Remarks by the Director of PANCAP on the occasion of 2018 High-Level Dialogue on Comprehensive Sexuality Education (CSE) in Health and Family Life Education (HFLE)

I bring you greetings on behalf of Dr The Honourable Timothy Harris, Prime Minister of St. Kitts and Nevis and Lead Head with responsibility for Human Resources, Health and HIV and Ambassador Irwin LaRocque, Secretary-General of the Caribbean Community.

I wish to congratulate UNFPA for convening this follow-up meeting to the 2018 High-Level Dialogue on Comprehensive Sexuality Education (CSE) in Health and Family Life Education (HFLE) and to acknowledge the support of other partners.

A recent evaluation of the Caribbean Regional Strategic Framework on HIV and AIDS, 2014 to 2018, found that Age-appropriate, gender-sensitive, evidence-informed programmes that provide comprehensive sexual and reproductive health education,  being delivered throughout the education sector and in community settings, had not been met during the period under review.  The evaluation found that there was inadequate provision of HIV life skills based on sexuality education, and implementation of the HFLE curriculum is uneven across Caribbean countries, ranging from no implementation to limited implementation at three levels (primary, secondary and teachers training institutions). This finding was supported by the analysis of the PANCAP Partners’ Survey which revealed that capacity was limited in the delivery of age-appropriate, gender sensitive, evidence-informed programmes that provide CSE throughout the education sector and the community and in providing technical guidance and support to establish and maintain high-quality standards for prevention programmes.

It was therefore not surprising that UNAIDS data on adolescents suggest that they are highly vulnerable because of early and forced initiation of sex; high pregnancy rates; and low level of knowledge about HIV prevention.  Key population youth remain at particularly high-risk with reports of estimated HIV prevalence among gay and bisexual adolescent boys as high as 14% to 27%, and 27% in transgender adolescents.

The same evaluation recommended that governments should support the revision and strengthening of the HFLE curriculum to include more relevant age-appropriate information on stigma and discrimination with reference to youth and adolescents, and especially information on sexuality, sexual and reproductive health including HIV and AIDS and other STIs.

Given the serious concerns regarding the findings of the CRSF 2014-2018 evaluation in relation to the inadequate impact of the prevention response in the Region, the PANCAP Executive Board called upon national governments to take note that while tens of thousands of cases of HIV infections have been prevented, we need to significantly reduce new infections.  This requires us to promote age-appropriate sexual education and skills and extend sexual reproductive health services to all youth and key populations and to advocate for the introduction of innovative prevention approaches and improve the quality of prevention services to ensure greater impact in reducing new HIV infections.

In 2017, PANCAP developed a Caribbean Regional Youth Advocacy Framework on Sexual and Reproductive Health and Rights.  It identified the need to address the dissonance between the age of consent for sex (16 in most territories and the age at which adolescents can access SRH services (18 years); comprehensive sexuality education to be implemented in schools across the Caribbean, where it is not a usual phenomenon; and advocacy towards gender-inclusive policies and laws. To advance these priorities, a Regional Youth Steering Committee, comprised of CARICOM Youth Ambassadors and Key Population Youth Leaders, was established in July 2017 to oversee the implementation of the Framework.  To effectively do this, youth leaders were trained to advocate for substantive policy changes across the region in support of reducing their vulnerability to HIV infection by improving access to HIV combination prevention, care, treatment and support services, in recognition of their sexual and reproductive health and rights.  In May 2018, the Second Regional Meeting of Youth Leaders on SRH and Rights was convened and over 40 youths from CARICOM Youth Ambassadors, youth leaders from Key Populations agreed to advance the priorities of the Caribbean Regional Youth Advocacy Framework.[1] Youth representatives have been engaged in high-level advocacy with Ministers of Education and Health at the 2018 High-Level Dialogue on CSE in HFLE, and 2018 COHSOD–Ministers of Health on the priority issues mentioned earlier. They have also been positioned to represent Caribbean youth on the PAHO EMTCT TWG and the recently established PAHO Youth Advocacy Group. In relation to the latter, two of these youth recently attended its inaugural meeting which was held in Washington D.C. and actively participated in a workshop on School Health Programming. One of them is present with us here today – Dennis Glasgow, who is also the youth representative on the PAHO EMTCT TWG.

