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Image: The Management Committee that promotes the Law.

In the Dominican Republic, cases of discrimination against LGBTI populations and people with HIV are becoming increasingly evident, particularly in health services. In view of this situation, Dominican civil society has united to promote a Law against discrimination.

The health services centers, which serve the most vulnerable populations, are spaces where the LGBTI community faces various situations of discrimination. They are denied care or are treated poorly. In the workplace, the rights of gay men and transgender women are also violated; where the latter is the object of ridicule, a dynamic that throws them into sex work in order to survive.

Likewise, access to the justice system represents an odyssey for LGBTI groups due to the existing homophobia. The most recent case was that of Said, a gay boy who was just 13 years old when he was raped and strangled in his home. One month later, the case has been closed without finding the perpetrator.

The situation of people with HIV is not different; discrimination is present in all forms and places, from access to health to the performance of diagnostic tests as a condition to be hired or to stay in a job, an illegal practice according to Law 135-11 on HIV and AIDS.

Yudelka, a woman who was fired from her job for testing positive for HIV, told Corresponsales Clave: “I knew I had HIV, but I thought that after seven years of being in the company I would not be fired for this reason, although they did not explain to me the reason for my dismissal. Four months later, I got pregnant and the humiliation I went through during the birth was horrible, my medical history was marked and after the cesarean section I had been isolated because I could not be with the other women, which marked my life forever. “

Against this background, activists from different population groups have joined efforts to develop strategies that allow political articulation and demand that the “Draft General Law of Equality and Non-Discrimination” be sent to the National Congress. The proposal of Law was delivered to the Executive Branch two years ago and is still shelved.

As a first step, on Monday, August 20, the group sent a letter to the Executive Branch asking for information on the status of the piece of legislation; the following steps will be: implement a national informative campaign, intervene in the media, collect signatures, make sit-ins and alliances with other civil actors so that the need of this Law is of public knowledge.

Karina Crisóstomo, the current general coordinator of the advocacy plan, called on the entire country to be united for this Law.  Achieving this law would bring us closer to the 90-90-90 goals and the consolidation of a large part of the Sustainable Development Goals. It would be an inclusive law that will not leave anyone behind.

Ingrid Bretón, president of Fundación Paloma, called on Dominicans to join this struggle: “Dominican society is the one that discriminates the most for different reasons, due to social inequality, economic or health; this law is for everyone and we must all go out and defend it”, she said.

The members of the “Management Committee” that promotes the Law have called on all civil society to join this advocacy campaign for the State to take note of the need for this law and the urgency of it becoming a guarantor of the rights of Dominican citizens, especially those groups that are most vulnerable.

Rosalba Karina Crisóstomo, the current general coordinator of the advocacy plan, made the following call, “as a civil society we are promoting this draft law because the Dominican State must guarantee that we all have equal treatment.”

However, the Dominican Republic has a legal framework that makes visible the most vulnerable groups; according to the latest regional political mapping carried out by HIVOS (2016), violations of the rights of these groups are increasing due to the lack of clear rules that allow them to the full claim of their rights, while the laws are difficult to interpret in that sense.

The “Draft General Law on Equality and Non-Discrimination” was the result of the hard work of the National Group for the Elimination of All Forms of Stigma and Discrimination (GRUNEED), with the support of renowned consultants from different public ministries, members of organized civil society and international agencies such as UNDP and UNAIDS, and under the coordination of the National Council for HIV and AIDS (CONAVIHSIDA). When it was presented several years ago, the draft law was considered by the president of the republic as an important law and, in his own words, would be included in its 2016-2020 Government Plan.

It is expected that the draft law will generate some kind of controversy due to the pressures of the Catholic Church and other evangelical churches, but it is important that the debate is established and that Congress has a position on the protection of the right to equality and non-discrimination of people.

When Danielis Diaz stopped receiving HIV and AIDS drugs four months ago, she had a life or death choice – stay home and become another lifeless casualty of Venezuela’s crumbling health system, or flee to Colombia. 

