Press Release – Page 6

Youths commit to challenging the barriers to accessing sexual and reproductive health services

Wednesday 31 July, 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, convened the Third Regional Meeting of Youth Leaders on Sexual and Reproductive Health and HIV and AIDS on 30 July 2019 in Port-of-Spain, Republic of Trinidad and Tobago.

The forum will facilitate the drafting of a roadmap with strategies for sustaining youth advocacy for the promotion of gender equality, HIV prevention, actions to end gender-based violence and access to quality sexual reproductive health (SRH) services to meet the needs of adolescents and youth regardless of disability, age, citizenship, gender identity and sexual orientation.

In opening remarks, Director of PANCAP, Dereck Springer reflected on the creation and relevance of the Caribbean Regional Youth Advocacy Framework (CRYAF) on Sexual and Reproductive Health and Rights. “After developing the CRYAF with input from youth, we recognized that it was important to build youth leaders’ advocacy skills so that they would be better prepared to advocate at the regional and national levels”, stated the Director. “This was done during the second meeting of youth leaders, and the approach was successful as we now have a dynamic group of young people who are passionate and innovative in their approach to advocacy”.

Mr Springer stated that PANCAP has been supporting youth leaders to advocate at the regional level, which included funding for youths to engage in regional forums with Ministers of Health and Education. PANCAP also supported youth leaders’ participation in the Joint Regional Dialogue with Faith Leaders, Parliamentarians, Civil Society Leaders and National AIDS Programme Managers. A presentation by youth leaders advocating for access to sexual and reproductive health services was also positively received at the Meeting of the Council for Human and Social Development (COHSOD).

The PANCAP Director praised the development of action plans by the youth body. “I was impressed that youth leaders recognized the need to adapt their advocacy approach from the regional to the national platform,” stated Mr Springer, “I was also impressed by the reports of all the advocacy work implemented at the national level which called attention to issues concerning adolescents’ health and rights, gender equality, HIV prevention, actions to end gender-based violence and access to quality sexual reproductive health (SRH) services to meet the needs of adolescents and youth”.

He also encouraged youths to continue utilizing digital platforms, including social media, to propagate their advocacy messages. “I am proud when I see our youths utilizing innovation to provoke responses on issues which they are passionate about,” stated the PANCAP Director, “continue to use the technology available to remain visible”. He outlined the plethora of new knowledge which will be gained by youths during the meeting and urged participants to utilize the new skills to collaborate and heighten sexual and reproductive health advocacy across the region.

In her remarks, Ms Renatta Langlais, Member, PANCAP Steering Committee on Youth Advocacy (PSCYA) praised participants for their consistent commitment to attending PANCAP youth forums and challenged them to utilize the new skills gained within the PSCYA and CARICOM Youth Ambassadors Corps. “We are here to share and learn from each other, we are here to meaningfully contribute to our healthy development as Caribbean youth,” stated Ms Langlais.

She highlighted that the task of achieving the three main priority areas set by the Caribbean Regional Youth Advocacy Framework in 2017 has been challenging. These included aligning the age of access to sexual and reproductive health services to the age of sexual consent, introducing Comprehensive Sexuality Education (CSE) to all Caribbean schools and advocating for Gender Neutral Laws and policies to be passed and implemented, especially those protecting the rights of victims of gender-based violence regardless of gender, orientation, race or status.

“Change does not come easily in our Caribbean Society,” stated Ms Langlais “It is difficult to show someone a new path when they are already set in their ways. We all want a healthy society, but many allow prejudice, stereotypes and stigma to block the road to progress”. However, she praised the progress made by the youth body in formulating goals, indicators, and challenging barriers to SRH services by adolescents and youth. “We must face obstacles of tradition, apathy, ignorance and lack of political will, head-on. The road we are travelling is very Caribbean, full of potholes of politics and bigotry; sometimes we fall in them, other times we manage to avoid them”.

She further praised the PANCAP Director and the Partnership for consistent commitment to building the capacity of youth leaders in advocacy and urged participants to utilize collaboration as the key to fostering change and reaching policymakers with advocacy messages.

Ms Terez Lord, CARICOM Youth Ambassador (CYA), Republic of Trinidad and Tobago in her remarks reminded participants of the significance of the CARICOM Youth Ambassador Corps (CYAC). “We, in this room, represent the hopes and the dreams that were born in 1993 when the CYAC was formed.

We hold the hopes of our Heads of Government who created this mechanism that was to be of the young people, for the young people and by the young people”. She further highlighted that the CYAC was intended to be the catalyst to integrate and infuse the perspectives and solutions proposed by youth across the region into national, regional and international policy and practices. She also expressed gratitude to PANCAP for supporting youths to fulfil the mandate of the CYAC by building their capacity to advocate at all levels. She stated “as a unit, we have the strength and we have prowess – but only if we want to. In the international community, our presence is strong, and our voices are distinct”.

The CYA urged youths to utilize their collective skills to advocate for change. She stated “If collaboration is currency, then perhaps we as CARICOM can indeed have one common currency. We must be keen on ensuring CARICOM representation so that Heads of Government can recognize our presence, respect our intellect, accept our contributions and implement our recommendations”.

She urged youths to utilize the forum to create innovative, inclusive and impactful recommendations. “CARICOM Youth Ambassadors are a dynamic group of young people who are always prepared to disrupt old ways, mount a challenge to the status quo and contribute meaningfully and constructively to the sustainable development of our region,” stated Ms Lord.

Keynote speaker, Shaquille Knowles, Chairperson, Caribbean Regional Youth Council (CRYC) praised PANCAP for providing a space for young people to discuss issues affecting youth including universal health and SRH. He expressed his anticipation for the specific outcomes from the meeting which include the development of practical solutions capable of increasing youth’s access to quality health services, and a commitment to stand up against issues that have prevented adolescents’ access to quality universal health and SRH services.

He expressed his passion for advocating for SRH for adolescents and outlined the challenges affecting adolescents’ access to quality health services which included the inability to afford health services and the stigma associated with receiving health services to treat specific illnesses. “Unfortunately, as the world continues to revolve without adequately addressing these key challenges within our critical demographic – more adolescents continue to grapple with the challenges with access to services that ‘healthy’ individuals take for granted,” stated the CRYC Chair.

He recounted an experience in which a family member died as a result of inadequate access to preventative health care services. “This loss of life could have been prevented with adequate resources to properly educate persons on the preventative measures to avoid being infected with HIV and measures to reduce the stigma of HIV within our communities and homes,” stated Mr Knowles.

“I have witnessed continued efforts to reduce the prevalence rate of the HIV and other STIs in the Caribbean thanks to efforts from PANCAP, Ministries of Health and advocates,” stated the CRYC Chair, “However, we must remain steadfast in transforming the lives of the world’s most critical population by continuing the work to reduce the detrimental effects of a lack of access to universal health services”.

He concluded by challenging participants to use innovation to advocate for adolescents’ access to SRH and to use their platforms to keep health for young people at the top of every policymaker’s agenda.

-ENDS –

What is PANCAP?

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.

What are the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 Targets?

By 2020, 90% of all people living with HIV will know their HIV status.
By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

Contact:

Timothy Austin

Communications Specialist

PANCAP Coordinating Unit

CARICOM Secretariat

Turkeyen, Greater Georgetown, Guyana

Email: taustin.consultant@caricom.org

Tel: (592) 222-0001-75, Ext. 3409 | Visit www.PANCAP.org

Editor’s Notes:

Overview of PANCAP Youth Initiatives

The Caribbean Regional Strategic Framework (CRSF) 2014-2018 articulates the vision and collective priorities of Caribbean states through their membership in the Pan Caribbean Partnership against HIV and AIDS (PANCAP). The CRSF recognises that resources must be strategically allocated to target the epidemic at regional, country, community and individual levels. Doing so effectively will require establishing and sustaining an enabling environment (Strategic Priority Area 1) by addressing social and cultural drivers of the epidemic and by removing barriers to access sexual and reproductive health information, education and services. In particular, more conscious efforts to address human sexuality are needed in order to equip young people with the regional public goods including knowledge and tools they need for healthy development.

As of 2014, there were 280 000 [210 000–340 000] people living with HIV, 8800 [5700–13 000] AIDS-related deaths among adults, and 44% [33%-54%] of adults living with HIV accessing HIV treatment in the Caribbean. Young people, especially among key populations, in Caribbean are disproportionately at risk of HIV infection, and they face greater barriers to accessing prevention services. According to the Pan American Health Organization (PAHO), HIV prevalence among young people is 0.07% and 0.05% in females and males in the non-Hispanic Caribbean and 0.2% and 0.3% in the Hispanic Caribbean both respectively. In Jamaica, where the data are available, higher estimated HIV prevalence has been reported among gay, men that have sex with men (14%) and transgender adolescent girls (27%). While the regional response has realised some progress with a 43% reduction among adults and a 90% reduction in children acquiring HIV, gaps and challenges remain. HIV prevalence remains high among Key Populations (KPs) such as Sex Workers (SW), Men who have Sex with Men (MSM), and young people. At the same time, challenges regarding stigma and discrimination, violations of human rights and gender-based violence continue to hinder access to services for young people in general.

