Release Type: News Article

The Organization of Eastern Caribbean States (OECS) Regional Coordinating Mechanism (RCM) leveraged the strategic advantage of the media by hosting a workshop on how to create effective HIV Advocacy Public Service Announcements (PSAs).

The initiative was facilitated by Dr. Allyson Leacock, Executive Director of LIVE UP: The Caribbean Media Alliance and Chair, Barbados Broadcasting Authority (BBA). The 3-day workshop brought together key population advocates and select Health officials, media operatives and partners to foster alliances for stigma reduction.

Key Populations (KPs) in the Caribbean, People Living with HIV (PLHIV), Men who have sex with men (MSM), sex workers and the Transgender community still face troubling levels of stigma and discrimination in their communities.

Discrimination remains a barrier to accessing HIV prevention services and retaining and ensuring adherence levels.  It also takes a toll on the mental health of PLHIV. KPs often lack the resources, funding and sensitive services to deal with these issues.  Sensitized KPs can engage the media who can become advocates and partners in the cause.  There is evidence that the media can be utilized as an effective tool for advocacy, strategy, and programming to address structural barriers.

Dr. Leacock challenged the participants to change the generic HIV stigma narrative and empower key populations to create their own messages and have their voices heard while enlightening audiences to love, protect and respect all people.

Given her 12-year track record of training media on how to report responsibly and accurately on the multi-faceted and complex issue of HIV and having created over 100 behaviour change PSA media campaigns,  Dr. Leacock used this experience to effectively engage key populations on ways in which to create their own messages and use the power of media to become unwitting advocates to reduce stigma and discrimination in our region.

According to Dr. Leacock “the workshop was designed to be interactive through sessions with practical exercises, details of advocacy and the multiple media tools available that can be used by advocates, while Health officials and partners were shown tangible examples of ways to reduce stigma in their services, using the approaches they understand”.

This workshop and the programme that it supports proved to be unique because of the mutual benefits for the media, key populations and Ministry officials who were provided with the opportunity to collaborate on their own PSAs.

The OECS RCM used its grant not only to build its stigma reduction capacity but also to build the capacity of several local Civil Society Organizations (CSOs) that are working on stigma reduction advocacy programming as well. Dr. Leacock noted, “Giving key populations the tools as well as the platform with which to amplify their efforts and voices is novel and unprecedented”.

She highlighted that while the objective of the workshop was to produce one PSA, the media operatives involved in the training offered further guidance and expertise, which resulted in the production of three PSAs.

The decision

On Tuesday, 13 November 2018, the Caribbean Court of Justice delivered its decision in the case of McEwan and others v Attorney General of Guyana. The CCJ is Guyana’s final court of appeal.

The Court ordered that Section 153(1)(xlvii) be struck from the laws of Guyana and that costs are to be awarded to the appellants in the appeal before the CCJ and in the courts below.

A panel of five judges heard oral arguments in the case on June 28, 2018: the Hon. Mr. Justice Adrian Saunders, President, the Hon. Mr. Jacob Wit, the Hon Mr. Justice Winston Anderson, the Hon. Mme Justice Maureen Ragnauth-Lee and the Hon. Mr. Justice Denys Barrow.

The video recording of the four hour hearing is available at:
http://www.caribbeancourtofjustice.org/audio/gycv2017-015/20180628/gycv2017015_280618.mp4

CASE BACKGROUND

On 6 February 2009, seven persons were arrested under the 1893 Summary Jurisdiction (Offences) Act section 153 (1) (xlvii) for being a “man’, and in ‘any public way or public place’ and for ‘any improper purpose’, appearing in ‘female attire’, which is a summary offence. They spent the weekend locked up at Brickdam Police Station in Georgetown.

“Man” under this summary offense has been treated by state officials as including persons whose birth certificates describe them as “male” and who identify as transgender or trans women.