Today, the 32-year-old transgender woman is about to restart her free antiretroviral medication at the Censurados Foundation, a non-profit HIV and AIDS rights group that runs a clinic out of a garage in Colombia’s border city of Cucuta.

Diaz is one of more than a million Venezuelans to arrive in Colombia over the past 18 months, driven from their country by economic collapse, growing poverty and severe shortages of food and medicine.

“The doctors would say, ‘Nothing this month, try next month,’” recalled Diaz, who received free medication for 12 years as part of Venezuela’s once-lauded national HIV and AIDS-treatment programme.

“Doctors told me to take vitamins and eat lentils while waiting for the drugs. While you wait, you’re waiting to go to the cemetery,” said Diaz, who is a hairdresser in the daytime and a sex worker at night.

Run by a team of voluntary nurses, social workers, and psychologists, the clinic in Cucuta is a lifeline for her and about 45 other Venezuelan migrants, about half of whom are members of the LGBT+ community.

‘LACK OF FUNDS’

Since 1991, Venezuela has distributed free antiretroviral drugs to fight HIV and AIDS. The medication keeps the virus in check while increasing a person’s chances of living a long and healthy life.

But like the rest of the country’s public health system, its treatment programme has fallen apart amid an economic meltdown that has triggered the biggest exodus of people in modern Latin American history.

First the laboratory tests and regular check-ups stopped, then the antiretroviral drugs ceased, and finally, specialist doctors left the country, according to Venezuelan migrants living with HIV.

Since 2015, the country’s “complex economic situation” has deprived the health ministry of funds to buy medicine, according to Regina Lopez de Khalek, Venezuela manager of the U.N. agency for HIV and AIDS, UNAIDS.

“This situation has got worse in the last year and the ministry has not been able to make a regular and continued purchase,” Lopez de Khalek told the Thomson Reuters Foundation.

“And of course this means that some antiretrovirals have been progressively running out.”

Shortages have hit Venezuela’s LGBT+ community hard, as it is disproportionately affected by HIV.

Men who have sex with men are most at risk of contracting the disease, along with female sex workers, drug users, and transgender women, according to UNAIDS.

Earlier this year, and most recently in August, Venezuela bought antiretrovirals through the strategic fund of the Pan American Health Organization, Lopez de Khalek said.

Some of that medication has begun to arrive in recent weeks.

“We hope this means people can have a regular treatment until December or January 2019, so we can have a continuity of treatment,” Lopez de Khalek said.

DEATH CROSSING

For some Venezuelans, such measures have come too late.

Growing numbers of HIV-positive LGBT+ people are dying after crossing into neighboring Colombia, activists say.

According to Juan Carlos Archila, who heads the Censurados Foundation, nine Venezuelans have died of AIDS-related illnesses in Cucuta’s main public hospital since January. They included a 16-year-old boy, three transgender women, and four gay men.

Some of them had stopped taking their medication due to shortages back home, he said.

“When they get to Colombia, many are malnourished, their health has deteriorated considerably,” said Archila, who is a nurse. “Their defense systems are so low. They can’t even defend themselves from a common cold.”

Wilson Castaneda, head of the LGBT+ rights group Caribe Afirmativo in the northern coastal city of Barranquilla, said 11 LGBT+ Venezuelans with HIV have died there this year alone

“Venezuelans have been abandoned by their own country. When they get to Colombia, they find they can’t get the medicine they need or afford to buy it,” Castaneda said.

“They face a life and death situation.”

Basic HIV and AIDS medication costs about $95 a month in Colombia – far out of reach for most migrants, activists say.

Colombia’s public health system provides antiretrovirals for free, but not to undocumented Venezuelan migrants. Only those needing emergency care, including pregnant women, get free treatment.

