well as the 2016 UN Political Declaration to which all CARICOM States are committed. In his view, it reflects the attempt to better understand the convergence of the social and theological perspectives that would contribute to agreements on what it takes to reduce stigma and discrimination.

Dr. Yitades Gebre, PAHO/WHO Representative to Suriname, said the theme of the dialogue is a reminder that every human life is of inestimable value. He expected the outcomes of the dialogue to create an environment that is inclusive and to provide options for bridging diversity, breaking down the barriers of stigma and discrimination and increasing involvement of treatment and prevention partners. Taking action on these issues is consistent with the PAHO/WHO goal for achieving Universal Access to Health for all.

Giving the keynote address, His Excellency Patrick Pengel, Minister of Health, Suriname and Chair of the PANCAP Executive Board stated that Suriname is pleased to host the dialogue. It is a country known for its liberal embrace of diversity. He reiterated the fact that Suriname joined other CARICOM Countries in supporting the 2016 UN High-Level Political Declaration aimed at ending HIV/AIDS by 2030 and that It is particularly committed to the UN 90-90-90 targets. He stressed the importance of partnerships and access to information to reduce stigma, hence the need to strengthen the health information systems, improve the continuum of healthcare and implementing policies reflecting equity in health and life circumstances. This requires compassion for all, commitment to principles that empower rather than marginalize and action that is inclusive and does not leave anyone behind. He advocated for human rights health desks as an important mechanism linking inter-religious networks and key populations. He stated that the dialogue hosted by PANCAP and bringing together Religious Leaders and representatives of key populations is applauded by the Government of Suriname

Colin Robinson gave the vote of thanks with the charge that participants “unpack the tools” needed to do the work: their faith, hopes, and biases.

Plenary Sessions on the Perspectives of Religious Leaders and Key Populations

The first two Plenary Sessions dealt with the complementary issues of the experiences of Religious Leaders and Key Populations. They more specifically dealt with gay, lesbian, bisexual, persons of trans experience and intersex persons, sex work experiences, young people and confronting the challenges of stigma and discrimination.

Among the major issues that emerged were: (a) the general experiences that require special attention by both Religious Leaders and Representatives of Key Populations and (b) the policies that promote inclusion of Key populations in the decision making process.

General Issues emerging from the dialogue between Religious Leaders and Key Populations

• The lived experience of people is at the heart of human sexuality and is a part of who people are.
• Where there is a conflict in matters of religion, philosophy, psychology, law, and human rights principles, it should be ensured that the latter is given consideration.
• In promoting health and well-being there is need to engage the religious community in better understanding of the critical issues of stigma and discrimination and the special challenges of key populations which include youth.
• Account must be taken that different populations/vulnerable groups overlap—e.g., LGBTI people may be people living in poverty; people with disabilities may be young people; people living with HIV may be elderly people.
• Trans persons presented a special case in relation to gender identity, as distinguished from sexual orientation.
• The importance of the Trans person’s relationship to God is not to be underestimated or disregarded.
• Tackling the major social determinants of health includes poverty which compounds the challenges faced by LGBTI and other Key populations with special reference to access, adherence, stigma, and discrimination.
• Need for the Religious Community to create spaces of hospitality that bring disparate groups together and create the basis for healing, compassion, love, and inclusion.

Four (4) Working Groups addressed specific issues relating to:

• Addressing gaps in treatment and prevention of HIV.
• Addressing determinants of Stigma and Discrimination and partnerships between religious groups and Key Populations in the solution
• Forging Partnerships between Religious Leaders, Parliamentarians and LGBTI towards achieving legislative reform, and
• Ways in which Religious Leaders and Members of Key Populations can appreciate each other’s positions and overcoming differences to achieve results of access to Public Health by key populations.
Issues arising from the discussion and for further consideration:
• Promote and implement policies for inclusion
• Recognize the voice and importance of PLHIV spearheaded by in-country CRN+ networks
• Identify those areas of common agreement and pursue policies with empathy
• Sex Workers “performing a service” and not “selling their bodies” as their human rights to earn a living.
• Reconsider the definition of Sex Work and engage in ongoing dialogue with Governments and sex workers to foster an enabling environment towards ending AIDS by 2030.
• Discuss the concept of Transgender within sacred scripture and theological constructs
• Take cognizance of information based on scientific evidence on human sexuality and sexual and gender diversity
• Incorporate the theological guidelines that ‘all human beings are made in the image of God’ and that ‘God Almighty dwells within all of us’
• Religious teachings may undergo changes based on interpretation and practice.