The Acting Chief Magistrate hearing the case on 9 February 2009 in the Georgetown Magistrates Court, told the seven that they were confused about their sexuality and that they were men, not women, and advised them to go to church.’ They were convicted and ordered to pay a fine of GUY $7,500 each.

In 2010, four of the arrested persons—Gulliver (Quincy) McEwan, Angel (Seon) Clarke, Peaches (Joseph) Fraser and Isabella (Seyon) Persaud—and the Society Against Sexual Orientation Discrimination (SASOD), filed a constitutional action arguing that the law was inconsistent with the Guyana Constitution 1980. All four litigants identify as trans persons.

Their main argument was that this 1893 vagrancy law, which uses terms like ‘improper purpose’, ‘male attire’ and ‘female attire’, is very vague and fails to “give the person of ordinary intelligence a reasonable opportunity to know what is prohibited.”

“… legal provisions which interfere with individual rights must be formulated with sufficient precision to enable a citizen to regulate his conduct.”

Observer Publications v Matthew, Privy Council, appeal from Antigua and Barbuda, 2001

The litigants also argued that the law violated the right to freedom of expression since clothing is a form of expression that communicates ideas and representations of personality, identity, and beliefs. They also argued that the law violated the constitutional guarantee of equality before the law and non-discrimination and they challenged the conduct of the magistrate.

THE HIGH COURT AND COURT OF APPEAL DECISIONS

The High Court in 2013 and Court of Appeal in 2017 did not accept these arguments and they struck out SASOD as an applicant in the case. One of the reasons given by both courts for dismissing the case is their conclusion this 1893 colonial law enjoys the protection of the Constitution’s saving law clause. That savings law clause limits human rights-related constitutional challenges to laws that were in force before the date the 1980 Constitution came into effect.

Both Guyana courts affirmed that giving expression to one’s gender identity through clothing was not itself a crime. To constitute a crime, the expression must be in public for an ‘improper purpose’ according to then Chief Justice (ag.) Chang.

This response, though positive, did not satisfy the Guyana trans community which remained concerned about the vagueness of this offense, the unrestricted discretion it gives the police to say what the law means and its potential for discriminatory application.

“The Chief Justice was relatively clear that once you are expressing your gender identity, it’s not criminal …. But the law really stifles us, because what could be an improper purpose? The trans community is very worried, and still fearful of arrests, in light of this decision.”

–Gulliver McEwan, first named Appellant, Director, and co-founder of Guyana Trans United (GTU)

WHAT WERE THE MAIN ARGUMENTS IN THE APPEAL BEFORE THE CCJ?

On June 28, 2018, the Caribbean Court of Justice (CCJ), based in Trinidad, heard arguments in the appeal from McEwan and the other appellants about this post-emancipation vagrancy law.

The main arguments presented by the appellants are:

• That 1893 cross-dressing offense, a vagrancy law, is vague; it is not formulated with sufficient precision to allow the ordinary person to regulate his or her conduct.
•  The cross-dressing offense violates the fundamental rights of McEwan and the other litigants to freedom of expression and equality and non-discrimination.
• The Magistrate’s exhortations to the appellants that they were confused about their sexuality and must attend church and give their lives to Christ breached their fundamental rights to protection of the law, freedom of conscience and non-discrimination.
• SASOD was permitted to appear in its own right or in a representative capacity under the Constitution and it was no answer that persons affected by the law were already litigating since the law impacted a far greater community than the four litigants.
• The savings law clause does not prevent the courts from reviewing this 125-year-old law because that savings clause does not protect laws that violate fundamental constitutional law principles like the rule of law or separation of powers, among other reasons.

THE CCJ HEARING ON JUNE 28, 2018

The four litigants who were all present at the CCJ hearing on June 28, were represented by attorneys-at-law Douglas Mendes, S.C. (Trinidad and Tobago), lead counsel, and C.A. Nigel Hughes (Guyana), Mishka Puran (Guyana), Clay Hackett (Trinidad and Tobago) and Isat Buchanan (Jamaica). Solicitor General Kim Kyte-Thomas, Kamal Ramkarran, and Selwyn Pieters represented the Attorney General.