“For those migrants with irregular status, they receive medical attention only in case of a life-threatening emergency, which precludes ongoing treatment for HIV,” said Chelsea Sommer, a protection officer with the U.N. refugee agency.

Colombia’s health ministry declined to comment. Authorities have said that about 54,500 Venezuelans received emergency care in public hospitals across the country over the past year.

Medical experts warn that irregular treatment on both sides of the border could lead to rising levels of drug-resistance, which emerges when a patient does not stick to a prescribed plan.

That is a concern for Carlos, a gaunt 27-year-old gay man from Venezuela who was diagnosed with HIV in 2013. He said he had not been able to take his antiretrovirals for five months.

“Restarting my new treatment means I can breathe again,” said Carlos, who declined to give his surname. “I just hope that I won’t be resistant to it.”

As he waited to see a nurse at the Censurados Foundation clinic, he recalled participating in huge anti-government street protests that gripped Venezuela in 2014.

“I was fighting in the streets for a better country,” he said. “Now I’m fighting for my health.”

Image: Ms. Lisa Thompson, Chief of Party, Advancing Partners & Communities (APC)

Advancing Partners & Communities (APC), in partnership with Ministry of Public Health (Guyana) and National AIDS Programme Secretariat (NAPS), launched four public service announcements (PSAs) that provide knowledge about general HIV testing, partner and sexual contact testing, and the importance of accessing and remaining on HIV treatment.  The PSAs were produced by APC, with funding provided by the United States Agency for International Development (USAID) and the U.S President’s Emergency Plan for AIDS Relief (PEPFAR) at a cost of approximately G$13 Million.  This cost includes the distribution and broadcast expenses for the PSAs.

Ms. Lisa Thompson, Chief of Party, APC, explained that the PSAs are high-quality digital informational videos and the goals of the PSAs are to increase testing uptake, especially for partner and sexual contacts of HIV positive individuals, and to increase the number of persons on HIV treatment and remaining adherent.

She revealed that the APC project, through funding from USAID and PEPFAR will also be supporting the airing of the PSAs for the rest of the year via radio and television.

Ms. Thompson further highlighted that the videos and radio messages were developed by a task group comprising of representatives from the NAPS, civil society organizations (CSOs), APC and other experts from John Snow Research and Training Institute (JSI).

She stated, “through consultations and brainstorming sessions, it was determined that each topic would be produced in three formats: a one-minute animated video, an abbreviated version of the same video edited to 30 seconds, and a voice-only version produced for radio”.

She urged the stakeholders present to use and share the PSAs widely, “Help us to get the word out. Help us to encourage persons to know their status”, stated Ms. Thompson, “You go and get tested if you don’t know your status. When you know your status then you have information that can help you make the best decisions for yourself. Through the government and civil society, services remain available and this includes free HIV testing, treatment, and other support services”.

The PSAs are available on the PANCAP YouTube Channel and PANCAP.org.  Click below to view:

PSA: Disclosing your status 

PSA: Getting tested for HIV 

PSA: Antiretroviral drugs 

PSA: HIV Treatment Adherence 

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What is the Advancing Partners and Communities Project (APC)?

The Advancing Partners and Communities Project (APC) is an HIV focused project that is funded by the United States Agency for International Development (USAID), through the President’s Emergency Plan for AIDS Relief (PEPFAR) initiative”.

The APC project supports the work of the national program in addressing HIV/AIDS related issues

Through Community based client advocates and civil society organizations, APC supports the national HIV/AIDS program of the Government of Guyana through the national AIDS Program Secretariat (NAPS). Guyana’s national strategy Health Vision 2020 “Health for all in Guyana” A National Health Strategy for Guyana 2013 -2020” notes that “To meet the vision for 2020, the strategy targets the tri-partite goal:

i) advance the well being of all peoples in Guyana;
ii) reduce health inequities and;
iii) improve the management and provision of evidence-based, people-responsive, quality health services.

