Professor Rose-Marie Belle Antoine Advocates for a Pragmatic Approach to Migrants’ Access to Health

Tuesday, 26 June 2018 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, commenced the Regional Forum on Migrants and Mobile Populations Rights and Health with timely messages on the state of migrants’ access to health in the region.

In opening remarks, Director of PANCAP, Mr. Dereck Springer highlighted that the Migrants Forum builds on the programmes and interventions that PANCAP, with funding from development partners, have been supporting national governments and civil society to implement and address the needs of migrants and mobile populations.

He referred to the PANCAP-GIZ-EPOS Migrant Project, which worked to improve inclusion of migrants on regional and national HIV Bodies in order to advocate for equal access to health care in Antigua and Barbuda, the Dominican Republic, Haiti, Guyana, Suriname, Sint Maarten and the Republic of Trinidad and Tobago.

The Director explained that under the PANCAP Global Fund Round 9 Project, in collaboration with ILO Decent Work Programme Office, efforts were made to integrate migrant-specific interventions into the national HIV response in Antigua and Barbuda, Barbados, Belize and Trinidad and Tobago. Key population-specific interventions targeting MSM, sex workers, miners and loggers have been implemented under the Global Fund project in Guyana. Jamaica, Belize, Suriname and Haiti have also implemented Global Fund-funded projects for key populations. However, the Director informed that these interventions typically cease with the end of external funding support.

Ms. Aurora Noguera Ramkissoon, UNFPA Caribbean Liaison Officer delivered remarks on behalf of Ms. Dawn Foderingham, Fast Track Adviser and Team Leader for the UNAIDS Caribbean Sub-regional Team. Her remarks focused on the state of migrants accessing health in the region. She explained that the region has been shaped by the forces of migration, which has resulted in opportunities and challenges.

However, despite this history, the Caribbean has not adequately addressed the issue of how migrants and mobile populations are afforded basic human rights, including access to health services.

She highlighted the practical considerations on both sides of the debate. Some argue that by protecting the health of migrants you naturally protect the health of the local or host population. Others raise concerns about the increased costs to the host country. What is too often missing in the discussion is the human aspect: the fundamental understanding that migrants are human beings: entitled to the same important human rights as other members of the population. This understanding is reinforced in the Sustainable Development Goals, which call for the empowerment of vulnerable groups including refugees, internally displaced persons and migrants as well as their access to essential, quality health-care services.

With respect to the regional AIDS response, Ms. Foderingham’s remarks highlighted that migrant populations must of necessity be defined as a vulnerable and key population. She posited that migrants and mobile populations are exposed to a unique set of factors and complex obstacles that make them more vulnerable to HIV, including limited access to health services and information, as well as exposure to situations that may increase high-risk sexual behavior. She proposed that to meet the universal health coverage targets set by the Sustainable Development Goals, it is crucial that the rights of migrants to access health services—including HIV services—be urgently addressed.

She emphasized that the right to health is universal, and in so doing UNAIDS commends PANCAP on leading the discussion and planned action on this issue, with the intent of developing a regional framework that promotes appropriate access to HIV services of migrants. Ms. Foderingham stated that she was hopeful that in developing this framework and advocating with COHSOD for its ratification, that the vulnerable population of migrants will have their right to health respected and upheld.

She concluded that there are migration and refugee crises in every part of the world. Ms. Foderingham remarks posited, “In the Caribbean, we say that if your neighbor’s house is on fire, you should wet your own. I urge us all to work diligently over the next two days to create a framework that would ensure a human rights-based, sustainable and feasible approach to ensuring migrant and mobile populations have healthcare access, including HIV prevention, treatment, care and support”.

In her feature address, Professor Rose-Marie Belle Antoine, Dean of the Faculty of Law at The University of The West Indies, St. Augustine stated that there is no doubt that the HIV prevention agenda has experienced a significant lull, but it seems that now the region has been re-energized. She stated that in all of the studies and the policy framework developed, there were two clear universal principles for addressing HIV and migrant populations in the region: (1) there must be a commitment to a human rights framework that places a premium on civil and political fundamental rights of the dignity of the individual and equality.