In addition to the four litigants, over twenty representatives from civil society organizations and universities were present to observe the proceedings. Representatives of the Faculty of Law The UWI Rights Advocacy Project (U-RAP), which has been involved from the outset of the case, were also present.

One of the major hurdles for the appellants in their challenge to the 125-year old law was the existence of a savings law clause in the Constitution. Mendes SC began his presentation on June 28 by noting the groundbreaking decision of the CCJ the day before, on Wednesday, June 27—the case of Nervais and Severin v AG of Barbados—which significantly limits the negative impact of savings law clauses in cases challenging colonial laws. In that case, the CCJ declared that the mandatory death penalty in Barbados was unconstitutional and that the savings law clause was not a barrier to that declaration.

In the main, both sides appeared to agree that dress consistent with one’s gender identity, even if that identity is different from the sex assigned at birth, was wholly legal. As a result, the focus of the hearing became whether the term, “improper purpose” was sufficiently certain to allow ordinary persons to know exactly what was being prohibited. In his comments, Justice Wit emphasized that the test must be based on ordinary citizens as the standard and not legal experts, and charges should stem from crimes and not one’s manner of dress.

Mendes SC in his presentation argued that criminalizing just thought—an “improper purpose”—was impermissible. And he also pointed out the thought of only some (“man” in “female attire”/ “woman” in “male attire”) was criminalized. No offense was committed if a “man” was dressed in “male attire” for an “improper purpose”; likewise if a “woman” was dressed in “female attire” for an “improper purpose”.

The State suggested that any arbitrary and discriminatory enforcement of this law could be addressed through appeals and applications for judicial review. During the hearing, President Saunders raised the question of whether transgender persons who are not of great means or social influence may lack meaningful access to these procedures and thereby be at risk if the law is not sufficiently certain.

WHY IS THIS CCJ APPEAL SO IMPORTANT?

This constitutional law and human rights case will have great significance because it will consider:

• The proper scope of saving law clauses for the second time in four months.
• The significance of unique human rights provisions in the Guyana Constitution that expand equality rights and incorporate international human rights law.
• The importance of the principle of the rule of law and the right to due process in Caribbean constitutions, and their insistence that criminal laws must be ‘certain’ about what they are prohibiting.
• The impact of the law on the fundamental rights of a group that has faced discrimination and social exclusion—gender non-conforming and transgender persons.

I wish to share my sincere gratitude to the USAID-funded Abt Associates Health Finance and Governance (HFG) Project, which ended after six years of technical support to the Eastern and Southern Caribbean and PANCAP. HFG’s support was aimed at advancing national and regional efforts to sustain the response to HIV.

The project added value to the beneficiary countries and PANCAP. Countries were supported to conduct National Health Accounts given that health-spending data is critical for informing health-financing mechanisms as countries aim for universal health coverage, and for sustainable national responses to HIV. Countries were provided with tools for sustainability planning and ministries of health and finance were brought together to plan for domestic resource mobilization and social contracting.

HFG, in collaboration with PEPFAR and UNAIDS, supported countries to develop HIV investment cases and contributed to reframing the dialogue on sustainability and financing to one of country ownership and domestic investment in HIV.

HGF must be lauded for its technical support that enabled PANCAP to develop its first Resource Mobilization Strategy, an essential tool for mobilizing both financial, human and other resources for the implementation of the Caribbean Regional Strategic Framework on HIV and AIDS and sustainability of the PANCAP Coordinating Unit.

We wish Abt Associates every success in the future and look forward to future collaborations.

With funding from the 10th European Development Fund, PANCAP convened a Parliamentarians Consultation in Paramaribo, Suriname. In delivering the keynote address, Speaker of the National Assembly, Dr. Jennifer Geerling-Simmon, declared that the consultation added value and quality to the work of parliamentarians. She underscored the role of human rights in ensuring access to treatment, care, and support for people living with HIV and key populations.