This is consistent with the UNAIDS goals of 90-90-90 – 90 percent of all people living with HIV know their status; 90 percent of those persons are on treatment and 90 percent of those on treatment are virally suppressed.

Image: Chief Medical Officer (CMO) of the Ministry of Public Health, Dr. Shamdeo Persaud and Writer/Producer of PSAs and Ads, Mosa Telford.

In an effort to re-sensitize the Guyanese public on HIV and AIDS testing, treatment and prevention, a series of Public Service Announcements (PSAs) and advertisements were launched.

The National AIDS Programme Secretariat (NAPS) collaborated with the Advancing Partners and Communities Project (APC) to produce the content to be aired on all media platforms especially radio and television. Also, partnering in the effort was the United States Agency for International Development (USAID) and the U.S President’s Emergency Plan for AIDS Relief (PEPFAR).

The launch of these Ads and PSAs signal the commitment of the Ministry of Public Health and APC to re-sensitize the population on the ongoing campaign for the prevention and control of the spread of HIV and AIDS.

Chief Medical Officer (CMO), Dr. Shamdeo Persaud indicated that this is a part of several initiatives embarked upon by the ministry contributing to ending the Worldwide HIV/AIDS epidemic.

Further, the UNAIDS 90-90-90-Treatment for all goal is one that is being revisited, with specific focus channeled towards ensuring that by 2020, 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90 percent of all people receiving antiretroviral therapy will have viral suppression.

Noting that the Guyanese public may have been de-sensitized, Dr. Persaud said there is a need for effective implementation and distribution of the information. “It’s good that we are back on the trail because we did have a lull in the active programme of informing the public.”

Four 30 second ads, four one-minute PSAs along with audio pieces for radio have been produced, all focusing on knowing one’s status, treatment adherence and the prevention of the spread of the disease. The productions are all high quality, digital animation, information videos and audios which are likely to be aired at all public health facilities, other agencies organizations throughout the country.

Ms. Lisa Thompson, Chief of Party, APC, explained that the PSAs are high-quality digital informational videos and the goals of the PSAs are to (1) increase testing uptake, especially for partner and sexual contacts of HIV positive individuals; and (2) increase the number of persons getting on HIV treatment and remaining adherent.

She revealed that the APC project, through funding from USAID and PEPFAR will also be supporting the airing of the PSAs for the rest of the year via radio and television. The overall production and broadcast cost is approximately G$13,000,000.00 

Ms. Thompson further highlighted that the videos and radio messages were developed by a task group comprising representatives from the NAPS, community-based organizations (CSOs), APC and other experts from John Snow Research and Training Institute (JSI).

She stated, “through consultations and brainstorming sessions, it was determined that each topic would be produced in three formats: a one-minute animated video, an abbreviated version of the same video cut down to 30 seconds, and a voice-only version produced for radio”.

She urged the stakeholders present to use and share the PSAs widely, “Help us to get the word out. Help us to encourage persons to know their status”, stated Ms. Thompson, “You go and get tested if you don’t know your status. When you know your status then you have information that can help you make the best decisions for yourself. Through the government and civil society, services remain available and this includes free HIV testing, treatment, and other support services”.

Mosa Teleford, the Writer and Producer for the scripts of the Ads and PSAs, said this is the first time she had prepared content for an animated production, however, the process has been rewarding given her previous years of experience in scripting for HIV and AIDS productions.

Telford said: “My writing career was actually launched by working in HIV and AIDS awareness through the March project which we now know as Merundoi and even before that as a teenager, I was part of a youth group and we were also doing a lot of HIV and AIDS awareness in the nineties, early 2000s.”

This is in alignment with Ministry of Public Health and support partners working towards fulfilling the tripartite health vision 2020 which aims to advance the well-being of all people in Guyana, reduce health inequalities, and improve management and provision of evidence-based responses to tackle health-related matters.

What is the Advancing Partners and Communities Project (APC)?