To work more systematically with young people belonging to KPs who are more difficult to reach, PANCAP/Global Fund grant programme proposed to collaborate with CVC/COIN to link at-risk youth with the CYAP. The CYAP provides a unique platform for leadership development and collaboration that can strengthen the participation of a more diverse and better-informed youth constituency in CARICOM decision-making. This will serve a mutually beneficial purpose of strengthening the relevance and impact of the Youth Ambassadors as well as providing access to high-level CARICOM fora for KP youth, allowing for collaborative approaches to high-level advocacy that better links the issues and priorities of CARICOM to those of young people. This initiative supports the inclusion and participation of some Key Population groups (i.e. PLHIV, MSM, SW and youth) in the regional response addressing the critical gaps given the overwhelming evidence of the main drivers of HIV transmission in these groups.

The First Meeting of Youth Leaders held in April 2017 allowed for in-depth discussion of sexual health issues affecting young people, identified what are barriers to their access to sexual health services, as well as identify what knowledge and tools are required to protect themselves from HIV. The meeting provided input required to develop a regional advocacy framework on key sexual health issues affecting youth and to inform subsequent training to strengthen advocacy skills of regional youth leaders. This has strengthened the inclusion of youth leaders in the regional and national responses to work towards a more coherent and holistic approach to issues affecting youth from key populations and young people living with HIV: the dissonance between the age of sexual initiation (before age 15), prevailing legislation on the age of consent (16 years), and the age for independent access to health care (18 years) with the exception of Jamaica in which age for independent access for health care is 16, the implementation of Comprehensive Sexuality Education in all schools in the Caribbean and Gender-neutral laws that protect victims of sexual exploitation.

The formalization of a Steering Committee on Youth Advocacy and follow up meetings are an innovative approach to mobilise regional youth leaders to actively engage in high-level advocacy and policy dialogues by linking the CYAP with PLHIV youth leaders and other sexual and reproductive health youth activities/leaders.

The Second Meeting of Youth Leaders held in May 2018, provided the opportunity for an in-depth discussion on the achievements and challenges confronted by youth leaders in addressing the three priority areas identified in the Caribbean Regional Youth Advocacy Framework (CRYAF) to set in motion practical advocacy tools and techniques that can be adapted per country context. The meeting served to identify regional and international mechanisms that can be used as best practice models for the achievement of priority objectives, provide the opportunity to exercise advocacy techniques with parliamentarian(s), CSO representation and CYAs through a panel discussion addressed sexual and reproductive health issues and concerns identified by youth leaders. The meeting enabled the adaptation of standardized data collecting and reporting tool used by youth leaders in their respective countries. This informed PANCAP of opportunities to support an innovative approach to mobilize regional youth leaders to actively engage in high-level advocacy, as well as further develop advocacy tools and materials to review and address policies, practices and laws that affect young people’s vulnerabilities to HIV.

Helpful links:

PANCAP Youth web page: https://pancap.org/what-we-do/youth/
Caribbean Regional Youth Advocacy Framework on Sexual & Reproductive Health and Rights: https://pancap.org/pc/pcc/media/pancap_document/Final_Caribbean-Regional-Youth-Advocacy-Framework-on-SRHR.pdf

Caribbean Youths to create roadmap to advocate for Sexual Reproductive Health Services for adolescents and youth

Image: Kevin Mendez, Chair, PANCAP Youth Advocacy Steering Committee

Thursday 25 July, 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, will convene the Third Regional Meeting of Youth Leaders: Sexual and Reproductive Health and HIV and AIDS on 30 July – 2 August 2019 in Port-of-Spain, Republic of Trinidad and Tobago.

The meeting comes approximately one year after the Second Meeting of Youth Leaders and 18 months ahead of the 2020 deadline for reaching the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 Targets—90% of people living with HIV diagnosed, 90% of diagnosed people on treatment and 90% of those on treatment virally suppressed.

Regional youth leaders will be involved in drafting a roadmap with strategies for sustaining youth advocacy for the promotion of gender equality, HIV prevention, actions to end gender-based violence and access to quality sexual reproductive health (SRH) services to meet the needs of adolescents and youth regardless of disability, age, citizenship, gender identity and sexual orientation.

According to Kevin Mendez, Chair, PANCAP Youth Advocacy Steering Committee, the forum will also facilitate sharing of success stories, and lessons learnt from regional youth leaders calling attention to issues concerning adolescents’ health and rights. “Youth leaders will combine their experiences and knowledge to identify innovative ways to address gaps in the achievement of the priority areas of the Caribbean Regional Youth Advocacy Framework on Sexual and Reproductive Health and Rights,” stated the Chair, “our goal is to strengthen the Caribbean regional HIV response and create a roadmap with strategies for sustaining youth advocacy”.

In excess of 40 participants will attend, consisting of CARICOM Youth Ambassadors (CYAs), youth leaders from Key Populations, representatives of the Caribbean Family Planning Affiliation (CFPA), Pan American Health Organization (PAHO)/ World Health Organization (WHO), Caribbean Vulnerable Communities Coalition (CVC), CariFLAGS, Caribbean Right Here, Right Now (CRHRN), and the Youth Coalition for Sexual and Reproductive Health and Rights. Over 15 Caribbean territories will be represented.

What is PANCAP?

What are the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 Targets?

By 2020, 90% of all people living with HIV will know their HIV status.
By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

Contact:

Timothy Austin

Communications Specialist

PANCAP Coordinating Unit

CARICOM Secretariat

Turkeyen, Greater Georgetown, Guyana

Email: taustin.consultant@caricom.org

Tel: (592) 222-0001-75, Ext. 3409 | Visit www.PANCAP.org

Editor’s Notes:

Overview of PANCAP Youth Initiatives

Helpful links:

PANCAP Youth web page: https://pancap.org/what-we-do/youth/
Caribbean Regional Youth Advocacy Framework on Sexual & Reproductive Health and Rights: https://pancap.org/pc/pcc/media/pancap_document/Final_Caribbean-Regional-Youth-Advocacy-Framework-on-SRHR.pdf

Faith Leaders Consultation convened in Guyana to discuss ending HIV-related stigma and discrimination

PANCAP convened the Guyana Faith Leaders Consultation, today 3 June 2019 at the CARICOM Secretariat, Georgetown, Guyana. The meeting formed part of a series of regional meetings with faith leaders under the PANCAP Justice for All Programme. Bishop Michael E. Perreira, Senior Pastor Eccles Assembly of God and Member, Regional Consultative (Religious) Steering Committee, chaired the meeting with the support of PANCAP Director Dereck Springer and PANCAP Advisor, Dr Edward Greene.

Outcomes:

Faith leaders agreed to incorporate HIV messages into their faith-based work and planned activities
- Director of PANCAP Dereck Springer challenged the meeting to utilise youth groups/ clubs to propagate messages about ending stigma and discrimination
- He noted that HIV messages could be integrated into the holistic education of youths, especially awareness about other social issues, including teenage pregnancies, illegal drugs, etc.
Faith leaders agreed that stigma and discrimination continue to be significant barriers to vulnerable groups accessing health and that there is an urgent need for more education on the matter.
Bishop Pereira urged faith leaders to take ownership of events and activities to promote HIV awareness and ending stigma and discrimination.
Dr Ronald McGarrell, Inter-Religions Organisation of Guyana (IRO) and Family Federation for World Peace, indicated that the IRO had designated a communications focal point who will be responsible for receiving information on HIV awareness and disseminating the knowledge to all representatives within the IRO.
Faith leaders agreed to work with the National AIDS Programme Secretariat (NAPS) concerning information and knowledge sharing as well as working in communities to end stigma and discrimination.
Finally, faith leaders reached consensus on working with the IRO on activities developed to sensitise Guyanese on HIV-related stigma and discrimination.

