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Director’s Message September – October 2021COVID-19 threatens the AIDS Elimination Agenda

October 5, 2021

The ongoing COVID-19 pandemic threatens to reverse years of progress across many Sustainable Development Goals (SDGs). While the virus has impacted everyone, it affects the world’s poorest and the most vulnerable people the most. The SDGs related to HIV and AIDS speak to ending AIDS and other communicable diseases by 2030. This is further reflected in the Caribbean Regional Strategic Framework on HIV (CRSF) 2019 – 2025 that serves as the guiding strategy for the Caribbean Region. However, actions to accelerate the CRSF have been significantly impacted by the disruptive nature of the pandemic. Health systems are struggling to mitigate the disruptions, which takes away the focus from the elimination agenda.

At the end of 2020, 82% of People Living with HIV in the region were diagnosed. Two thirds (67%) of all People living with HIV were on treatment, and 59% were virally suppressed. This highlights that there are still significant gaps to get to the 2030 agenda of ending AIDS in the Caribbean.

For us to get on track to end AIDS by 2030, Caribbean countries must step up the pace around prevention, testing, treatment, care and ending stigma and discrimination. This is going to necessitate a doubling up of efforts requiring us to ensure the continuity of services in a significantly disrupted environment while at the same time accelerating progress around the elimination goals.

Key Populations must be at the centre of the response to ensure that we strategize correctly to meet service delivery during the pandemic and respond to the elimination agenda. Key populations and their sexual partners accounted for more than 60% of new infections in 2020 and continue to be disproportionately affected by both the pandemic and the HIV epidemic.

Some strategies that must be adapted are decentralizing services to access points preferred by Key Populations to ensure uninterrupted access to HIV services and reducing contact with clinics. We would also need to scale up Multi-month Dispensing (MMD) and community refills of ART, PrEP and other medications. We will also need to maximize online service delivery options. However, while doing so, we must ensure that these services are assessable, affordable and Key Populations have the necessary infrastructure to access these services.

While the pandemic can be disruptive, it presents us with an opportunity to implement new strategies to mitigate its impact and ensure continuity of services. If these solutions are sustained beyond the pandemic, they may also modernize HIV and key population programming and position us towards the elimination agenda.