The Speaker acknowledged the legislative, representational and oversight roles of parliamentarians in ending AIDS and in achieving the Sustainable Development Goals (SDGs), particularly 3, 5 and 16.

Parliamentarians reviewed the recommendations of the Legal Environment Assessment and the National Health Accounts and agreed on key short-term actions for addressing them.

Parliamentarians agreed to use the CARICOM Model Anti-Discrimination Legislation to harmonize various pieces of legislation including redress; evaluate the existing Health Care Act with the aim of providing affordable health care to everyone; advocate for the utilization of the Employment Act to address breach of confidentiality; advocate for greater involvement of NGOs in the human rights response; and advocating for attention to persons with disabilities.

In relation to the National Health Accounts, parliamentarians agreed to provide the oversight required for allocating more funding to prevention; improving efficiencies by consolidating and streamlining financial schemes; and increasing domestic mobilization and the share of health spending for HIV.

I am encouraged by the concrete actions that parliamentarians have agreed to take to advance Justice for All in Suriname as well as by their commitment to meet again with the PANCAP Team during the first quarter of 2019 to report on progress.

We now look forward to our consultation with parliamentarians in Belize during the latter part of November 2018.

Image: The CMLF Team, (L-R), Ms. Louise Mathura, Administrative/Finance Assistant, Ms. Valerie Wilson, Director, Ms. Wendy Kitson-Piggott, Laboratory, and Quality Systems Specialist, Dr. Wayne Labastide, Associate

The Caribbean Med Labs Foundation (CMLF) is celebrating 10 Years of pioneering work. Noted for being the Caribbean’s first indigenous NGO devoted to medical laboratory issues, it is important to reflect on the origin of this groundbreaking entity.

CMLF was established in 2008 on request from regional Ministers of Health, in the context of a Caribbean environment that needed such an organization to support Caribbean Governments’ responses to 21st-century public health challenges.

Reflecting on the CMLF’s journey over the last 10 years, the organization can be described as people-centered, inclusive, innovative, cutting-edge, reliable, data-driven and evidence-based.  One of its driving principles has been to encourage a sense of ownership and responsibility among Caribbean stakeholders (or clientele) towards achieving successful public health outcomes.

CMLF has spearheaded transitions in policy, planning and quality improvement for the regional laboratory sector. The organization is proud of its reputation of being very resourceful.  It is usually the first point of contact when laboratory challenges arise. As a result, CMLF has invested in capacity development within the region.

The organization receives significant support from Ministries of Health, which is an indication of how important the work of the CMLF is to the regional public health response.

More importantly, the CMLF is proud of its work with people at all levels within the public health system.  In fact, an integral part of the entity’s operations is a deliberate strategy of fostering cooperation with all public health partners.

Indeed the region cannot mount the type of comprehensive response to 21st-century public health challenges without strong indigenous NGOs.  With the continuing support of current and future partners, CMLF aims to expand their resources, scope, and impact over the next 10 years.

Image: The CMLF Achievements Timeline

To view or download the full timeline, CLICK HERE. 

The USAID-funded Health Finance and Governance (HFG) project has spent the last six years working with partners in the Eastern and Southern Caribbean to help countries to plan for the sustainability of the HIV response. HFG has supported planning processes to increase inclusivity and build country ownership in developing strategies to mobilize domestic resources to prepare for the transition from Global Fund and PEPFAR funding. This is especially important for civil society organizations (CSOs) working with key populations.

As HFG comes to a close, it is important to reflect on how this work can be used and built upon moving forward. Overall, the sustainability plans for Barbados, the Dominican Republic, Guyana, Suriname and the Republic of Trinidad and Tobago outline strategies to mobilize domestic resources, build partnerships, strengthen the health system, and protect the human rights of people seeking testing, treatment, and care for HIV. These plans are based on data from National Health Accounts estimations, Sustainability Index Dashboard (SID) exercises, conversations with local stakeholders, and meetings with national governments and international partners through a participatory consultation process.