The Advancing Partners and Communities Project (APC) is an HIV focused project that is funded by the United States Agency for International Development (USAID), through the President’s Emergency Plan for AIDS Relief (PEPFAR) initiative”.

The APC project supports the work of the national program in addressing HIV/AIDS related issues

Through Community based client advocates and civil society organizations, APC supports the national HIV/AIDS program of the Government of Guyana through the national AIDS Program Secretariat (NAPS). Guyana’s national strategy Health Vision 2020 “Health for all in Guyana” A National Health Strategy for Guyana 2013 -2020” notes that “To meet the vision for 2020, the strategy targets the tri-partite goal:

i) advance the well being of all peoples in Guyana;
ii) reduce health inequities and;
iii) improve the management and provision of evidence-based, people-responsive, quality health services.

This is consistent with the UNAIDS goals of 90-90-90 – 90 percent of all people living with HIV know their status; 90 percent of those persons are on treatment and 90 percent of those on treatment are virally suppressed.

Washington, D.C., 25 September 2018 (PAHO/WHO). Between 2000 and 2015, deaths from tuberculosis (TB) fell by 37.5% in the Americas and new cases dropped by 24%. However, the rate of decline must be accelerated for the Region to be able to end the disease, according to a new report by the Pan American Health Organization (PAHO).

Tuberculosis in the Americas 2018, a report issued on the eve of the first United Nations High-level Meeting on Ending TB, provides a complete and updated assessment of the TB epidemic and progress made in treating and preventing the disease in the Region.

In 2017, the World Health Organization (WHO) estimated 282,000 new cases of TB in the Americas, 11% of which were in people living with HIV. In all, 87% of cases were concentrated in 10 countries, with Brazil, Peru, and Mexico reporting just over half the total. An estimated 24,000 people died last year from tuberculosis in the Region, and 6,000 of them were coinfected with HIV.

“Ending TB will only be possible if we step up the reduction in new cases and deaths,” said PAHO Director, Carissa F. Etienne. “We need to expand access to diagnosis and quality treatment for everyone who needs it and to address social determinants that affect health and favor transmission of the disease,” she noted.

Although preventable and curable, tuberculosis is currently the Region’s most lethal infectious disease and its persistence is largely due to the serious social and economic inequities in the Americas. Since 2015, deaths fell on average by 2.5% per year and new cases dropped by 1.6%, but they need to fall at a rate of 12% and 8% per year, respectively, to achieve the intermediate targets for 2020 and continue to decline until 2030.

Ending the worldwide tuberculosis epidemic is one of the targets of the Sustainable Development Goals (SDGs). WHO’s End TB Strategy, adopted by the World Health Assembly in 2014, aims to reduce deaths from TB by 90% and the incidence of the disease (number of new cases each year) by 80% by 2030, compared to 2015 levels.

Diagnosis, treatment, and multidrug-resistant tuberculosis

The report notes that more than 50,000 people in the Region––almost half of them under 15 years of age––do not know they have the disease and have not been treated. This diagnostic gap increased by 3,000 people, compared to 2016. Rapid diagnostic testing, a new tool that could help to close the gap, was used in just 13% of diagnosed cases, up slightly from 9% in 2016.

Treatment for TB has saved thousands of lives. However, in the last five years 75% of patients were cured, which is below the target set for 2030 (at least 90% cured). To step up progress, the report recommends that countries improve patient monitoring to ensure follow-through on treatment (8.6% abandon treatment) and address access barriers to health care, among other issues.

Multidrug-resistant tuberculosis is also a serious threat, with an estimated 11,000 people in the Region currently infected by this form of the disease. Among those who develop it, the cure rate is just 56%.

Caribbean countries with the lowest incidence of TB

The Americas is the region with the lowest percentage of new TB cases in the world (3% of the total) and is the first region with a real opportunity to eliminate the disease as a public health problem. According to the report, 15 countries,12 of them from the Caribbean, have low TB incidence (less than 10 cases per 100,000 people) and are on the road to elimination.