Economic and social rights must be included like the right to health and the right to work – that being an offshoot of the right to health. This commitment must transcend borders so that all persons are entitled to such rights, wherever they are located; and (2) there must be a pragmatic approach to the right to health and to rights in general, recognizing that a non-discriminatory strategy for public health benefits the entire population. Put simply having undocumented persons in our communities without access to HIV testing and treatment endangers not just them, but all of us.

Referring to the first universal principle, Professor Antoine stated, “given that the legal framework supporting access to HIV services for migrants is generally weak in the countries under study, in my capacity as the Regional Consultant, I framed some human rights principles to facilitate the objectives of the project. These principles were supported by the Component 1 group in November 2011 as the principles to be used as the basis for the development of the national policy guidelines and are as follows:

The principle that all persons, including migrants and mobile populations, should be able to access a minimum standard of medical treatment for HIV, may be located under a number of internationally recognized human rights principles.

These include:

1. Every person has a right to health, an economic and cultural right which is derived from the broader right to life. While it is recognized that states have a margin of appreciation or leeway in determining how to translate this right in dollars and cents terms, at minimum, a state should do all in its power to ensure the health of those persons within its jurisdiction, especially in situations where its citizens and general population may be placed at risk because of related health issues;

2. Every person has a right to life and to protection of his or her life. In recent times, international human rights law has recognized that this extends to a state protecting the life of non-resident ‘aliens’ and other non-citizens where their lives are threatened because of a lack of, or hindered access to HIV treatment. We see this, for example, in recent asylum cases. This principle is broad enough to encompass migrants and mobile populations. Indeed, their standing before the law is greater than persons who come to a country to seek asylum.

3. Another principle – The principle of equality and non-discrimination is accepted as a fundamental principle of international and domestic human rights law. While constitutions may make exceptions in certain circumstances with regard to citizens, where a person resides in a state, pays taxes and contributes to a national health insurance scheme, there is no legitimate basis to apply this exception and the principle of equality in its absolute sense must stand. As such, every migrant person who contributes to taxes and national insurance should have EQUAL access to HIV treatment.

Several international instruments contain the principles of universal access to HIV care and treatment. These include the International Covenant on Economic, Social and Cultural Rights, the International Convention on the Protection of the Rights of all Migrant Workers, the WHO Resolution on Health of Migrants and the Political Declaration on HIV and AIDS (UNGA Declaration). The principles contained in these Agreements should serve as guiding principles for domestic legislation and policy. This universal access of care for all must specifically include migrant and vulnerable migrant women and children”.

Referring to the second universal principle, Professor Antoine emphasized that there must be a pragmatic approach to the right to health and to rights in general and reiterated that a non-discriminatory strategy for public health benefits the entire population.  She stated, “Thinking of the dollars and cents necessary to bring about a broad, non-discriminatory route to public health as an obstacle is counterproductive. We can save in the short term, but we all lost out in the long term”.

Professor Antoine also addressed access to health services by migrant sex workers. She stated that the region continues to have challenges in terms of discriminatory, harmful policies against sex work. She advocated for an end to judging sex workers and called for the region to confront the issue head-on and provide a safe route to testing, education, and treatment.

She stated, “Consider modifications to criminal laws on sex work, at least to provide mechanisms for legal treatment where HIV is present, if not to decriminalize such conduct. Such a policy must make special provision for undocumented migrants who are sex workers, such as amnesty for such persons and a ‘no questions asked’ policy, clearly advertised in a reassuring way. These are not necessarily legal amendments but are ancillary to legal policies and laws”.

Professor Antoine concluded that the greatest task in moving forward in relation to improving access to HIV treatment for the migrant population is the tool of political persuasion. She challenged the participants to use all of their moral, intellectual, scientific and medical resources to persuade the political power brokers that it is in the interest of the region to provide access to treatment for all migrants and that future policy changes in health should not change this.

She further stated that a Pragmatic Approach should be utilized to convince officials that the region must provide migrants with HIV prevention and treatment access in order to protect the general population. “A rights-based framework is needed now, more than ever before”, recommended Professor Antoine.

– ENDS –

Editor’s notes:

The Regional Forum on Migrants and Mobile Populations Rights and Health will be held from 26 – 27 June 2018 in Port-of-Spain, Republic of Trinidad and Tobago.