Present were Pastor Orin Bruce, Eccles Assembly of God, Bishop Francis Alleyne, Roman Catholic Church, Rev. Dr Ronald McGarrell, Inter-Religions Organisation of Guyana (IRO) and Family Federation for World Peace, Pandit Chaman Lall Poonai, Arya Samaj in Guyana, Mrs Omadai Prashad, Guyana Oneness University, Bishop Peter Koulen, Guyana United Apostolic Mystical Council, Ras Simeon Selassie, Guyana Rastafari Council, Ras Kahfra, Bishop Chaitram Lall, Assemblies of God, Ms Lorna McPherson, National Spiritual Assembly of the Baha’is of Guyana, Pastor Joseph Inniss, World Vision New Testament of God, Rev. Noel Holder, Guyana Congregational Union of Churches (GCU), Mr Telford Layne, Seventh Day Adventist, Father Carl Peters, Anglican Diocese of Guyana, Captain Wilkings Buissereth, The Salvation Army, Ms Lisa Mae Agard, PANCAP Regional Coordinating Mechanism (RCM) for the Global Fund Project and Dr Rhonda Moore, National AIDS Programme Secretariat (Guyana).

PANCAP and Government of Barbados host Parliamentarians Consultation

Wednesday, 29 May 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), with funding from the CARIFORUM 10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation, collaborated with the Ministry of People Empowerment and Elder Affairs, Barbados and the Barbados National HIV/AIDS Commission to convene a consultation with parliamentarians in Barbados. Dr Jacqueline Wiltshire, Deputy Permanent Secretary (ag), Ministry of People Empowerment and Elder Affairs chaired the meeting.

In delivering the Keynote address Hon Cynthia Forde, Minster of People Empowerment and Elder Affairs emphasized that leadership, as well as personal and political courage, were required to deal with the determinants that drive HIV. She reminded the meeting of the political leadership provided by the administration of former Prime Minister Owen Arthur who made HIV a priority by placing it within the Office of the Prime Minister.

Minister Forde challenged all parliamentarians to be involved in a system of governance that is grounded in the social protection of all groups. She stated that her Ministry and the National HIV/AIDS Commission take their mandate seriously and are working assiduously to transform the social landscape for all citizens and to ensure their right to fully participate in all spheres and contribute to social development and evidence-based policy. The Minister emphasised that no one must be left behind and in this regard, her Ministry has taken its responsibility seriously. “Both government and parliamentarians have never made HIV a political issue but instead have funded a multi-sectoral response including services that are offered free of cost to all,” stated Minister Forde. She also observed that parliamentarians and faith leaders do not fathom the extent of their impact on citizens as they are in a privileged position to work collectively to eliminate the scourge of HIV. She called on all parliamentarians to recommit to an AIDS-free Barbados and Caribbean.

Ambassador Daniela Tramacere, Delegation of the European Union to Barbados, the Eastern Caribbean Countries, the OECS and CARICOM/CARIFORUM reminded the meeting that stigma and discrimination are still hampering efforts to reduce new HIV infections, increase the number of persons accessing anti-retroviral treatment and ensure that those who have contracted HIV can live full and productive lives. “The EU has invested approximately Euros 530,000 in PANCAP over two years from October 2017 to August 2019. We believe that our investment can also have a multiplier effect. Through sessions such as this, the message can be amplified to communities across the nation and the region,” stated the Ambassador. The EU Representative shared that through increased engagement and coordination, faith-based collaboration with health officials and political leaders can play a pivotal role in reducing the stigma and discrimination associated with HIV and AIDS. “Indeed, HIV/AIDS is not an individual issue but one that touches every part of society and our economy. This is our collective problem, and we need to come together to develop a collective solution,” stated Ambassador Tramacere.

Mr Dereck Springer, Director of PANCAP, provided an overview of PANCAP’s engagements with parliamentarians under its Justice for All programme that seeks to affirm human rights and reduce stigma and discrimination. The Director noted that both the Global Fund to Fight AIDS, Tuberculosis and Malaria and the CARIFORUM 10^th European Development Fund are contributing to PANCAP’s work with parliamentarians geared towards creating a more enabling environment for people living with HIV and key population groups. He reminded the meeting of the crucial role that parliamentarians must play in response to HIV and acknowledged that parliamentarians come from families and society and regularly engage with their constituencies thus enabling them to understand the challenges faced by people living with and affected by HIV. He also highlighted the legislative, representational and oversight roles of parliamentarians.

Dr Anton Best, Senior Medical Officer, Ministry of Health, Barbados delivered a presentation that included an overview of the epidemiology of HIV in Barbados as well as the implementation of Treat All and Pre Exposure Prophylaxis (PrEP).

Dr Frank Anthony, PANCAP Consultant, provided a historical perspective of HIV, the advances being made in relation to the science, presented on the key actions required by parliamentarians in relation to their legislative, representational and oversight roles, and facilitated a discussion on key policy and legislative issues that require changes and which are within the control of parliamentarians.

During the plenary discussion led by Dr Frank Anthony, parliamentarians agreed to establish a Joint Parliamentary Committee to identify priorities for action.

The consultation was also attended by representatives of faith-based organisations, civil society organisations, and UN agencies representatives.

– ENDS –

Contact:

Timothy Austin
Communications Specialist
PANCAP Coordinating Unit
CARICOM Secretariat
Turkeyen, Greater Georgetown, Guyana
Email: taustin.consultant@caricom.org
Tel: (592) 222-0001-75, Ext. 3409
Website: www.pancap.org

What is PANCAP?

10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation

Under the 10th (EDF) Programme of Support for Wider Caribbean Cooperation, PANCAP will strengthen coordination on human rights issues in keeping with the Justice For all Roadmap through the HIV and AIDS Thematic Task Force in CARIFORUM.

CARIFORUM

CARIFORUM refers to the Grouping of Caribbean States which are signatories of the Georgetown Agreement establishing the African, Caribbean and Pacific Group of States (ACP). The ACP grouping is composed of 79 African, Caribbean and Pacific states.

CARIFORUM is the recipient of and manages the implementation of Caribbean Regional Indicative Programmes financed by the EDF and Caribbean regional programmes financed by individual Member States of the European Union. It also provides technical assistance to agencies/institutions implementing projects under these programmes.

European Union

The Member States of the European Union have decided to link together their know-how, resources and destinies. Together, they have built a zone of stability, democracy and sustainable development while maintaining cultural diversity, tolerance and individual freedoms. The European Union is committed to sharing its achievements and its values with countries and peoples beyond its borders’.

Background to the PANCAP Justice for All (JFA) Roadmap

The PANCAP Justice for All (JFA) Programme was established in September 2013 as a regional response to the UN High-Level Political Declaration (June 2011) designed to reduce AIDS-related stigma and discrimination. The objectives of the JFA Roadmap are:

Enhancing family life and focusing on those in need
Increasing access to treatment and affordable medicines
Reducing gender inequality including violence against women, girls and adolescents
Promoting prevention with special reference to sexual and reproductive health and rights including age-appropriate sexual education
Implementing legislative reforms for modifying AIDS-related stigma and discrimination

Barbados Parliamentarians Sensitization Forum

Wednesday 29 May 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), with funding from the CARIFORUM 10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation, hosted the Barbados Parliamentarians Sensitization Forum at the Radisson Aquatica Resort Barbados on 29 May 2019.

The Forum formed part of a series of engagements with parliamentarians, which commenced in 2013 under the PANCAP Justice for All (JFA) programme. Parliamentarians were involved in defining their legislative, representational and oversight roles to address the barriers toward achieving the UNAIDS 90-90-90 Targets[1], eliminating stigma and discrimination and contributing to the end of AIDS. They discussed pursuing actions with specific timelines and made recommendations for the establishment of a National Parliamentarians Action Group to function as a coordinating mechanism to facilitate communications with and among National Parliamentary Committees.

Parliamentarians also utilised the forum to identify ways to collaborate with other stakeholders in the HIV response, including faith leaders, civil society, youth and Key Populations.

Featured speakers included Hon. Cynthia Y. Forde J.P., L.C.P. Minister of People Empowerment and Elder Affairs, Barbados, Hon. Gline A. Clarke, J.P., B.Sc., Dip. Ed., Deputy Speaker of the House of Assembly, Barbados, and Mr Dereck Springer, Director of PANCAP.

– ENDS –

What is PANCAP?

10th European Development Fund (EDF) Programme of Support for Wider Caribbean Cooperation

CARIFORUM

European Union

The Member States of the European Union have decided to link together their know-how, resources and destinies. Together, they have built a zone of stability, democracy and sustainable development whilst maintaining cultural diversity, tolerance and individual freedoms. The European Union is committed to sharing its achievements and its values with countries and peoples beyond its borders’.