To facilitate a greater understanding of CSE, PANCAP synthesised the UNESCO International technical guidance on Sexuality Education: An evidence-informed approach, into nine infographics that contain key messages on the different aspects of sexuality education. The infographics are on: Health and Wellbeing; Relationships; Sexuality and Sexual Behaviours; Skills for Health and Wellbeing; The Human Body and Development; Understanding Gender; Values, Rights, Culture and Sexuality and Violence and Staying Safe. These were developed primarily for faith leaders and other PANCAP stakeholders, to demystify comprehensive sexuality education, facilitate their buy-in and reduce opposition to the rollout of the curriculum in schools.  We are awaiting feedback from the Regional Consultative Committee of Faith Leaders.

The Partnership is currently developing a CRSF 2019-2023 which acknowledges that young people face persistent challenges to realising their sexual and reproductive rights, including the gap between the age of sexual consent (16) and the age (18) at which they can independently access health services, for example, HIV testing. Cognisant of these lessons, the draft CRSF 2019-2023 clearly articulates as a strategy – the need to design, resource,  pilot,  evaluate, and scale-up regional cross-sectoral initiatives, to implement comprehensive sexuality education in schools with high levels of risky behaviour.

I believe that we all hold the view that the delivery of CSE in schools must receive buy-in from parents and guardians, religious leaders and community gatekeepers for its successful implementation in the school system.  My own experience as a science teacher, designer and facilitator of youth peer education and as a consultant, who in 2008 was tasked with evaluating Guyana’s implementation of HFLE has helped me to better understand the critical importance of engaging parents, faith leaders, community gatekeepers. It is essential to help them to understand what we mean by CSE and clearly articulating its benefits to obtain their buy-in.  We must advocate for the inclusion of CSE in the curriculum of teacher training institutions to enable every graduate teacher to enter the school system with the knowledge and skills, and level of comfort to deliver CSE in HFLE.  CSE cannot, and must not be delivered as an academic subject. This may require revitalising the creative thinking of some of our teachers to enable them to include CSE in HFLE.

Our young people continue to call upon us to engage them in the design of such programmes to reduce their risk and vulnerability. Only recently, Dennis Glasgow made that call at the “Women Deliver Conference” in  Vancouver, Canada. Let us, therefore, answer that call and ensure meaningful engagement and involvement of our young people so programmes can be adapted/developed to meet their needs.  As parents, we all have a responsibility to ensure that our children, including those who are adolescents and young adults, are given the tools to develop life skills that would enable them to make choices that will reduce their vulnerability, and most importantly allow them to survive in today’s complex and fast-moving world. A world in which many of them are growing up without extended family and community support. A world in which they now have easy access to information through the many digital platforms.  A world in which they often feel alone and unsupported. I, therefore, challenge us all, particularly our policymakers to move beyond the conversations in these rooms to decisive action following this meeting. I wish us all a productive meeting.

Thank you.

[1] https://pancap.org/what-we-do/youth/

Director’s message – June 2019

From its inception, PANCAP recognised the significant role that faith leaders can play in the prevention of HIV, provision of care and support and reducing the stigma and discrimination that is often associated with HIV and AIDS. More recently, PANCAP has been working closely with faith leaders both at the regional and national level to support them to clearly define and execute their role.

During the first half of this year, PANCAP has been conducting a series of annual national level consultations under the Justice for All programme with faith leaders in Grenada, Guyana, Jamaica, St Kitts and Nevis, Suriname and the Republic of Trinidad and Tobago. Our next stop is Barbados.  The need for faith leaders to engage in public campaigns to increase awareness of HIV has emerged as a common action among this community.  Many of the faith leaders who attended the consultations for the first time lamented the fact that they were unaware of the UNAIDS 90-90-90 Targets by 2020 and the goal to end AIDS by 2030; Ninety (90%) of all people living with HIV should know their status; 90% of all those who are diagnosed HIV positive to be on sustained antiretroviral treatment (ART); and 90% of those on ART having an undetectable viral load. If this target is achieved, we can end AIDS because People living with HIV (PLHIV) would have improved quality of life and longevity, and virally suppressed PLHIV would not transmit the virus thereby significantly contributing to the prevention of new HIV infections. This message continues to resonate with faith leaders.  Another message that is resonating with faith leaders is that stigma and discrimination are significant barriers to ending AIDS as they prevent persons from accessing prevention, treatment, care and support services.