From this planning process it is clear that in order to sustain the HIV response in the Caribbean, it will be critical for governments to work with local CSOs to ensure that resources are available to continue their essential services to their communities. The sustainability plans call for a renewed commitment to a multi-sectoral response that engages new partners and a strengthened coordination role for ministries of health.

For more information on the HFG project’s work with countries in the Caribbean on sustainability planning see www.hfgproject.org.

The National AIDS Commission (NAC) Belize has launched the country’s first HIV services mobile App.  As part of the HIV, AIDS, and Tuberculosis (TB) response in Belize, the NAC collaborated with software development firm LXJ Code Belize to develop and launch the App, which is now available on both IOS and Android platforms.

According to the NAC, the app is a readily available source of information on all the major HIV service facilities in the country. It provides the user with real-time data on the nearest health facility, services offered, location, links the user to the service providers’ Facebook and website for more information and provides timely updates on upcoming events from varying partner agencies within Belize’s HIV response. The NAC Health Services App is meant to function as a gateway that links innovation and necessity.
The NAC highlighted that the creation of the App became necessary due to the lack of readily available knowledge on HIV services available in Belize. The commission views this as one of the main barriers to achieving the 90-90-90 Targets as Belizeans have reported not having adequate information on available HIV services.

In 2016, the NAC in collaboration with CODE-IT launched its first app, titled “Infections”. The gaming app was designed to engage users in a fun and interactive gaming experience while imparting key knowledge about HIV and AIDS. This app was a pioneering effort and was recognized as one of the most innovative communication strategies in the region. “Infections” is free for download at the Google Play store.

For more information on both Apps, visit the NAC’s website.

ANGUILLA – Youths conduct rapid testing for Caribbean Wellness Week  

Image: CARICOM Youth Ambassador (Anguilla), Devon Carter conducting HIV rapid tests for Caribbean Wellness Day.

The Anguilla National Chronic Disease Unit conducted HIV rapid testing during the Caribbean Wellness Day Health Fair on 28 September 2018. Devon Carter, CARICOM Youth Ambassador, Anguilla, assisted the Unit in the administration of HIV rapid tests.  “I am grateful for the opportunity to practice the skills which I developed from a HIV Rapid Testing and Counselling Certification Training Programme in Anguilla,” stated Devon.

SAINT VINCENT AND THE GRENADINES – CARICOM Youth Ambassadors certified as Voluntary HIV and AIDS Counselling and Testing Providers

Image: CARICOM Youth Ambassadors SVG committee members, Shadyn McLean and K-Danna Charles with representatives of the National AIDS Secretariat, St. Vincent and the Grenadines

CARICOM Youth Ambassadors, SVG committee members, K-Danna Charles, and Shadyn McLean participated in a four-day workshop on “Voluntary Counselling and Testing for HIV” hosted by the National AIDS Programme Secretariat,  Ministry of Health and the Environment on 25 – 28 September in St. Vincent and the Grenadines. They are now Qualified Voluntary HIV and AIDS Counselling and Testing Providers.  PANCAP congratulates the Youth Ambassadors on taking this bold step in acquiring skills to provide vulnerable populations with essential health services.

REPUBLIC OF TRINIDAD AND TOBAGO – Youth Ambassadors launch initiative focused on a preventative approach to HIV

Image: CYAs Terez Lord and Dexter Wilson

In September, the Republic of Trinidad and Tobago CARICOM Youth Ambassadors, Terez Lord and Dexter Wilson embarked on a sensitization forum premised on a preventative approach to HIV and other Sexually Transmitted Infections (STIs).  The forum was held during “Guild Fest – Orientation Week” and hosted by The University of the West Indies (UWI) St. Augustine Guild of Students.