Background to the PANCAP Justice for All (JFA) Roadmap

Enhancing family life and focusing on those in need
Increasing access to treatment and affordable medicines
Reducing gender inequality including violence against women, girls and adolescents
Promoting prevention with special reference to sexual and reproductive health and rights including age-appropriate sexual education
Implementing legislative reforms for modifying AIDS-related stigma and discrimination

[1] By 2020, 90% of all people living with HIV will know their HIV status,

By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and

By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

PANCAP Learning Exchange promotes value of PrEP for prevention of HIV transmission

Image: (Front row, second from left) Ms Prenell King-Rolle, Acting Permanent Secretary, Ministry of Health, The Bahamas , Dr Pearl McMillan, Chief Medical Officer, Ministry of Health, The Bahamas, Dr Nikkiah Forbes, Director of the National HIV/AIDS and Infectious Disease Programme, Ministry of Health, The Bahamas; (Front row, first from right) Dr Shanti Singh-Anthony, Knowledge Management Coordinator, PANCAP Knowledge for Health Project with participants of the PANCAP Learning Exchange and employees of the Ministry of Health, The Bahamas.

Friday, 17 May 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, collaborated with The Bahamas Ministry of Health National AIDS Programme to coordinate a learning exchange that focused on The Bahamas’s experience in the implementation of Pre-exposure prophylaxis (PrEP). The capacity building initiative was held from 6 -10 May 2019 and also focused on “Treat All”, the transition to Dolutegravir, and laboratory support for viral suppression.

The initiative was led by Dr Shanti Singh-Anthony, PANCAP Knowledge Management Coordinator, who explained that the learning exchange was designed for participants to experience first-hand the process utilized by The Bahamas Ministry of Health National AIDS Programme to coordinate and collaborate with civil society organisations, the private sector, and other stakeholders to deliver comprehensive HIV services to communities, particularly key populations.

Dr Singh-Anthony also highlighted that participants were exposed to critical aspects of The Bahamas’ PrEP programme and benefitted from an explanation of how the country transitioned to the use of the highly effective antiretroviral therapy, Dolutegravir.

The countries participating in the learning exchange event included Guyana, Jamaica and the Republic of Trinidad and Tobago.

Multi-disciplinary country teams participated in the event. The teams comprised of National AIDS Programme Managers, Clinical Care Coordinators, HIV clinicians and civil society organisation (CSO) representatives who work closely with the national programme in the implementation of PrEP and other aspects of the HIV response. A total of seven persons from the three countries participated and interacted with representatives of the Ministry of Health The Bahamas, clinical and laboratory staff, and CSO representatives.

Dr Singh-Anthony explained that site visits were conducted to community clinics where participants interacted with key clinic staff in the areas of HIV testing, treatment, community outreach, documentation, and monitoring and reporting. This allowed participants to understand how services are organised and delivered, the number and skill set of the clinical team, and other resources available for supporting service delivery.

Participants also interacted with the beneficiaries of the clinics, particularly key populations and participated in community outreach activities led by the National AIDS Programme and CSO teams aimed at increasing access to services by key populations.

Dr Singh-Anthony believes that the Learning Exchange is critical to the implementation of PrEP in the Region. “The Caribbean is on the cusp of fully embracing and implementing PrEP. Hence, it was crucial for PANCAP to lead this multidisciplinary team on a learning journey to expand their understanding of how PrEP can improve clinical management and outcomes for individuals at risk for HIV. The overarching aim is for the Learning Exchange to act as an impetus for more expansion of knowledge on PrEP and its eventual implementation across the Region”.

The Learning Exchange forms part of the PANCAP Knowledge for Health Project with funding from the United States Agency for International Development (USAID).

Contact:

Timothy Austin

Communications Specialist

PANCAP Coordinating Unit

CARICOM Secretariat

Turkeyen, Greater Georgetown, Guyana

Email: taustin.consultant@caricom.org

Tel: (592) 222-0001-75, Ext. 3409

Website: www.pancap.org

Helpful links:

PANCAP Knowledge for Health Project

https://pancap.org/pancap-work/applying-knowledge-management-to-strengthen-pancaps-coordination-role-for-the-regional-hivaids-response/

Video – HIV – Pre-exposure prophylaxis (PrEP) in the Bahamas

https://pancap.org/pancap-events/hiv-pre-exposure-prophylaxis-prep-in-the-bahamas/

What is PANCAP?

PANCAP Regional Meeting concludes with calls for holistic approach to providing migrant health services through an intersectoral strategy

Thursday, 11 April 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, concluded the regional meeting to provide guidance on the implementation of the Regional Framework on Migrant Health and Rights on 11 April 2019 in Port-of-Spain, Republic of Trinidad and Tobago.

The purpose of the meeting was to facilitate input from regional stakeholders for finalising a guidance document on how to implement the Framework on Migrant Health and Rights within their country context.

The outcomes of the meeting included an agreement on a holistic approach to providing services for migrants including social services through an intersectoral strategy.

Participants emphasised that the health priorities of each territory must guide the implementation of the Migrant Framework at the country level as well as all policies governing access to migrants’ health.

Participants also agreed on the implementation of the Framework on Migrant Health and Rights at the country level in the interest of protecting and safeguarding public health throughout the region.

Participants were exposed to country presentations from Guyana and the Republic of Trinidad and Tobago, which provided details of the situation and response to Venezuelan migrants as well as experiences from Antigua and Barbuda, Belize, The Bahamas and the Organisation of Eastern Caribbean States (OECS). These experiences illustrated the need for the implementation of the Framework to ensure consistent access to health by migrants.

There was also broad agreement on the need to implement the Framework at the country level from a Human Rights perspective.

Participants called for research into the financial and human resource capacity that is essential to provide holistic health services for migrants. The meeting noted the urgent need for strategic information for decision-making regarding the type of services necessary for migrants. It was also recommended that countries research the requirements for a minimum package of services for migrants.

Participants also recommended research into sourcing a financial mechanism to mobilise funding for access to all healthcare by migrants.

Building strategic partnerships within the public health system to advance holistic treatment for migrants was proposed as a necessary step which would provide immediate results for improving access to services by migrants. Participants also advocated for creating strategic alliances with social services to offer comprehensive care for migrants including sexual and reproductive health services, housing, nutrition, etc.

There were calls for an education, training and sensitisation programme for immigration and border patrol officers to provide guidance on the health, social and psychological requirements of migrants.

Educating the media on the positive impact of migration and highlighting the benefits of integrating migrants into society through public awareness communication campaigns was also recommended. Participants emphasised the need to utilise the regional media to highlight the positive aspects of migrants’ culture to reduce negative perceptions.

Mr Dereck Springer, Director of PANCAP, committed to PANCAP continuing high-level engagements with policymakers, including Ministers of Health and Finance and the CARICOM Secretariat to advocate for access to health by migrants as a public health priority.

The Director highlighted that PANCAP would follow up with countries on the implementation of the Migrant Framework through the PANCAP Justice for All Programme and the PANCAP Policy and Strategy Working Group on Stigma and Discrimination.

The PANCAP Director concluded the meeting with a challenge for participants to advocate at the country-level for an intersectoral holistic approach to providing services for migrants which would incorporate their social and psychological needs. He noted that the draft guidance on the implementation of the framework proposed by participants is not prescriptive and can be adapted based on the requirements of each territory.

Participants included Port Health Medical Officers, Representatives of Ministries of National Security and Border Affairs, Legal officers and Protection Officers, International Development partners, Permanent Secretaries, Ministries of Health, Chief Medical Officers, National AIDS Programme Managers, Immigration Officers, Civil society partners that work with key populations, Youth Leaders, Private Sector, Academia, and the International Organization for Migration.

– ENDS –

Helpful links:

PANCAP Rights-Based Framework for Migrant Health and Rights 2018

https://pancap.org/pancap-documents/pancap-rights-based-framework-for-migrant-health-and-rights-2018/

Meeting to provide guidance to countries on how to operationalise the regional framework on migrant health and rights – Event page

https://pancap.org/pancap-events/regional-forum-on-migrants-and-mobile-populations-rights-and-health-2/

What is PANCAP?

Editor’s Notes

Background to the Meeting to provide guidance to countries on how to operationalise the regional framework on migrant health and rights

CARICOM governments have signed on to the International Organization for Migration (IOM) and other relevant international conventions as evidence of their commitment to protect and promote the rights of migrants. The International Convention on the Protection of Migrant Workers and Members of Their Families 1990 is the most comprehensive instrument protecting the rights of migrants but only St Vincent and the Grenadines has ratified this convention. With respect to migrant workers, some countries have ratified the following conventions: #97 Migration for Employment; #111 Concerning discrimination in respect of employment and occupation; and #138 Concerning minimum age for admission to employment.