Faith leaders have now clearly articulated their responsibility, particularly those who have been sensitised, to ensure that the information is shared among other faith leaders and their congregations. They have also taken responsibility for collaborating with their national AIDS programmes to support public awareness campaigns to remind people, especially adolescents and youth that we still live in a world of AIDS, and to provide them with correct information and education thus enabling them to assess their risk to HIV. They will continue to support HIV testing, care and support. Faith leaders also committed to advocating, on behalf of the National AIDS Programme, with policymakers for increased domestic resources for HIV, including for prevention. In one of the consultations, faith leaders, in recognising that religious leaders are not a homogeneous group, identified the need to explore the possibility of a ‘theological centering’ or areas of common agreements as they advance their response. Such centering is crucial as faith leaders confront stigma and discrimination that is also experienced by members of the LGBTI community who too require sexual and reproductive and HIV services.

I have assured faith leaders of PANCAP’s support through our Knowledge Management programme. They will be provided with information which can be accessed on our website, support for message design and facilitation of webinars, research articles, case studies, evidence, fact sheets and infographics tailored to their specific needs. I also reminded faith leaders that in an environment of limited resources, they do not necessarily need money to respond as information sharing can be incorporated into their existing programmes within and outside their place of worship. Technical support is also available to them through their national AIDS programmes and civil society organisations involved in the response to HIV and other social issues that make people vulnerable to HIV.

I am hopeful that the faith community’s response will be fully owned by faith leaders and that they will work collaboratively with their national AIDS programmes and civil society partners. The PANCAP Coordinating Unit, with support of the Global Fund, the 10th European Development Fund, Dr Edward Greene, PANCAP Advisor and the Policy and Strategy Working Group on Stigma and Discrimination, has given them wings and we will now let them fly and soar.

Sir Elton John and President Macron Call for $14 Billion for Global Fund Replenishment

PARIS – Sir Elton John joined French President Emmanuel Macron to call on the world to raise at least US$14 billion for the Global Fund to save 16 million lives over the next three years. The two addressed supporters of the Solidays music festival after President Macron presented Sir Elton the Légion d’honneur, France’s highest award, for his lifetime contribution to the arts and the fight against HIV.

“The fight against AIDS has been my passion for many, many years,” said Sir Elton. “We have made such incredible progress, but we cannot become complacent. A fully replenished Global Fund is essential if we are going to consign this disease to history. I commend President Macron for his leadership in this effort.”

Sir Elton was joined by President Macron, who called on the world to step up the fight to save 16 million lives through a successful Replenishment of the Global Fund. Watch the full remarks here.

President Macron presented the award to Sir Elton at a ceremony this afternoon at the Élysée Palace in Paris, in the presence of global health leaders including Peter Sands, Executive Director of the Global Fund and Lelio Marmora, Executive Director of Unitaid.

“Sir Elton John has been one of the most steadfast and outspoken supporters of the fight against HIV, and France is a world leader in rallying support, funding and research to end AIDS,” said Peter Sands, Executive Director of the Global Fund. “This award acknowledges Sir Elton’s lifetime contributions in music, as well as his work to support millions of people living with HIV and AIDS around the world.”

Under President Macron’s leadership, France will host the Global Fund’s Sixth Replenishment pledging conference in Lyon 10 October 2019. The Global Fund seeks to raise at least US$14 billion for the next three years to help save 16 million lives, cut the mortality rate from HIV, TB and malaria in half, and build stronger health systems by 2023.

The Elton John AIDS Foundation, established in 1993, was one of the early groups providing lifesaving treatment and dignified care and support for people living with HIV. Today, the foundation partners with the Global Fund to provide treatment and support to millions of people around the world.

About the Global Fund: The Global Fund is a partnership designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics. As a partnership between governments, civil society, the private sector and people affected by the diseases, the Global Fund mobilizes and invests nearly US$4 billion a year to support programs run by local experts in more than 100 countries. By challenging barriers and embracing innovative approaches, we are working together to better serve people affected by the diseases.

Information on the work of the Global Fund is available at www.theglobalfund.org

Follow the Global Fund on Twitter: http://twitter.com/globalfund

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Faith leaders agreed to address HIV-related stigma and discrimination at consultation in Jamaica

PANCAP convened a Consultation with Faith Leaders in Jamaica on 6 June 2019 at the Bahai Centre, Mountain View, Kingston.  The meeting was held in partnership with the Religious Group Steering Committee (RGSC) and representatives of religious leaders as a follow up to a consultation held in 2017.