“Countries are adopting measures to tackle TB, but they cannot lower their guard and must redouble efforts, along with the collaboration of society at large, including the affected communities,” said Marcos Espinal, Director of PAHO’s Department of Communicable Diseases and Environmental Determinants of Health.

The report’s other recommendations for accelerating progress toward eliminating TB, especially in the countries with the greatest disease burden, include: promoting the study of contacts with people who have TB, especially children under 15; stepping up implementation of simpler treatment regimens and introducing drugs for children; reaching the most vulnerable populations and addressing social determinants, and ensuring that plans are financed with a country’s own resources rather than depending on external funds.

To download the full report on PANCAP.org CLICK HERE.

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Helpful links:

Report: Tuberculosis in the Americas 2018
http://iris.paho.org/xmlui/handle/123456789/49510?locale-attribute=es

Tuberculosis
www.paho.org/tuberculosis

UN General Assembly High-Level Meeting on Ending TB 2018
\www.paho.org/hq/index.php?option=com_content&view=article&id=14404:un-general-assembly-high-level-meeting-on-ending-tb&Itemid=72316&lang=en

Image: (L-R) PANCAP Director, Mr. Dereck Springer with H.E. Sandra Granger, First Lady of the Republic of Guyana and Vice Chair, SCLAN and Ms. Laura Tucker-Longsworth, OBE,  Speaker of the Belize House of Representatives and PANCAP Champion.

The Spouses of CARICOM Leaders Action Network (SCLAN) in collaboration with the Pan Caribbean Partnership against HIV and AIDS (PANCAP) hosted a special forum entitled “Pressing forward for the health and well-being of women, children and adolescents” as a side event during the United Nations General Assembly in New York on Monday 24 September 2018. The Forum was designed to increase awareness and to stimulate interest, especially among First Ladies to advocate for the development of programs that will support the safety, physical and psychological well-being of women, children and adolescents around the world.  The event was chaired by Hon. Kim Simplis Barrow, First Lady of Belize and Chair of SCLAN.

It was intended to bring together First Ladies, Spouses of Heads of Government and UN Representatives to facilitate knowledge exchange which can contribute positively to progress in key areas such as mental health, the reduction of gender-based violence, teenage pregnancy, and HIV and AIDS. This initiative also aimed to build upon the long-term efforts set forth by the global community including former UN Secretary-General Ban Ki-moon’s Every Woman, Every Child Global Movement and the Global Strategy for Women’s Children’s and Adolescents’ Health (2016-2030).

Present were Hon. Dr. Patricia Minnis, First Lady of The Bahamas, Hon. Kim Simplis Barrow, First Lady of Belize and Chair of SCLAN,  H.E. Sandra Granger, First Lady of the Republic of Guyana and Vice Chair, SCLAN, H.E. Martine Moise, First Lady of the Republic of Haiti, Hon. Eloise Gonsalves, First Lady of Saint Vincent and the Grenadines, Ms. Laura Tucker-Longsworth, OBE,  Speaker of the Belize House of Representatives, PANCAP Champion and Director of PANCAP, Mr. Dereck Springer.

The 15th Caribbean Cytometry and Analytical Society (CCAS) Expert Summit, which was convened on 26th – 30th August in Saint Lucia, provided a platform for PANCAP to share Test Treat Defeat – Caribbean Advocacy for Ending AIDS as a public health threat. The presentation focused on PANCAP’s high-level advocacy for the reduction of stigma and discrimination, the provision of affordable medicines and commodities, and adequate domestic financing for increasing the level of testing, treatment and viral suppression required to end AIDS as a public health threat in the Caribbean, and the successes to date.