Religious Leaders Caucus focused on the need for ongoing dialogue and networking within and among religious communities and with members of key populations. Key Populations Caucus affirmed that strengthening Caribbean democracy and justice for all entails a commitment to the principle of including marginalized groups in a range of policy-making and governance, including representation in legislatures, political parties and at planning tables. It was affirmed that key populations and their interests deserve as much a place in governance as do religious representatives.

Recommendations for Constructive Dialogue between Religious Leaders and Key Populations

• Creating spaces of hospitality: “welcome of the strangers/the others in their otherness based on respect— e.g. community evangelism in the Dominican Republic”
• Establishing the basis for places of worship to give parents tools on Sexuality and incorporate holistic sexuality education into their programmes, including those for youth.
• Making every effort to reach marginalized populations, including advocating for and/or reasonable legislative changes, and seeking to cooperate in this venture.
• Establishing a national mechanism to address social and psychological approaches for dealing with the challenges affecting key populations.

Prayer and Worship

Members of the various religious communities were given opportunities to guide the assembly in moments of meditation, at the beginning and at the end of each day. Reflections were held on the basis of the respective religious traditions present at the consultation. This was an opportunity to engage the faith of the participants with the lived realities discussed within the consultation. This meditation set the tone of the conversations in the plenary, small groups and individual encounters. Through this interreligious approach, participants were able to learn more about one another’s faiths and could also begin to create a better understanding and respect for other faith and perspectives.

The Way Forward

Members of the Regional Consultative Steering Committee for the Implementation of Recommendations to End AIDS by 2030 will meet before the end of February to deliberate on the recommendations from this consultation. Specific focus will be on strengthening the religious networks in each territory and encouraging religious leaders to include representatives from key populations on the steering/management committees. It is anticipated that at least one consultation will be held in each territory in the next twelve to eighteen months. Recommendations from these consultations will be fed into another regional consultation of religious leaders and key populations in two to three years.

Appreciation

Religious Leaders and members of Key Populations worshipped God in joint services on the morning and afternoon of each day. This was to give thanks to God for mercies in making this dialogue possible and in providing a space for both groups to engage in this historic dialogue. We are therefore grateful to God for inspiration and guidance and to our partners locally in Suriname, regionally in CARICOM and PANCAP and globally, especially Global Fund for tangible assistance. To God be the glory.

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.

ARTICLE I

PREAMBLE

We: the participants at the Forum to Relaunch the CARICOM/PANCAP Champions for Change Initiative including parliamentarians, policy makers, lawyers, healthcare practitioners, educators, religious leaders, artistes, sports and media personnel, youth, members of civil society including People Living with HIV (PLHIV), reaffirm our commitment to the goals of ending AIDS by 2030;

Noted with concern: the lapse since 2006 in the implementation of PANCAP Champions for Change Commitment initiated in St Kitts and Nevis on the occasion of the CARICOM/UK Conference, Reduce Stigma and Discrimination Against living with HIV/AIDS November 22-24, 2004. Among the outcomes were Champions for Change Conferences with specific Stakeholders:

• Representatives of Faith Based Organizations 22-23 November, 2005;
• Leaders of the print and electronic media, owners of the regional broadcasting media houses, freelance journalists, publishers, information and communication specialists, video and film producers, cultural and other artistes in Barbados, 7-9 December, 2006; and
• the establishment of the PANCAP Stigma and Discrimination Unit, 2009-2012;

Recognising the Caribbean’s advances in the response including increased access to antiretroviral treatment resulting in persons living longer;

Deeply concerned however that the Caribbean remains the second most affected region in the world and compounded by co-infection with Tuberculosis and increased burden from NCDs and other emerging diseases;

Convinced of the need to reinstate the Champions for Change Commitment given the scientific evidence that AIDS can be ended by accelerating actions to reduce stigma and discrimination and increase access to prevention and treatment;

Recognising that HIV transmission is preventable through individual behaviour, which is influenced positively or negatively by cultural, social, economic, political and legal systems.