The forum was chaired by Rev. Canon Garth Minott, Chair of the Regional Consultative Steering Committee and PANCAP Champion, who announced a new initiative of the Religious leaders in partnership with the Ministry of Health and Wellness, Jamaica. The Jamaica Council of Churches (JCC) has signed an agreement with the Ministry as a sub-sub-recipient of the Global Fund Grant for intervention in human rights advocacy with special focus on reducing stigma and discrimination within religious organizations generally and among religious leaders in particular. A mapping exercise, which is an integral part of the project will assist in identifying religious agencies offering services for healthy living which will serve to enhance the directory of services offered by the National Family Planning Board.

Rev. Canon Minott reported that the RGSC has formed valuable partnerships with the AIDS Healthcare Foundation (AHF), the Joint United Nations Programme on HIV/AIDS (UNAIDS), Ministry of Health and Wellness, the United Theological College of the West Indies (UTCWI) and the Jamaica Theological Seminary (JTS).  He further stated that there has been a meeting with five parliamentarians which resulted in an agreement to focus on providing sensitisation on issues related to sexual health and the role parliamentarians can play as leaders in society.

In his remarks, Dereck Springer, Director of PANCAP shared that significant progress has been made in responding to the HIV epidemic. However, there is still more work to be done to achieve the UNAIDS 90-90-90 Target by 2020 and to end AIDS as a public health threat by 2030. He stated that the national consultations build upon the work that is being done at the regional level and noted that it is at the country-level that the real work is done to address stigma and discrimination that impede individuals’ access to prevention, treatment, care and support services. He lauded the work that is being done by the RGSC in supporting the national response through increased partnership with the Ministry of Health and Wellness, Civil Society Organisations (CSOs), development partners and the private sector. He acknowledged the presence of two persons who are living with HIV and noted that their input is critical for shaping the faith community’s response.

Ms Karlene Temple-Anderson, Grants Manager, Ministry of Health and Wellness, commended the Religious sector’s contribution to Jamaica’s efforts to achieve the UNAIDS 90-90-90. She shared that at the end of 2017, there was an estimated 34,000 People Living with HIV (PLHIV) in Jamaica and 26,426 were diagnosed. However, only 12,908 were on treatment and 7,315 were virally suppressed.   The national prevalence of HIV is 1.8% while the prevalence in Men who have sex with men (MSM) was 29.6% and transgender people 51%.  Female sex workers were 2.0%. As at April 2019, Jamaica now purchases all its anti-retroviral drugs and laboratory reagents and consumables. She noted that partnership with the faith community was helping to fill gaps in the response and that the Faith-Based Organisations (FBOs) are involved at every level of the response including on the Country Coordinating Mechanism for the Global Fund Grants.

Ms Temple-Anderson challenged faith leaders to focus on gender norms and practices that support vulnerability of women and girls, violence against women and girls, norms of masculinity that support poor health-seeking behaviours among men; abstinence, fidelity and partner reduction; elimination of intimate partner and domestic violence, cross-generational relationships between older men and young girls and the need to remove the perception that the Faith community is a place of exclusion rather than a refuge. She also encouraged faith leaders to develop social marketing and mass media campaigns to address prevention, benefits of treatment and retention in care.

Ms Manoela Manova, UNAIDS Country Coordinator for Jamaica stated that there is a public role for FBOs in the response.  She posted that FBOs can overcome obstacles through partnerships and that they have a role to play in creating an enabling environment, increasing testing and retention on treatment and care.  She further stated that FBOs have the power to influence and therefore have a pivotal role in policy and legislative reform and in the development of the national strategic plan for HIV and AIDS.   She advocated for the inclusion of FBOs in developing strategies and policies for vulnerable groups.

Outcomes

Faith leaders agreed to address stigma and discrimination within the faith community, facilitate a dialogue with the community of PLHIV around the benefits of disclosure and to focus efforts on policy, partnership building and training of faith leaders.  They also reached consensus on utilizing knowledge synthesis to disseminate educational material as well as feedback on progress received from the faith community.

Knowledge Management Tips – Capture your ideas better with visual note-taking

National AIDS Programme Managers and Civil Society Organisations are tasked with using innovation for HIV messaging, community/public education and employee training and capacity building. Brainstorming ideas and capturing those new concepts is not an easy task using “old school” text on a whiteboard or recorded minutes.  For your next idea-generation meeting, try “visual notetaking”.

