Archives: Media Releases

Two gay men exiled from Caribbean nation challenge draconian ‘buggery’ and ‘gross indecency’ laws

On 26 July 2019, two gay men filed court proceedings to challenge St Vincent and the Grenadines’ “buggery” and “gross indecency” laws, which criminalise homosexuality. Both men, who have been advised by Jeremy Johnson QC and Peter Laverack of 5 Essex Court, assert that their dignity and autonomy are stripped by these laws. They have filed claims with Affidavits stating that they have been exiled from the Caribbean nation due to the severely draconian and damaging effects of these laws.

Javin Johnson, aged 22, successfully claimed asylum in the United Kingdom in 2017 having established that he could not live as a gay man in St Vincent. Sean Macleish, aged 53, is a Vincentian resident in Chicago, Illinois. Macleish has publicly advocated to the Caribbean nation’s Prime Minister for the removal of these laws so that he may return home with his partner but to no effect.

These challenges coincide with Prince William and his family holidaying in the country on the exclusive island of Mustique, whose website states “there are no rules on Mustique”. LGBT visitors, however, would be liable to arrest and imprisonment for up to 10 years if caught being intimate. Prince William stated this month that he would be “absolutely fine” if his own children were gay.

The two claimants are unknown to each other, having separately decided that now is the time for decriminalisation. They say that these laws violate multiple and overlapping rights in the Constitution, which are there to protect all Vincentians, no matter who they are or who they love.

These court challenges come in the wake of Jason Jones’ successful challenge to Trinidad and Tobago’s anti-gay laws, a week after a similar challenge was filed in Dominica, and with other challenges already afoot in Jamaica and Barbados.

Commonwealth Caribbean nations inherited these laws during British colonial rule. Now uniquely in the Americas, these nations continue to criminalise homosexuality, placing them in an ever-decreasing minority globally.

The challenges were filed by local lawyers, Zita Barnwell and Jomo Thomas, listing English barristers Jeremy Johnson QC and Peter Laverack of 5 Essex Court, London, as the intended trial advocates. 5 Essex Court was instructed by a team at Hogan Lovells, which includes Charles Brasted, partner, Tom Smith, senior associate, and Iris Karaman, trainee solicitor.”

The two challenges are expected to be heard together in the High Court in Kingstown. The British Privy Council may have ultimate say on these colonial-era laws, as St Vincent and the Grenadines still sends its appeals to the old imperial court in London.

The Global Fund – An Open Letter to 7-Year-Olds

Calling on the World

The Global Fund is calling on the world to step up the fight against AIDS, Tuberculosis (TB) and Malaria.  After years of remarkable advances, new threats have slowed progress and enabled the diseases to gain ground.

  • Nearly 1,000 girls and young women are infected with HIV every day.
  • Tuberculosis is now the world’s leading infectious killer.
  • A child dies from Malaria every 2 minutes.

In 2019, we have a unique opportunity to take a massive step toward the Global Goal of ending these epidemics by 2030.  The Global Fund aims to raise at least US$14 billion to save 16 million more lives and prevent 234 million infections and cases.  We need your help to make this happen. Join us at this important moment as we call on the world to #StepUpTheFight.

An Open Letter to 7-Year-Olds

On Tuesday, 30 July, the Global Fund launched an Open Letter addressed to 7-year-olds around the world, the group that turns 18 in 2030.  While today’s adults are leaving the next generation with a long to-do list, we’re making a promise to 7-year-olds everywhere to do everything we can to end AIDS, TB and Malaria by 2030, so they don’t have to.

Signed by the Global Fund’s most influential supporters and partners with the aim of encouraging wide public support, the Open Letter is a global call to action in the final phase of the #StepUpTheFight campaign to commit to the shared goal to end these epidemics.

Download and sign the Open Letter to 7-year-olds here or visit https://www.stepupthefight.org/

Support the launch of the Open Letter and post a tile with one of the suggested messages to your social media channels.  To download the social media messages, click on the following link: https://digital.theglobalfund.org/CS.aspx?VP3=SearchResult&VBID=278T3ZOXVMB

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:

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?

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:

WHO recommends Dolutegravir as preferred HIV treatment option in all populations

Based on new evidence assessing benefits and risks, the WHO recommends the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.

Initial studies had highlighted a possible link between DTG and neural tube defects (birth defects of the brain and spinal cord that cause conditions such as spina bifida) in infants born to women using the drug at the time of conception. This potential safety concern was reported in May 2018 from a study in Botswana that found 4 cases of neural tube defects out of 426 women who became pregnant while taking DTG. Based on these preliminary findings, many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.

New data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa have now expanded the evidence base. The risks of neural tube defects are significantly lower than what the initial studies may have suggested.