Previous assessments/studies have found that in the majority of countries, the HIV-related needs of migrants and mobile populations are not integrated in the national HIV response and existing health care programmes. Little data is available on diverse mobile populations and there are no culturally and linguistically appropriate HIV intervention programmes targeting mobile populations, especially high-risk groups including sex workers and MSM. Strict immigration policies adopted by some governments may drive sex workers underground, thereby making them and their clients more vulnerable to contracting HIV. Migrant workers in some countries are consistently listed among the most vulnerable populations owing to, among other factors; their legal status, lack of access to information and services, language barriers and poverty. However, to date no comprehensive strategies exist to address HIV prevention among this vulnerable population. There is limited understanding of the profile of the epidemic among migrant workers or the factors that increase this population’s vulnerability to HIV.

Given the challenges outlined above PANCAP, with funding from the Global Fund in June 2018, developed a regional rights-based framework to increase the access of migrants and mobile populations to HIV prevention, care, support and treatment.

The Framework sets out a roadmap for equitable and non-discriminatory access to health care services across the Caribbean for mobile and migrant populations regardless of age, race, colour, sex, language, religion, political or other opinion, national or social origin, sexual orientation, gender identity, property, birth or other status. The Framework responds to the findings of two multi-country studies conducted by PANCAP over the period 2011 – 2015 which highlighted the barriers to access HIV services by migrant and mobile populations. Following a participatory approach involving representation from Government, (Ministry of Health, Chief Medical Officers, National AIDS Programmes, Immigration Officers) Civil Society (Migrant groups and other key population groups) and international and regional organisations including, PANCAP, UWI, IOM, UNHCR and UNAIDS at a regional forum in Trinidad and Tobago from the 26-27 June 2018, the mandate was for the development of a more comprehensive roadmap for a Regional Rights-Based Framework to Increase the Access of Migrants and Mobile Populations to HIV Prevention, Care, Support and Treatment.

The Framework is rationalised with the vision of regionalism under the CSME and sets out guiding principles and recommended strategies for regional and national action. The Protocol on Contingent Rights was adopted and opened for signature at the 39th Regular Meeting of the Conference of Heads of Government of the Caribbean Community held in Montego Bay, Jamaica on 4-6 July 2018. It was signed by seven countries (Barbados, Grenada, Haiti, Jamaica, Saint Lucia, St Vincent and the Grenadines and Suriname) but is not yet in force. The Protocol grants rights to CARICOM nationals exercising the right of establishment, provision of services, movement of capital or free movement of skills. Spouses and immediate dependents are also entitled to enjoy these rights.

The Framework on Migrant Health and Rights was subsequently endorsed by the Priority Areas Coordinating Committee (technical committee of the PANCAP Executive Board), PANCAP Executive Board and the Council for Human and Social Development – Ministers of Health). The Priority Areas Coordinating Committee recommended that PANCAP should identify a model that can be used to guide countries in operationalising the Framework to their county context.

PANCAP Regional Meeting to Focus On Implementation of Migrant Health and Rights Framework

Tuesday, 2 April 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, will host a regional meeting to provide guidance on the implementation of the Regional Framework on Migrant Health and Rights on 10 – 11 April 2019 in Port-of-Spain, Republic of Trinidad and Tobago.

The Framework was developed by stakeholders at the Regional Forum on Migrants’ and Mobile Populations’ Health and Rights in June 2018 with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The purpose of the Framework is to increase the access of migrants and mobile populations to HIV prevention, care, support and treatment. The Framework provides a roadmap for equitable and non-discriminatory access to health care services across the Caribbean for mobile and migrant populations regardless of age, race, colour, sex, language, religion, political or other opinion, national or social origin, sexual orientation, gender identity, property, birth or other status.

The Framework was subsequently endorsed by the Priority Areas Coordinating Committee (PACC – the technical committee of the PANCAP Executive Board), PANCAP Executive Board and the Council for Human and Social Development – Ministers of Health (COHSOD). The PACC recommended that PANCAP identify a model to guide countries in operationalising the Framework within their country context. This will be the focus of the upcoming regional meeting.

The meeting is occurring a few weeks after Hon. Terrence Deyalsingh, Minister of Health, Republic of Trinidad and Tobago announced that migrants will receive the same free health care as nationals, particularly in relation to sexually transmitted diseases.

The Minister was speaking at the Seventh Meeting of National AIDS Programme Managers and Key Partners held on 11 – 13 March in Port-of-Spain. The Minister further stated, “We have taken a decision in Trinidad and Tobago, you know we have Venezuelan migrants, to treat them as nationals. Because migrants do not live in isolation in the countries they migrate to. They mix with the rest of the population; they integrate themselves with the environment. So we have taken a policy decision at the Ministry of Health to treat all migrants regardless of their country of origin as citizens of Trinidad and Tobago when it comes to public health”.

PANCAP Director, Dereck Springer stated that the Minister’s announcement could not be more timely as a pivotal aspect of the upcoming meeting will be the input provided by participants for finalising a guidance document on how to implement the Framework on Migrant Health and Rights within their country context.

The Director further highlighted that the objectives of the meeting are to share the findings of a desk review on models/guidance for operationalising the Framework on Migrants Health and Rights and validate the findings of an assessment of the needs of countries’ health systems to provide services for migrants.

Participants will include Port Health Medical Officers, Representatives of Ministries of National Security and Border Affairs, Legal officers and Protection Officers, International Development partners, Permanent Secretaries, Ministries of Health, Chief Medical Officers, National AIDS Programme Managers, Immigration Officers, Civil society partners that work with key populations, Faith Leaders, Youth Leaders, Private Sector, Academia, the International Organization for Migration and the Office of the United Nations High Commissioner for Refugees – The UN Refugee Agency.

– ENDS –

Helpful links:

PANCAP Rights-Based Framework for Migrant Health and Rights 2018

https://pancap.org/pancap-documents/pancap-rights-based-framework-for-migrant-health-and-rights-2018/

Meeting to provide guidance to countries on how to operationalise the regional framework on migrant health and rights – Event page

https://pancap.org/pancap-events/regional-forum-on-migrants-and-mobile-populations-rights-and-health-2/

What is PANCAP?

Editor’s Notes

Background to the Meeting to provide guidance to countries on how to operationalise the regional framework on migrant health and rights

National AIDS Programme Managers and Civil Society urged to collaborate on innovations to reach key populations with HIV prevention and to retain people on treatment and care

Tuesday, 12 March 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, commenced the Seventh Meeting of National AIDS Programme (NAP) Managers and Key Partners in Port-of-Spain, Republic of Trinidad and Tobago on Monday 11 March 2019.

The meeting was hosted 22 months ahead of the end of 2020 deadline for reaching the UNAIDS 90–90–90 Targets — 90% of people living with HIV diagnosed, 90% of diagnosed people on treatment and 90% of those on treatment virally suppressed.

In opening remarks, Director of PANCAP, Mr Dereck Springer highlighted that PANCAP recently evaluated the Caribbean Regional Strategic Framework on HIV and AIDS (CRSF) 2014-2018 and will be using the results to inform the development of the new CRSF 2019-2023. The evaluation found that the Region has made progress in responding to the epidemic but it also clearly illustrated that there is more to be done, particularly in relation to implementation of innovative activities to achieve prevention, retain people in treatment and care, reach key populations with services and create an enabling environment.

“Compared to 2013 when it felt as though we were in the midst of winter, we are now a much more united partnership. We are all PANCAP,” stated the Director, “the Partnership is much stronger and more resilient because of the work being done by everyone. We have demonstrated an indomitable will to overcome the many challenges including financial and human resources in our effort to serve the people of the Caribbean. PANCAP has restored its goodwill; the presence of over 135 partners here today is testimony of this goodwill and a recognition that the PANCAP brand is synonymous with good leadership, respect for partners, meaningful engagement and accountability. There is no other partnership for health like ours”.

The Director stated that there is renewed confidence in PANCAP and this has been achieved because the Partnership has placed people at the heart of the matter. “We have made them central to the Partnership, influencing policy and actively contributing to the decision-making process,” stated Mr Springer, “Our priority was to ensure that those of us within the leadership of the organisation did not become remote and disconnected from the views of the people whom we serve – the people who know best what their needs are and what needs to be done to meet them”.

He further stated that the Partnership is now more visible. “We are sharing our knowledge, we are improving coordination – both alignment and harmonisation,” stated Mr Springer, “We are demonstrating our added value to the Caribbean region. Our strategic regional approach to HIV builds on a strong history of collaboration in public health to overcome the challenges inherent to the unique geography, economy and culture of the Caribbean”.

The Director highlighted that a key objective of PANCAP is to achieve value for money by promoting economies of scale, as the region’s small developing states may provide limited capacity for developing the complex programmes needed for a comprehensive response to HIV.

The partnership marked 18 years of its existence on 14 February 2019. From its inception in 2001, there have been notable successes including the fact that HIV incidence and AIDS-related deaths have been reduced, and seven countries have been certified as having achieved the dual targets for the elimination of mother-to-child transmission of HIV and Syphilis.