Visual notetaking or “sketchnoting”  is a process of representing ideas non-linguistically (That’s a fancy way of saying, “drawing pictures”). Visual notetaking can include concept mapping but also more artistic ways of visually capturing and representing ideas.

On the simpler side of the visual notetaking continuum, visual notes can be used to create narrated art. On the complex end of the spectrum, some visual notetaking applications support the creation of narrated “sketchnotes” (whiteboard animation videos) which include audio narration synchronised to screencasts of drawings. Visual or graphic facilitation can be used at meetings to summarise presentations and guide discussions. Whether simple or complex, visual notes can be used to more deeply process information as well as communicate it to others with images.

For example, Knowledge Management Coordinator, PANCAP Knowledge for Health Project, Dr Shanti Singh-Anthony introduced Visual Notetaking to the PANCAP Advisory Group on Resource Mobilization in February 2019 to capture the group’s ideas for a marketing approach to PANCAP’s resource mobilisation.  Illustrated below are the results:

The technique proved ideal for concisely capturing the meeting’s ideas for target audiences,  key messages, marketing collaterals and other critical elements of a marketing plan for PANCAP. Dr Singh-Anthony recommends visual note-taking for any activity where ideas must be captured and communicated succinctly.  She posited “The old English adage – a picture is worth a thousand words applies nicely to visual note-taking. Visual note-taking allows you to capture and present complex ideas in ways that are easily understood and remembered. I have found this tool to be extremely useful as a student and professional and highly recommended it!”

To learn more about visual notetaking and some of the other ideas shared in our article, view Rachel Smith’s 18 minute TEDx talk, “Drawing in Class,” which provides an excellent overview about the “what and why” of visual notetaking.

To learn more about how PANCAP utilises Knowledge Management for learning and sharing, click here.

Transforming Lives through Innovation: Implementation of high-impact prevention programmes for adolescents, young women and men

Image: Consultation with Dangriga’s Child-Friendly Advisory Board

With the support of Gilead Sciences Inc., Spouses of Caribbean Leaders Action Network (SCLAN) partnered with the Ministry of Health, Belize and the Anira Foundation in Guyana to implement the project, “Transforming Lives Through Innovation: Implementation of high-impact prevention programmes for adolescents, young women and men.”

The goal of SCLAN’s project in Belize is to expand access to HIV prevention and treatment to 600 females and 400 males, particularly the high-risk population ages 15-24 years in Dangriga Town, Stann Creek District.

Stann Creek district has the second highest rate of infection and the highest HIV-related mortality. With this information, it was important to begin the project with consultations with various stakeholders working in HIV and sexual and reproductive health.

The sessions were productive and positive feedback was received on effective ways to engage youth and collect essential baseline data to inform an effective peer education programme. Baseline data is a powerful tool to create meaningful policies, strategies and projects.

A community mapping was also completed to determine the target population, which will be exposed to a sexual behaviour survey that will measure knowledge and attitude on sexual practices, gender-based violence as well as other sexual and reproductive issues.

The next steps will involve the creation of peer education target groups, along with a peer education curriculum and public awareness campaign.
For more information on this initiative, contact Judy Waight, Programme Officer, SCLAN at jwaight@sclan.org

Capacity building for Regional Civil Society focused on sex workers hosted in Guyana 

Image: Facilitators and participants of the Caribbean Sex Work Coalition (CSWC) capacity building initiative

The Caribbean Sex Work Coalition (CSWC) recently trained 15 members from six of its member countries. Sex Workers from Belize, Barbados, Guyana, Jamaica, Republic of Trinidad and Tobago and Suriname participated in a three-day Sex Worker Implementation Tool (SWIT) workshop followed by a  two-day Organisational Management Training aimed to build the capacity of sex workers to manage their civil society organisations efficiently.

According to Co-chair and Coordinator, CSWC, Miriam Edwards, three days of training were dedicated to building the capacity of sex workers to monitor and evaluate their progress in following the guidelines specified by the SWIT.  The SWIT offers practical guidance on effective HIV and STI programming for sex workers. It provides evidence for the necessity of decriminalisation of sex work, the involvement of sex workers in developing policy, and the empowerment and self-determination of sex working communities as a fundamental part of the fight against HIV.  SWIT was created by the World Health Organization (WHO) and is based on WHO’s 2012 recommendations on HIV and Sex Work.