Reaffirming our original and more recent commitments to accelerate the response to HIV made through:

• The Caribbean Partnership Agreement establishing PANCAP (2001)
• The UN General Assembly Special Session on HIV/AIDS (2001)
• The Nassau Declaration: The Health of the Region is the Wealth of the Region (2001)
• CARICOM PANCAP Model Anti-Discrimination Legislation (2012)
• PANCAP Justice for All Roadmap (2014)
• 2030 The Sustainable Development Goals, especially Goal 3 Ensure healthy lives and promote the well-being for all ages (2015)
• The UN High-Level Political Declaration: Fast Tracking the Response to End AIDS by 2030 (2016)
• Caribbean Cooperation in Health IV (2016)

Note the recommendations related to the regional and international commitments in the Caribbean aimed at the contribution of stakeholders to ending AIDS by 2030 through the PANCAP Consultations with:
 Faith Leaders (in collaboration with UNAIDS and AIDS Healthcare Foundation) in Trinidad and Tobago, February, 2017;
 National AIDS Programme Managers and Key Partners, in Trinidad and Tobago, March, 2017;
 Youth Leaders (in collaboration with PAHO) in Trinidad and Tobago, April, 2017;
 Parliamentarians (in collaboration with UNDP) in Jamaica, May, 2017;

Support the recommendations of:

 The ‘Every Caribbean Woman Every Caribbean Child’ (CARIWAC) Initiative for reducing gender violence, teenage pregnancies and cervical cancer, and eliminating mother-to-child transmission of HIV and Syphilis;
 The Spouses of Caribbean Leaders Action Network (SCLAN) in championing the CARIWAC Initiative.

Acknowledge that it is the legal, moral and ethical responsibility of all states to meet their human rights obligations and protect the public health of all people.

ARTICLE II
DECLARATION

We SOLEMNLY DECLARE as Champions for Change to pursue our obligations to positively contribute to the ending of the AIDS epidemic by 2030 in keeping with our regional and international commitments and to:

 promote TEST, TREAT and DEFEAT AIDS in keeping with UNAIDS 90-90-90 targets by 2020;

 advocate for access to affordable medicines and strengthening laboratory systems as a human right by 2020;

 also advocate for and support enactment of appropriate legislation, regulations and other measures to eliminate all forms of discrimination and to ensure the full enjoyment of human rights and fundamental freedoms of persons living with, at risk and affected by HIV by 2020;

 further advocate for an enabling environment for all members of vulnerable communities including men who have sex with men, sex workers, persons who use drugs, girls and adolescents by 2020;

 advocate for the Caribbean to become the first region in the world to eliminate Mother-to-Child Transmission of HIV and syphilis by 2020;

 promote taking AIDS out of isolation through an integrated health/multisectoral approach in keeping with SDG#3 by 2020;

 also promote the implementation of Universal Health Access in keeping with the WHO/PAHO (2016) and World Health Assembly (2017) Declarations by 2020;

 promote the recommendations of the CARICOM Council of Human and Social Development-Minister of Health (2015) to implement the PANCAP Justice for All Roadmap in short (2018), medium (2020) and long term (2030) phases;

 support the programme complementarity between PANCAP and CARPHA to accelerate the Caribbean response to ending AIDS by 2018;

 also support the Regional Faith Leaders Consultative Committee and the National Faith Leaders Networks to intensify their efforts to provide spiritual, psychosocial, economic and physical care for persons living with HIV and in their respectful dialogue with LGBTI by 2018;

 advocate for the sustained allocation of resources for civil society and faith based organisations to participate in overall programmes for testing, treating and reducing stigma and discrimination and particularly to reach underserved communities by 2018;

 implement and sustain measures to empower adolescents and young adults to protect themselves and their peers from risks of infections by 2018;

 include the elderly living with HIV who are particularly vulnerable to other infections by 2018;

 include persons with disabilities, especially those living with and affected by HIV;

 advocate for more rigorous collection, dissemination and analysis of data as effective sources for making informed policy decisions by 2018;

 promote all efforts at increasing access to prevention, through age appropriate sexual and reproductive health education, including the implementation of recommendations for the revised Health and Family Life Education (HFLE) curriculum by 2018.

Article III

CONCLUSIONS

We, the participants of the relaunched Champions for Change, recognising that AIDS is far from over:

Urge CARICOM Member States to collaborate with PANCAP and UNAIDS to establish mechanisms to document, monitor and evaluate instances of violation of human rights and facilitate periodic reviews of implementation of the commitments to end the AIDS epidemic;

Also urge Member States to provide adequate budgetary allocations for ending AIDS.

Further urge Member States to use their influence to lobby at international fora for resources, the removal of barriers and other impediments to end AIDS;

Charge the PANCAP Coordinating Unit (PCU), in collaboration with UNAIDS and other partners, to make provision for institutionalised support for Champions for Change to effectively sustain their advocacy and actions.

We, the participants of the relaunched Champions for Change resolve to realise the intent of this Declaration.

13 September 2017