Strengthened national programmes have improved capacity to implement prevention, treatment and care activities. “We have built the capacity of civil society and positioned them to access their own funding,” stated Mr Springer, “substantial investments have been made in strengthening health systems and in scaling-up services for increasing numbers of people who are living longer with HIV. Regional public goods and services have facilitated this by lowering costs and reducing inefficiencies inherent in building capacity in multiple countries”. He further stated that countries contribute to, and benefit from, more affordable access to medicines and the sharing of technical skills, operational capacity, information, advocacy and specialised services. PANCAP has supported the OECS Pharmaceutical Procurement System under the Global Fund Round 9 grant, which has now expanded. Technical support is sourced within the region and is implemented through peer-learning methodologies and virtual and face-to-face knowledge sharing events.

“We continue to respond to the needs of the region and we are actively mobilising resources from our development partners such as PEPFAR, the Global Fund and UN agencies, albeit in an environment of scarcity while leveraging the technical expertise of our development partners to support our national governments to increase domestic resources for HIV” stated the Director.

He urged participants to use the meeting to review progress, learn from each other, explore innovative approaches and commit to implementing and scaling them up. “Let us make our voices heard so that we can inform the priorities and strategies for our new CRSF, stated the Director, “Let us be bold. Let us not fear the future, instead let us identify and embrace the many opportunities that present themselves for us to renew, refresh, streamline and refocus. Let us find within ourselves, our invincible summer. I am confident that this Partnership will build upon this solid foundation over the next years and will provide the leadership required for achieving the vision of ending AIDS in the Caribbean region”.

Ms Aldora Robinson, Director of the Health Promotion and Advocacy Unit within the Ministry of Health, Agriculture and Human Services, Turks and Caicos Islands and the National AIDS Programme Managers Representative on the PANCAP Governance Bodies stated that in light of the challenge of reduced international funding the meeting could be a “game changer”. “We cannot continue to do the same thing and expect different results,” stated Ms Robison, “we need to come together, NAP Managers and civil society, with purpose and innovation to accomplish results necessary to close the gap of the 90-90-90 Targets; building on the successes and gains already made”.

She advocated that National AIDS Programme Managers and civil society must work together in their individual countries where the context of the HIV response is often different.

“Each island must own their response,” Ms Robinson stated, “there is a critical need to increase access to HIV and STI Testing for key populations and we also need to pay attention to our 50-year olds and those who have retired. We look forward to an exciting and informative week where purpose meets innovation. We must always remember that we are working towards the same goal of an AIDS-free Caribbean”.

In brief remarks, Mr Ivan Cruickshank, Executive Director, Caribbean Vulnerable Communities (CVC) Coalition, reminded participants of the 2020 deadline for ending AIDS and urged that all stakeholders commit to using the meeting to foster innovative solutions to fill the HIV gaps. “We’re coming in on the heels of the recent UNAIDS report. There is unfinished business, so whatever we do this week, we must connect the dots,” stated the Executive Director, “we’re a Caribbean nation of track and field and we know in track and field, especially in a 400 metres race, the last 10 metres are usually the hardest. For many of us present here today, the last 10 metres are going to be critical. How we respond and how we achieve the targets depend on our collaborative spirit and ability to be innovative”.

Dr Lilian Pedrosa, Fund Portfolio Manager, Latin America and the Caribbean, the Global Fund, stated that it is a pivotal year for the The Global Fund to Fight AIDS, Tuberculosis and Malaria, which is approaching another replenishment period and attempting to secure additional funding to continue supporting the Global Fund grants. She reminded the meeting that the Global Fund has been supporting the Region since 2001, disbursing over US$800 Million specifically for the Caribbean Region. She applauded the success of the Region in achieving the decline of deaths from AIDS, as well as the decline in new infections. She also lauded the achievement of the validation of seven countries for the elimination of Mother-to-Child Transmission of HIV and Syphilis.

Dr Pedrosa emphasized that the Region should also be commended for the increase of domestic contributions for HIV. “When the Global Fund started as a partner in 2001, together with other partners, we were funding most of the response”, stated Dr Pedrosa, “What we have seen in the last few years is a new momentum where countries are really stepping up the plate and increasing their financial commitment to sustain the gains made in the fight against AIDS”.

She noted that despite the successes and increased domestic financing, there is the challenge of reaching the right key populations and increasing testing. She also noted there are some countries where the bulk of the epidemic is concentrated in key populations and national programmes continue to be challenged with retaining people in care. She emphasized however, that the most significant challenge faced by the response is stigma and discrimination.

She challenged the participants to utilize the meeting to reflect on the lessons learned from national programmes and to build on the unique partnership created by PANCAP. She also urged participants to use the resources and expertise within the Partnership to advocate within their countries for an end to stigma and discrimination. “We need to reach the finish line for ending AIDS together, as one Caribbean”, stated Dr Pedrosa.

Dr James Guwani, Team Leader, UNAIDS Caribbean Office, highlighted that the Caribbean joined the community of nations in a commitment to end the AIDS epidemic by 2030 as part of the Sustainable Development Goal agenda. Next year, 2020, the Region will reach a key benchmark to determine whether it is on course to realize the vision of a world without AIDS. He emphasized that every country will ask how close they are to diagnosing 90% of people living with HIV, to starting 90% of diagnosed people on antiretroviral therapy and to achieving viral suppression among 90% of those on treatment.

“While it is urgent and important that we press forward, I urge all of us as partners in the Caribbean AIDS response to first look back,” stated Dr Guwani. He shared that in 2004 and 2005 the region experienced an estimated 18,000 AIDS-related deaths. In 2017, that number had fallen by more than 40%. From 1997 to 2000, there were an estimated 30,000 new infections annually in the Caribbean. By the end of 2017, that number was reduced by half. In 2015, 45% of all people living with HIV in this region were on treatment. Two years later that number had increased to 57 percent—well over half of the HIV positive population.

Dr Guwani further stated that the numbers tell the story of a region that has gotten many things right including widespread access to treatment, increased testing availability and some traction with respect to prevention. “These strides are in large part thanks to the people and partnerships in this very room,” stated Dr Guwani, “As we redirect our attention to the uphill battle before us, let us remind ourselves of our capacity to mobilize leaders and communities, to inform and sensitize citizens and to treat and care for those living with HIV. We have what it takes to end this epidemic. We must now ask how we can harness our expertise, resources and passion to reach those who have not benefitted from the services on offer”.

He emphasized that the big picture is that in 2017, 73% of Caribbean people living with HIV knew their status, 79% of diagnosed people were on treatment and 70% of those on treatment were virally suppressed.

Dr Guwani challenged the meeting to answer the following questions: why are quarter of those testing positive in the Caribbean diagnosed late, why do so many people not stay the course having started treatment, and why aren’t prevention efforts reaching enough of the young people who now account for almost one-third of new infections in the region.

He urged the participants to combine evidence, analysis and insights to determine what the Region should do differently in order to reach the youth, men, women and members of key and vulnerable communities who continue to be left behind.

Ms Victoria Nibarger, PEPFAR Coordinator, Caribbean Regional Program, Office of the Global AIDS Coordinator and Health Diplomacy (S/GAC), Jamaica highlighted the recent case of a man living with HIV in London who had been “functionally cured” of HIV, following a bone marrow transplant from an HIV-resistant donor. She noted that more than 18 months have passed since the man last took ARVs, and there remains no trace of HIV in his blood. She shared that Anton Pozniak, President of the International AIDS Society, called it a “critical moment” in terms of the fight against HIV, but emphasized that at present it does not offer a large-scale strategy for a cure.

“I have no doubt that we are all united in our hope for a scalable cure,” stated the PEPFAR Coordinator, “but even in the meantime we have a historic opportunity to make what once seemed impossible possible – controlling and ultimately ending HIV as a public health threat around the world”.

She highlighted that when the United States government launched PEPFAR in 2003, HIV was a death sentence in many parts of the world. Thanks to the lifesaving efforts of PEPFAR and its partners, the world is a more secure place. Ms Nibarger explained that with strong bipartisan support across three U.S. Presidents and nine U.S. Congresses and working with our many partners around the globe, PEPFAR has invested more than 80 billion U.S. dollars in the global HIV response. The results have been incredible: more than 17 million lives saved, prevented millions of new HIV infections, and created the roadmap to controlling the pandemic.

The PEPFAR Coordinator emphasized that the region cannot achieve epidemic control so long as any one country is lagging behind. She stated, “This Seventh Annual Meeting is an invaluable opportunity for those of us working throughout the Caribbean to come together, to learn from one another, to strategize and to strengthen our joint resolve to combat HIV. This meeting can serve as a troubleshooting forum. I am confident that the collective wisdom on all fronts – health, culture, and politics – is sufficient to overcome challenges that are being faced”.