The SWIT training was supported by the Robert Carr Civil Society Networks Fund (RCNF).

Following the SWIT training, participants were involved in two days of capacity building focused primarily on Financial Management and the Principles of Good Governance. Participants were exposed to the basics of financial management through several practical exercises that included preparing budgets for their organisations, creating vouchers for payments, distinguishing between an invoice and a quotation, understanding the importance of accountability as well as the need for correct documentation for payments.

The Principles of Good Governance and Board Development were also critical elements of the training course. Participants had the opportunity to take part in several leadership exercises. This initiative was funded by the Caribbean Coalition for Vulnerable Communities (CVC).

A Recipe for Successful Transition from Donor Support

Written by Lisa Tarantino, Principal Associate | International Development Division | Abt Associates

The process of transition from donor support to country ownership of an HIV response is a daunting challenge for development partners, organisations and countries. If managed well, it can be an opportunity for countries to strengthen their HIV response and improve health system performance. Across the globe, governments, private-sector health care providers, civil society, communities, and development partners are making the transition to a more sustainable HIV approach. The global health community knows the well-documented components of a sustainable HIV response. The President’s Emergency Plan for AIDS Relief’s (PEPFAR) Sustainability Index Dashboard defines them according to the following themes: Governance, Leadership, and Accountability; National Health System and Service Delivery; Strategic Investments, Efficiency, and Sustainable Financing; and Strategic Information.

We have learned by experience that if some of the ingredients of sustainability are missing or inadequate, then the whole response will suffer. Like a cake that falls flat because you forgot to add the eggs, for example, donor transition can fail without a sufficiently robust and engaged civil society.

But a recipe is more than a list of ingredients. The actual amounts, timing and (baking) techniques are vitally important. Technical assistance (TA) could address all the right ingredients and still be ineffective if some are provided too late in the process. As in the example, if you add eggs too late in the process, then the cake could sink later. Similarly, development partners and local stakeholders should address as soon as possible foundational elements that secure the HIV response into full country ownership, such as financing, governance, and institutionalised engagement of non-government actors. Even civil society organisations (CSOs) that provide quality HIV services will flounder without donor funding in the absence of domestic funding, a supportive policy environment, performance monitoring and management capacity. What’s critical is managing the process with a long-term time horizon, political and programmatic engagement and communications, and monitoring and evaluation of the transition’s impact. All of this will help hold the shape of the HIV response together and continue to reduce the incidence of new infections and HIV deaths during the process.

Barbados is in the midst of what looks to be a successful transition from PEPFAR support. The country has been increasing its ownership of the response to HIV over the last 10 years. I have had the (unbelievably) good fortune of working on PEPFAR-funded programs in Barbados and in nine other Caribbean countries during their transition processes. I marvel at the bumpy but doggedly determined process by which Barbados and its development partners have strengthened the country’s HIV response while increasing country ownership with strengthened health financing, multi-sectoral capacity building and engagement, and collaborative stewardship. The TA ingredients came together at roughly the right time and in the right measure to:

•    Strengthen CSO capacity
•    Build private sector engagement and contracting capacity
•    Emphasise a health financing approach
•    Coordinate development assistance
•    Promote regional cross-learning and shared resources
•    Support internal champions in the Government of Barbados
•    Draft a sustainability strategy that reflects a health systems approach

Drawing from the lessons of countries in the Caribbean, here are seven ways that development partners and country stakeholders can ensure this happens:

Develop a clearly communicated long-term transition strategy, with political signalling of the transition by international and national parties and a plan for gradual, planned withdrawal.

Stakeholders and development partners need to coordinate, collaborate and be strategic, avoiding duplication. Country stakeholders should be engaged in this process.

Take a systems approach as early as possible in the transition process.  The HIV response needs to be integrated into a wider, well-functioning system to be sustainable.

Build capacity for institutionalised multi-sectoral engagement. CSOs and the private sector must have a sustainable role within the broader system.

Develop country strategies to sustain the HIV response beyond donor support that are realistic with successful transition as one objective.

Strengthen governance to ensure inclusivity and access. We need a clear-eyed approach to this crucial issue. Development partner-established mechanisms rarely survive. What will be the new or adapted governance structure?