The guidelines group also considered mathematical models of the benefits and harms associated with the two drugs; the values and preferences of people living with HIV, as well as factors related to the implementation of HIV programmes in different countries, and cost.

DTG is a drug that is more effective, easier to take and has fewer side effects than alternative drugs that are currently used. DTG also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens. In 2019, 12 out of 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10%.

All of the above findings informed the decision to update the 2019 guidelines.

In 2019, 82 low- and middle-income countries reported to be transitioning to DTG-based HIV treatment regimens. The new updated recommendations aim to help more countries improve their HIV policies.

As for any medications, informed choice is important. Every treatment decision needs to be based on an informed discussion with the health provider weighing the benefits and potential risks.

WHO also stresses the importance of providing information and options to help women make an informed choice. To this end WHO has convened an advisory group of women living with HIV from diverse backgrounds to advise on policy issues related to their health, including sexual and reproductive health. WHO highlights the need to continually monitor the risk of neural tube defects associated with DTG.

Dominican Republic piloted Pre-Exposure Prophylaxis (PrEP)

Image: Dr Robert Paulino-Ramirez (centre)

Director of the Institute for Tropical Medicine and Global Health at Universidad Iberoamericana (UNIBE), Dr Robert Paulino-Ramirez, presented on the Dominican Republic’s experience of piloting Pre-Exposure Prophylaxis (PrEP). Dr Paulino-Ramirez made his presentation during the session titled, ‘It’s time for PrEP in Latin America and the Caribbean’ at the 10th International AIDS Society Conference on HIV Science which is being held in Mexico City, Mexico from 20-24 July. Following an 18-month pilot, PrEP implementation is being expanded from 15 July 2019 to two extra sites. Of the 849 persons who were assessed for PrEP, 32 percent (271) started. Acceptability was high among persons targeted. Dr Paulino-Ramirez emphasized the importance of mental health interventions and behaviour change modifications in the delivery of PrEP. The pilot was a collaborative effort by the Ministry of Public Health, DIGECITSS (Dirección General de Control de Infecciones de Transmisión Sexual y VIH/SIDA [Division for Controlling STIs and HIV], PAHO and UNIBE.

Director of PANCAP, Mr Dereck Springer, in an intervention from the floor, shared that The Bahamas and Barbados had led the Caribbean in implementing PrEP. Mr Springer informed the audience that PANCAP, with funding from the Global Fund, had convened a PrEP Share Fair on 16-17 July in Barbados. Eleven countries participated in the event and had the opportunity to learn from The Bahamas and Barbados’ experience through interactive presentations, site visits and stories from clients who are receiving PrEP. He explained that countries also developed action plans, identified support needs and committed to advocating for PrEP’s implementation. The Caribbean is therefore poised to accelerate implementation.

PAHO Director sees need for change in legislative framework to integrate HIV into general health system

Image: Dr Clarissa Etienne, PAHO Director (centre) 

The PAHO Director, Dr Clarissa Etienne, suggested the need for change in the legislative framework to facilitate the integration of HIV into general health systems. The Director was speaking at the Global Fund Dialogue among leaders on mobilizing and promoting better use of HIV and health investment convened at the 10th International AIDS Society Conference on HIV Science which is being held in Mexico City, Mexico from 20-24 July.

Dr Etienne explained that this requires a legal and institutional framework. She stated that HIV prevention in care should be included in health packages and that emphasis on comprehensive care can reduce cost and improve efficiency. The second priority should be decentralizing of HIV services and strengthening of health care services at the first level of care and referral systems. Thirdly, countries should adopt principles of the primary health care approach – participation, people centeredness, multidisciplinary team, and address stigma and discrimination.

First Lady of Belize calls for empowerment of women and girls

Image: First Lady, Kim Simplis-Barrow, first from left

First Lady of Belize, Kim Simplis-Barrow, called for empowerment of women and girls as a priority for achieving universal health coverage and HIV targets.  The First Lady was speaking at the Global Fund Dialogue among leaders on mobilizing and promoting better use of HIV and health investment convened at the 10th International AIDS Society Conference on HIV Science which is being held in Mexico City, Mexico from 20-24 July.

Ms Simplis-Barrow emphasized that there is a critical need to address human rights and stigma and discrimination, gender inequality, violence against women and girls and poverty that place them at higher risk. All these issues serve as barriers to access to services. She lauded PANCAP and other partners’ support to Belize in the development of an Anti-Discrimination Legislation. She noted that Spouses of Caribbean Leaders have influence in bringing about an enabling environment.

The First Lady also called for a successful Sixth Replenishment of the Global Fund, which she believes would allow for the global financing mechanism model to continue. She reminded the audience that the Global Fund’s model is client-centred and addresses the holistic health needs of individuals and communities.

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.