She challenged participants to devote significant attention to the 90-90-90 Targets, for a progress check as 2020 approaches. The cascade for the collective region is approximately 73-57-40 of all people living with HIV.

Ms Nibarger applauded the Region for being well on its way to achieving the First 90. “We need to review testing strategies to ensure they are maximally efficient and that we are not over-testing certain populations, stated the PEPFAR Coordinator, “PEPFAR firmly believes that index testing and partner notification services are essential to ensuring that at least 90 percent of individuals know their status. We are confident that this is possible to do across the Caribbean, despite challenges related to stigma, discrimination and violence”.

She further stated that despite the great strides in implementation of Treat All, the percentage of those diagnosed who are on treatment remains low – around 57 percent of all PLHIV for the region. She urged the participants to work together to rapidly expand treatment coverage with the goal of every individual who is diagnosed with HIV rapidly initiating ART. She emphasized that there is overwhelming evidence that this policy results in better patient outcomes, stronger adherence and higher viral suppression rates.

“We believe the adoption of TLD (fixed-dose combination of tenofovir 300mg /lamivudine 300mg /dolutegravir 50mg (TLD), as a first-line regimen is essential to ensure better adherence and clinical outcomes. Differentiated service-delivery models, such as 6-month scripting, are more convenient for patients and can help to ease crowding at treatment facilities and pharmacies,” stated Ms Nibarger.

She further stated that the final 90 – viral suppression – has the farthest to go, with the current regional figure at about 40 percent. “We support the scale-up of viral load testing, which will help to ensure optimal clinical outcomes”.

On the issue of sustainability, the PEPFAR Coordinator explained that the PEPFAR budget for the Caribbean Regional Programme will be reduced for the next fiscal year, “We will closeout our bilateral programming in Suriname this Fall, followed by a planned closeout in Guyana and Barbados in Fall 2020. At this time, we do not have planned closeout dates in Jamaica or Trinidad and Tobago. As donor resources decline, host governments are taking on more of the financing – and this is commendable. We believe it is critical that governments continue to learn from one another about how to successfully mobilize domestic resources to strengthen sustainability and prepare for donor transition. As such, we look forward to the roadmap for sustainability that is an expected outcome of this meeting”.

She further stated “Treat All, index testing, multi-month scripting, viral load scale-up, increasing government resources are some of the minimum requirements for our 2019 PEPFAR Regional Operational Plan. They are WHO-supported policies and practices that PEPFAR is requesting to be in place ahead of our new fiscal year. There is strong evidence that they are necessary for efficient and effective programmes, which enable the reduction of HIV transmission and, eventually, epidemic control”

Ms Nibarger highlighted that despite the changes, she can confirm that PEPFAR remains fully committed to the sustainability of the Partnership, “It is these partnerships that make progress, and our joint goal of reaching the 90-90-90 targets, possible. We have heard you, our partners; we will not reach our goals if we focus only on services for members of key populations who are comfortable disclosing their status. Not everyone is willing or able to disclose. Therefore, we are proposing new strategies – including men’s health clinics – to broaden our reach and ensure that our PEPFAR dollars are finding those who need help.

We are looking at ways to support integrated service-delivery models that will better provide for the holistic needs of patients. We want to increase knowledge of private practitioners and their contributions to the HIV response as well as to link them to our clinical-mentoring activities. We aim to strengthen direct partnerships with local non-governmental organizations who are integral to the response”.

The PEPFAR Coordinator emphasized that PEPFAR worldwide will continue to prioritize strategic information, as decisions must be data-driven. She explained that it is through strong strategic information systems that the most accurate picture of the epidemic can be seen as well as the identification of areas where interventions are working, outstanding gaps, and efficient use of collective resources.

“This time together presents a great opportunity. I am hopeful that we will come away from this meeting with new ideas about how to accelerate progress toward 90-90-90. I hope that we will further strengthen the commitment to international best practices and figure out how we can adapt them to fit the context of the Caribbean region as well as individual countries. Just like with the news of the patient in London being “functionally cured,” progress is happening, and we have reason to be optimistic. Together, we can – and we will – end the HIV pandemic in the Caribbean,” stated Ms Nibarger.

Ms Sandra Jones, Technical Advisor HIV/STI, TB and Viral Hepatitis PAHO/WHO – Sub-regional Program Coordination, Caribbean highlighted that over the last 3-5 years the region has made progress towards reversing the HIV epidemic, achieving a reduction in the number of new HIV infections by 18% and deaths by 23%. “However, as demonstrated by the evaluation of the CRSF 2014-2018, there are gaps and challenges, resulting in uneven progress in the region”, stated Ms. Jones, “while there has been progress in placing more people living with HIV on treatment, much more needs to be done to increase the numbers and to retain people on treatment. In fact, significant effort is required for the Caribbean to achieve the UNAIDS 90-90-90 targets”.

She stated that the region has a unique opportunity to address the challenges, accelerate actions and close the gaps with specific indicators for HIV, the Sustainable Health Agenda for the Americas, the HIV fast-track targets and evidence-based interventions. She also stated that Regional Frameworks such as the CRSF, the Caribbean Cooperation in Health coupled with a strong primary care system in each of the Member States, and committed partners can assist the region in achieving the 90-90-90 targets.

Ms Jones emphasized that paramount to achieving the 2030 goal of ending AIDS is a paradigm shift. She stated, “The time to be innovative is now, given the overwhelming evidence for HIV prevention and treatment that are currently available. The rapid implementation of different innovations and evidence-based interventions for HIV prevention, care and treatment which include Pre-exposure prophylaxis (PrEP), Post Exposure Prophylaxis-PEP, self-testing, Treat All, as well as sexually transmitted infection (STI) prevention and Control, with emphasis on key populations and migrants, should be delivered in a more cohesive, integrated manner, focusing on universal access and coverage for everyone. The delivery of an integrated service for HIV and STI must continue to include civil society organizations. Providing linkage to care will ensure that “the unreached is reached, leaving no one behind”.

She further stated, “One of the achievements that the region is proud of is the Elimination of Mother-to-child Transmission of HIV and Syphilis (EMTCT). The Caribbean is a leader in EMTCT. Besides the validation of Cuba and six other Caribbean Countries in 2015 and 2017, seven of the nine countries validated are from the Caribbean. This achievement is possible due to the primary health care focus and the integration of HIV and Syphilis primary prevention and treatment services into national maternal and child health programme”.

Ms Jones explained that as a result, the estimated coverage of HIV testing among pregnant women increased from 58% in 2010 to 73% in 2017, while ART coverage for HIV+ mothers increased from 50% in 2010 to 75% in 2017. All these have resulted in a 27% reduction of new infections among infants from 2010 to 2017, with an estimated 5,800 new HIV cases averted.

She stated, “let us all remember that the elimination of the mother-to-child transmission, which we thought was not possible, is a tangible commitment to universal health and brings us closer to ending AIDS and other STIs as a public health problem in the Caribbean.

Ms Jones reaffirmed PAHO’s commitment to work hand-in-hand with Member States and with all partners including civil society organizations to provide the necessary policy advice, technical support and capacity building so that the Region can collectively reverse the HIV epidemic, ending AIDS and priority STIs as public health problems in the Caribbean.

Hon. Terrence Deyalsingh, Minister of Health, Republic of Trinidad and Tobago and Chair, PANCAP Executive Board highlighted that the HIV programmatic interventions by necessity also require political will, strategic leadership, good governance and an overall unrelenting bravery. He emphasized the need to analyse evidence in a sovereign way that is cognizant of the unique country socio-cultural and economic context for executive decision-making.

He stated that winning and losing battles among programmes, policies and legislative agendas must not daunt the focus on the war against the HIV epidemic, and improved quality of life for those living with and affected by HIV.

He shared that in 2015 Trinidad and Tobago had an uncertain future for the National AIDS Coordinating Committee (NACC) that became a loose amalgam to the health-based HIV and AIDS Coordinating Unit (HACU). There was staff attrition, minimal spending of US funds from the PEPFAR programme from 2010 to 2015 and the characteristic of the epidemic was still ill-defined in an embryonic case-based surveillance system and further stymied by these governance battles. “As a country, we were still quoting cases ever diagnosed as over 20,000 cases to characterize our evidence base for advocacy and decision-making without knowledge of all deaths, including those related to AIDS. The country was beginning to slowly recognize that the Spectrum UNAIDS estimates were congruous with the truer reality of 11,000 persons being alive and living with HIV.