Implement domestic resource mobilisation strategies. Start with data, build capacity for collecting it, obtain adequate funding, and allocate it effectively and efficiently.

Transitioning from donor support is not as easy as baking a cake. Innumerable factors impact whether a transition process succeeds. Development partners can mitigate risks with well-designed and delivered TA: the right ingredients, in the right amount, at the right time, put together and delivered with care.

Public Health Champion – Dr Peter Figueroa

In May 2019, Dr J. Peter Figueroa was recognised by the World Health Assembly as a health leader for his substantial contribution to public health in Jamaica, the Caribbean, the Americas and the world, over the past four decades[1].

This achievement reminds us of the integral role Dr Figueroa has played in the Region’s HIV response.  In this PANCAP Feature, we reflect on his ground-breaking work and significant contributions to Public Health.

Development of Primary Health Care in Jamaica

In the 1970s, after gaining his medical degree, Dr Figueroa worked in Jamaica’s Public sector.  He contributed significantly to the movement that developed Primary Health Care in Jamaica, including the introduction of community health aides, in advance of the 1978 Alma Ata Declaration. He was awarded a PhD in 1996 by the London School of Hygiene and Tropical Medicine and has since written or co-authored more than 150 published papers and co-edited three books on a range of public health topics.

Formation of the Junior Doctors’ Association (JDA)

As a young doctor, Dr Figueroa, motivated his colleagues in the Government service to form the Junior Doctors’ Association (JDA), now referred to as the Jamaica Medical Doctors Association (JMDA). As President of the JDA, he provided the leadership necessary to improve health services and conditions of work. Dr Figueroa also co-founded the Caribbean Public Health Association and the Caribbean College of Family Practitioners. In 1986 he earned a United Nations Peace Medal for his service as Vice-chair of the National Committee for the commemoration of the International Year of Peace.

Dr Figueroa’s roles over the years have included Principal Medical Officer – Epidemiology in the Ministry of Health; Chief Medical Officer; Director of the National HIV-STI Programme; Scientific Secretary and Chair of the Caribbean Health Research Council (CHRC); and temporary advisor to WHO on a range of public health topics.

 An integral figure in Jamaica’s HIV response

Dr Figueroa has been instrumental in the HIV response in Jamaica, leading the response from its inception in 1986 until 2008 and transforming it into a highly successful multi-sectoral programme. He led the development of a national surveillance system and the investigation of disease outbreaks and established the Epidemiology Research and Training Unit, which conducted numerous research studies including an HIV vaccine trial.

In his early career, he was one of the few clinicians willing to provide medical care to HIV patients. Dr Figueroa continues to provide medical care for People living with HIV at his current medical practice.  In a recent interview with the WHO he stated, “Many people were afraid back then, but we had a responsibility. We had to deal with it, so I lead the response in HIV for many years”.

Established condom usage as a norm

Dr Figueroa mobilised significant funding, established condom usage as a norm nationally and developed the public access anti-retroviral treatment programme. He also expanded STI services, leading outreach for HIV testing and prevention, resulting in a reduction of HIV prevalence among sex workers from 12 to under 4 percent. In addition, Dr Figueroa has been a member of the UNAIDS scientific expert panel since 2014.


“Health is more than health. It is having a just society. It is having the social conditions in place where persons, particularly the most vulnerable are not left behind” – Dr Figueroa


Beyond HIV

Dr Figueroa’s contribution to public health in the Caribbean goes well beyond his work in HIV. He has provided technical advice to many Caribbean countries and the CARICOM Council on Human and Social Development on a variety of public health issues since the 1980s. He served on the Scientific Advisory Council of the Caribbean Epidemiology Centre and since 1989 has been the Chair of the Caribbean Immunization Managers’ Annual Meeting. He is currently part of the Technical Advisory Group for immunisations conveyed by the Pan American Health Organization (PAHO).

Honorary Professor

The University of the West Indies’ Appointments Committee conferred the title of “Honorary Professor’ in the area of Epidemiology and HIV/AIDS on Dr Figueroa.  He received this honour while serving as Chief, Epidemiology and AIDS at the Ministry of Health in Jamaica.  The honour was presented in recognition of his substantial contribution to academic life through teaching and research[2].   He is currently a Professor of Public Health, Epidemiology and HIV and AIDS at the University of the West Indies, Kingston, Jamaica, where he has developed a doctorate programme in public health.