Caribbean public health practitioners also presented on the process and challenges for achieving the elimination of mother-to-child transmission of HIV and Congenital Syphilis, shared country experience implementing Pre Exposure Prophylaxis (PrEP), the OECS Pharmaceutical Procurement System, a best practice for the region, and reported on the laboratory strengthening support, which is being provided by the Caribbean Med Lab Foundation in the OECS.  The CCAS also received presentations from Cuba in relation to EMTCT and GHESKIO in Haiti in relation to HIV Treatment.

However, while CCAS provided an opportunity for Caribbean public health practitioners to be updated on new technologies and to share best practices and experiences in HIV, the absence of National AIDS Programme Managers was glaring. In response, I would like to urge our member states to support the participation of these managers. NAP managers are ideally positioned to contribute by sharing best practices and experiences. NAP managers will also be exposed to the technological developments and strategies for ending AIDS. The PANCAP Coordinating Unit (PCU) will advocate for such support for our valued NAP managers to attend the annual CCAS.

I would like to congratulate the Caribbean Med lab Foundation on the occasion of its 10th Anniversary which was celebrated at a dinner hosted by the organization on 30th August at the end of CCAS 2018. CMLF promotes and supports the achievement of quality laboratory services in accordance with appropriate standards, through advocacy, resource mobilization, collaboration, research, and education. CMLF has provided invaluable services to the Caribbean region over the last 10 years and must be lauded for its stellar work. The work they do is even more important as we strive to achieve the UNAIDS 90-90-90 Targets given the crucial role of laboratory services for achieving each of these targets.

The PCU supported the PACC in preparing for the 34th Meeting of the PACC and 28th Meeting of the PANCAP Executive Board, which were held on 4-6 September in Georgetown, Guyana. The meetings provided an opportunity to discuss progress and challenges as well as programmatic and policy guidance. These meetings received and discussed the draft report on the evaluation of the CRSF and made policy recommendations for the Council for Human and Social Development (COHSOD) – Ministers of Health meeting scheduled for the third week in September in Washington D.C. USA.

A joint PANCAP – CVC – COIN Multi-country proposal was submitted to the Global Fund in August for funding in the amount of USD$6.5 million for the period 1 October 2019 to 30 September 2022. The conceptual framework for this proposal builds on the top-down and bottom-up strategies of the current Global Fund grants to more effectively work towards integrating these approaches into strengthened national programs that benefit from the inclusion of civil society and communities as equal partners in decision-making, planning, implementation, and oversight. This approach is indicative of a broader commitment of the regional response to stronger integration of community, civil society and government efforts as equal partners and stakeholders in the HIV response, and to more effectively link progress at the regional level to actions and tangible results at the national level. The proposal provides a unique opportunity to institutionalize partnerships between civil society and governments and to develop effective and sustainable programs to meet the needs of key populations and thereby diminish the HIV epidemic. The Partnership awaits the outcome of the Technical Review Panel, which is currently reviewing proposals submitted in August 2018.

By Sarah Goddard, Abt Associates

Guyana has achieved significant progress in funding the national response to HIV but faces challenges related to scaling up of Treat All in an environment of declining donor funding. The USAID-funded Health Finance and Governance (HFG) project, in collaboration with PAHO/WHO, has supported a National Health Accounts (NHA) estimation exercise in Guyana to improve understanding of national funding and spending on health. A National Health Accounts dissemination meeting was held in Georgetown on 3 August, at which it was revealed that the Government’s share of HIV spending increased from 25 percent in 2015 to 64 percent in 2016, indicating increasing domestic resource mobilization for HIV.

Guyana’s Health Accounts will play an important role in the country’s health policy and future decision making for health expenditures. Ms. Julia Henn, Director of Health and HIV/AIDS Office, USAID/Eastern and Southern Caribbean, described the National Health Accounts as a “goldmine of information for policymakers.” One key recommendation is for Guyana to better leverage the private sector in order to diversify domestic funding sources for health and HIV. According to Mr. Tesfaye Dereje, Senior Health Finance Specialist of the HFG project, “Guyana is off to a great start.”