The Minister explained that in 2015 and 2016 there was a reintegration of the NACC into the Office of the Prime Minister to oversee HIV Prevention activities particularly in spheres of community engagement through social and NGO support services, addressing childhood sexual, age and gender appropriate education as well as, child abuse and domestic violence. This brought back purpose to the health-based HIV Unit to contribute to the national HIV programme as overseen by the NACC through preserving the traditional gains in HIV testing expansion and HIV treatment and unravelling and tackling the case-based surveillance and adopting the 90-90-90 cascade histogram to guide national decision making.

“This refocus was synergistic with the 2016 UNAIDS global resolutions and with the local arm of PEPFAR’s strategic realignment of their prevention and strategic information goals to increase persons on Antiretroviral (ART) and strengthen case-based surveillance,” stated Minister Deyalsingh, “The deliberate re-engagement of PEPFAR saw a then fledgling expenditure up to 2015, increase greatly in the 2016 and 2017 fiscal years. This has assisted Trinidad and Tobago to move closer to the desired 2020 Fast Track Targets from a HACU reported 2015 baseline 90-90-90 achievements of 83-74-42, to an overall target of 79-78-87 in 2017”.

Minister Deyalsingh emphasized that Trinidad and Tobago’s roadmap offers the words and phrases of steadfast, evidence-driven, organizational and political will, and willingness to change and innovate. “A reiterated call to get technical support for country case-based surveillance systems, opt-out testing as an accelerated strategy at select health care facilities that address STI, TB, mental health, substance abuse and hospital ward admissions and mental health focus on treatment adherence are key” stated the Minister.

The Minister further stated that the HIV epidemic has been better understood and managed more aggressively in the last three years with a trajectory to further improve. “The AIDS epidemic can be ended on, or before 2030,” stated Minister Deyalsingh, “We need to be honest and look hard at what the national evidence and national socio-economic situation are sometimes screaming at us to do. There is an overdue need to collaborate in an atmosphere of mutual respect beginning with countries recognizing the global comparator of apples with apples with regional partners. However regional and multilateral agencies must also accept that despite all the recommended plethora of actions that a sovereign country’s self-determined narrow critical path for success should be fully supported”.

Minister Deyalsingh challenged the participants to use the forum to highlight country positions, programmes and policy initiatives to provide not the “typical problem tree decorated with obstacles, but the solution tree decorated with the Caribbean resolve, as led by PANCAP to permanently root out these obstacles that must be perceived as only short-term programme gaps”.

The Minister commended the exceptional and creative leadership of the Director of PANCAP. He noted that the Region will owe him a debt of gratitude when it achieves the UNAIDS 90-90-90 targets. He acknowledged the presence of the youth – CARICOM Youth Ambassadors and key population leaders – to whom he urged that the baton be passed to lead the response in the future.

– ENDS –

Helpful links:

Seventh Meeting of the National AIDS Programme Managers and Key Partners Event web page

https://pancap.org/pancap-events/7th-meeting-of-the-national-aids-programme-managers-and-key-partners/

Global AIDS Update 2018 – Miles to Go

https://pancap.org/pancap-documents/global-aids-update-2018-miles-to-go/

Caribbean Regional Strategic Framework on HIV and AIDS

https://pancap.org/pancap-documents/caribbean-regional-strategic-framework-on-hiv-and-aids-2008-2012/

What is PANCAP?

Editor’s Notes

What are the Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 Targets?

By 2020, 90% of all people living with HIV will know their HIV status.
By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

Background to the National AIDS Programme Managers and Key Partners Meeting

The Caribbean Regional Strategic Framework (CRSF) 2014-2018 articulates the vision and collective priorities of Caribbean states through their membership in the Pan Caribbean Partnership against HIV and AIDS (PANCAP). The core premise is that stemming the HIV epidemic in the Caribbean rests on the commitment, capacity and leadership of national authorities and effective response. The primary goal of regional collaborative efforts is to support country responses by addressing common challenges in the areas of evidence-based policy formulation, and innovative responses to addressing legislative gaps, resource mobilisation, coordination and technical assistance., An effective regional response, guided by the CRSF 2014-2018, therefore requires that the links and interfaces between country programmes and regional support programmes be defined and agreed to by country partners. This is critical for strengthening country ownership of the PANCAP response and a shared responsibility to strategically align efforts to end HIV as a public health problem in the Caribbean.

The National AIDS Programme Managers and Key Partners Meeting provides an opportunity for joint decision-making in setting programmatic priorities and identifying partner contributions in order to strategically align efforts in the fight against HIV. The Meeting Agenda is intended to allow for in-depth analysis and discussion on the relevant aspects of the UN Post 2015 Agenda, and the overall advancements of the Caribbean Region in implementing new initiatives for HIV. It is within this context that opportunities and challenges for the Region and individual countries to expand the national responses will be discussed. PANCAP acknowledges the need for greater attention to intercountry linkages and greater collaboration with regional partners. This will serve to maximise synergies and provide a mechanism for making regional public goods available to national programmes to enhance their delivery and impact.

PANCAP Knowledge Management Share Fair to focus on improving access to HIV prevention, treatment, care and support by men and boys

Thursday, 7 March 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, will host a Knowledge Management Share Fair in Port-of-Spain, Republic of Trinidad and Tobago on 14 March 2019. Participants will include over 80 National AIDS Programme (NAP) Managers and Implementing Partners such as civil society organizations that work with people living with HIV and key population groups (including youth). The Share Fair is an initiative of the PANCAP Knowledge for Health project, which aims to enhance knowledge generation, sharing, and learning among HIV programme implementers and civil society around the implementation of Treat All [1] and the 90-90-90 Targets[2].

The Share Fair will expand on the capacity building initiatives implemented by the Project. These include the Knowledge Synthesis and Best Practices Workshop (2016), South-to-South Learning Exchanges to the Dominican Republic and Jamaica (2017-2018), Treat All Message Design Workshop (2017), “Collaborating and Learning towards Treat All” Share Fair (2018), PANCAP webinars, and other ongoing regional knowledge management efforts around 90-90-90 and Treat All.

It will provide a space for NAP managers and Civil Society Organization (CSO) representatives to showcase best practices from implementation experiences, discuss critical challenges, and provide recommendations for increasing access to services for men, including men who have sex with men and other key populations in achieving 90-90-90. Access to services by men will be a key issue during the Share Fair as the UNAIDS Global AIDS Update 2018 shows that gay men and other men who have sex with men accounted for nearly a quarter of new infections in 2017. The report also highlighted that efforts to reach men and boys, and particularly gay men and other men who have sex with men, are constrained by health services insufficiently tailored to their needs and limited community-based services.

To build capacity in the area of improving access to health by men, the Share Fair will include a Knowledge Café, which will highlight successful Men’s Health programmes. According to PANCAP Knowledge Coordinator, Dr Shanti Singh-Anthony, the intention is to highlight innovations from country programmes that have achieved positive results in relation to increasing access to prevention, treatment, care and support services by men and boys. Implementers of programmes who are challenged to reach men with health services can use the innovative practices to increase men’s access to quality health services.

“Previous Share Fairs were successful in forging stronger partnerships and collaboration between NAP Managers and CSOs and sharing of best practices,” stated Dr Singh-Anthony “we intend to build on these successes. We cannot afford to leave our men and young boys behind at this critical stage of the HIV response. The Share Fair will provide an ideal opportunity for the two groups to utilize the lessons learned from the region to enhance services for men. The overarching objective is to increase the number of men and boys who are accessing HIV prevention, treatment, care and support services”.

Participants will also share implementation experiences in relation to the provision of Pre-exposure Prophylaxis (PrEP), innovations for reaching and testing key populations, and strategies for sustaining the HIV response.

– ENDS –

Contact:

Timothy Austin

Communications Specialist

PANCAP Coordinating Unit

CARICOM Secretariat

Tel: (592) 222-0001-75| Email: taustin.consultant@caricom.org

Fax: (592) 222-0203 | www.pancap.org

Helpful links:

What is the PANCAP Knowledge for Health Project?

https://pancap.org/pancap-work/applying-knowledge-management-to-strengthen-pancaps-coordination-role-for-the-regional-hivaids-response/

Global AIDS Update 2018 – Miles to Go

https://pancap.org/pancap-documents/global-aids-update-2018-miles-to-go/

What is PANCAP?

Editor’s Notes

What are the Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 Targets?

By 2020, 90% of all people living with HIV will know their HIV status.
By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

[1] In September 2015, the World Health Organization (WHO) issued a new policy, which stated that anyone infected with HIV should begin antiretroviral treatment as soon after diagnosis as possible. With its “Treat-all” recommendation, WHO removed all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV; all populations and age groups are now eligible for treatment.

[2] Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 Targets:

By 2020, 90% of all people living with HIV will know their HIV status.
By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.