PANCAP Champion

Dr Figueroa has provided technical expertise to PANCAP since its inception in 2001. He was honoured at the inaugural PANCAP Champions for Change Awards in 2004 for his advocacy and innovation in the Region’s HIV response.  At the 15th Ordinary Meeting of the Regional Coordinating Mechanism (RCM) of PANCAP in 2010, he was selected as the recipient of the PANCAP Award for Excellence for his “substantial contribution to the HIV response”. Professor Figueroa was also Chair of the RCM in 2012 and provided leadership for resource mobilisation for the Region.  He also provided guidance as Chair of the Priority Areas Coordinating Committee (PACC) from its inception until the end of 2013. Dr Figueroa was also a pivotal figure in the development and evaluation of the various versions of the Caribbean Regional Strategic Framework on HIV and AIDS (CRSF).   He is currently the Vice Chair of the PANCAP RCM for the Global Fund Project QRA-H-CARICOM, No. 1122.

Now

Dr Figueroa currently serves as the chair of the Caribbean Immunization Technical Advisory Group, which advises Caribbean Ministers of Health, and as Chair of the Caribbean Certification Committee for Eradication of Poliovirus. Dr Figueroa has also made significant contributions to public health research, with a body of research on a wide range of public health and infectious disease topics.

Awards and recognition

Dr Figueroa has received numerous awards in his country, with accolades such as the Medical Association of Jamaica President’s Award, the Jamaica Public Health Hero Award, the Caribbean Health Research Council Award for outstanding contribution to Public Health and Research in the Caribbean, and the Order of Jamaica.

PANCAP salutes Dr Figueroa on his recent achievement; his expertise, drive and compassion for humanity will continue to inspire the Partnership and generations of public health advocates for years to come.

In an invited comment the Director of PANCAP, Mr. Dereck Springer, described Dr Figueroa as a giant in the field of public health and medicine who provides bold, decisive and insightful leadership to guide the strategic direction of the Partnership.

[1] Pan American Health Organization (PAHO) YouTube Channel:

[2]The University of the West Indies at Mona, Jamaica https://www.mona.uwi.edu/marcom/uwinotebook/entry/1385

Faith Leaders in Jamaica unite against HIV Stigma and Gender-Based Violence

Image: Rev. Canon Garth Minott, Chair of the Regional Consultative Steering Committee (The Religious Steering Committee) and PANCAP Champion

The clash of sexual practices with doctrinal values, faith, miracles and the need for scientific proof, psycho-­social support for people living with and affected by HIV and stigma reduction as a human rights issue, formed the discussion at the 2019 PANCAP Consultation. The discussion was held on Thursday, 6 June 2019 at the Baha’i Centre, Mountain View Avenue Kingston.

Dereck Springer, Director of the Pan Caribbean Partnership against HIV and AIDS (PANCAP), delivered remarks at the Jamaica Faith Leaders’ event, which is a follow up to a series of national and regional consultations held in 2018 and 2019 as a part of PANCAP’s Justice for All programme.

PANCAP has been holding discussions with Faith Leaders since its inception in 2001, recognizing the key role of religion in the life of Caribbean people. The PANCAP Champions for Change Programme, which started in 2004, identified religious leaders as critical influencers in reducing stigma and discrimination as an essential part of human rights. This 2019 consultation in Jamaica continues the work of creating the faith leaders network in Jamaica with emphasis on their part in ending HIV.

Other speakers included Karlene Temple-Anderson, Grants Manager, Ministry of Health and Wellness (MOHW) and Rev. Canon Garth Minott, Chair of the Regional Consultative Steering Committee (The Religious Steering Committee) and a PANCAP Champion, who presented a report on the Jamaica Faith Leaders Consultations. The report included work by the Muslim, Baha’i and Rastafari Inity communities.

Other Strategic Partnerships included AIDS HEALTHCARE FOUNDATION (AHF), UNAIDS, Jamaica AIDS Support for Life (JASL), United Theological College of the West Indies (UTCWI), International Association of Parliamentarians for Peace and The Jamaica Council of Churches (JCC).

For more information, contact Patricia Phillips on 876-­‐801-­‐9150 or patriciahopeyphillips@gmail.com

Contact:
Rev. Canon Garth Minott Telephone: 876-­‐337-­‐7739 Email: g.minott@gmail.com