The initiative was a collaboration between Trojan Condoms, the University of the West Indies Student Guild, the CARICOM Youth Ambassadors and the Commonwealth Youth Peace Ambassadors Network (CYPAN). The goal was to create awareness of HIV prevention and other STIs as well as early and unplanned pregnancy in youth. The activity aimed to reinforce a sense of trust in the integrity and effectiveness of consistent and proper condom use and dispel the commonly held misconceptions surrounding condom use, access, affordability, and reduced pleasure.

In an invited comment, Terez Lord stated, “We launched this project at the orientation week, Guild Fest at the beginning of the new academic school year to capture existing as well as new tertiary students who expressed a keen interest in learning about responsible sexual behavior and receiving free condoms. It was thoroughly engaging and impactful.”

REPUBLIC OF TRINIDAD AND TOBAGO – CARICOM Youth Ambassadors engage in high-level advocacy for Comprehensive Sexuality Education

Image: CYA Terez Lord

The Republic of Trinidad and Tobago CARICOM Youth Ambassador (CYA), Terez Lord attended the United Nations Population Fund (UNFPA) High-Level Meeting on Comprehensive Sexuality Education (CSE) integration into Health and Family Life Education (HFLE) on behalf of  PANCAP and the CARICOM  Youth Ambassadors Corps.

Terez attended to specifically address the mandate of the CARICOM Youth Ambassador Programme regarding the health of adolescents and youth.

The specific purpose of the meeting was to identify the challenges faced by all stakeholders,  acknowledge regional best practices which can be implemented and derive a plan of action to improve the integration and quality delivery of CSE through HLFE.

The Society against Sexual Orientation Discrimination (SASOD) is considered a pioneer in the fight for human rights especially those of the lesbian, gay, bisexual, and transgender communities.  Now the organization has taken another bold step by engaging the Ministry of Public Health, Guyana), and appealing for partnerships with governmental and Private Sector entities for the distribution of Pre-Exposure Prophylaxis (PrEP).

Initial PrEP Study conducted in Guyana

SASOD’s Public Health Consultant, Dr. Nastassia Rambarran reported that a study was conducted by the organization with HIV negative individuals.

The study included  47 persons from Regions Three (Essequibo Islands-West Demerara), Four (Demerara-Mahaica), Five (Mahaica-Berbice), Six (East Berbice-Corentyne) and 10 (Upper Demerara-Berbice).  The exercise sought to ascertain the level of knowledge, attitudes and delivery preferences in relation to PrEP.

According to Rambarran, the daily pill can result in 90 to 98 percent protection against HIV and is intended for persons with HIV positive partners.

Additionally, sex workers and transgender persons can also protect themselves from the virus but additional protection is needed against other Sexually Transmitted Infections (STIs).

Concerns about PrEP

SASOD also revealed that while a majority of the respondents of the study were interested in the benefits of the pill, they were concerned about the costs attached and the HIV stigma that follows when seeking information about PrEP.

Hence, the organization is advocating for Government and non-governmental organizations (NGOs) to distribute PrEP to these persons. SASOD explained that the organization would be able to negotiate a reduction of the cost to about US$10 for one month’s supply of the medication.

Founder and Managing Director of SASOD, Joel Simpson revealed that persons expressed some reservations about taking PrEP.  These include the fact that users must remember to take the pill daily. Persons also expressed concern about potential side effects, the frequency of required blood tests and a few respondents were in denial about being at risk.

Simpson also stated that there was a lack of education about PrEP. He revealed that the most significant barriers identified were the cost of PrEP and the continued stigma around HIV.

Next steps

The Managing Director also shared that the next steps would entail engaging the Public Health Ministry and the National AIDS Programme Secretariat (NAPS) to propagate the advantages of supplying PrEP.

He stated, “Our primary target audience for advocacy are the policymakers at the Ministry of Public Health. We think we have enough data for implementation and our next step will be to meet with the Programme Manager at the National AIDS Programme Secretariat”.