In excess of 40 participants, including government, private sector, civil society, migrant leaders, development partners and stakeholders, will be engaged in a review of information generated by the Legal Environment Assessments (LEA) processes, including those implemented by the Caribbean Vulnerable Communities Coalition (CVC/COIN), as well as learning from previous work in support of migrant rights completed under the CARICOM PANCAP Global Fund Round 9 Grant and the PANCAP/GIZ Migrants Project.

CARICOM Governments have signed on to the International Organization for Migration (IOM) and other relevant international conventions as evidence of their commitment to protect and promote the rights of migrants.

PANCAP commissioned research into the vulnerabilities of migrants in four Caribbean countries in 2012: Antigua and Barbuda, Barbados, Belize and the Republic of Trinidad and Tobago. These studies fed into efforts to integrate migrant-specific approaches into the work of national HIV programmes. At the end of the Project, migrant workers had access to HIV prevention services including education and testing for HIV in the beneficiary countries.

The PANCAP-GIZ Migrant Project worked in Antigua and Barbuda, Dominican Republic, Guyana, Haiti, Sint Maarten, Suriname and the Republic of Trinidad and Tobago. Each of the GIZ countries has developed a plan for migrants that is intended to sustain the interventions initiated under the GIZ project.

The GIZ Migrant Project worked to improve inclusion of migrants on regional and national HIV Bodies in order to advocate for equal access to health care. This was achieved as follows: Guyana (2 NGOs), DR (2 NGOs), Suriname (1 TWG–HIV + Migrant/MoH), Antigua (1 NGO 3 H Foundation),1 NGO (Caribbean Vulnerable Coalition Trainings to empower migrants and their representatives are conducted in: Antigua, the Dominican Republic, Guyana, Suriname, and Trinidad and Tobago).

The participation of migrant representatives on the Country Coordinating Mechanism (CCM) in Suriname enabled the inclusion of vulnerable migrants as a key population in its Global Fund grant and the founding of a non-governmental organization for migrants.

Comprehensive HIV prevention programmes to support reduction in the spread of HIV that facilitate linkages to the continuum of care and serve as a catalyst for reducing stigma, are lacking in the majority of countries. Many countries do not have targeted programmes for key populations and lack the capacity to develop and implement key populations-specific programming along the prevention, diagnosis, treatment and care continuum.

Under the PANCAP Round 9 Global Fund project, efforts were made to integrate migrant-specific interventions into the national HIV response in Antigua and Barbuda, Barbados, Belize and Trinidad and Tobago. Key population (KPs) specific interventions targeting MSM, sex workers, miners and loggers have been implemented under the Global Fund project in Guyana. Jamaica, Belize, Suriname and Haiti have also implemented Global Fund-funded projects for KPs. The findings of the PANCAP CVC-COIN Baseline assessment for the Global Fund grants suggest that some improvement was achieved with the GIZ project, which reported the following of migrant-friendly HIV services: NGOs in Suriname continue to provide migrant-friendly services for both HIV and Malaria. In Guyana, services for migrants and mobile populations were provided under the Global Fund grant but may not otherwise be sustained. In the Dominican Republic, MOSCTHA, a non-profit organization, has been implementing projects for more than 30 years, aimed at improving the quality of life of Haitian immigrants, their families, and other vulnerable populations.
MOSCTHA heads a migrant alliance, a network of more than ten local NGOs specifically working with Haitian immigrants on issues related to health and human rights.

Other specific vulnerabilities of migrant workers which are challenges to linkage and retention in care are:

• Not being aware of their right to information and right to health due to legal status, stigma, and socio-economic and cultural alienation.
• Not being exposed to the relevant HIV education and information
• Not aware of where to access basic prevention information and products, as well as where and how to utilize services from which migrants are excluded
• Lack of familiarity with the institutions and discourse in the host country
• Lack of citizen rights, dependency and xenophobia in the host societies
• Poor working conditions and absence of social security, such as health insurance
• Fear of deportation prevents access to health services to test for HIV, and even if they are tested, they may not collect the result.
• Sexual exploitation and human trafficking.
The PANCAP Coordinating Unit has commissioned a desk review and interviews with key informants to complement the aforementioned information.

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 and AIDS (UNAIDS) 90-90-90 Targets?

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

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

PANCAP aims to increase Migrants and Mobile Populations Access to HIV Prevention, Care and Support

Tuesday, 19 June 2018 (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 a Regional Forum for the Development of a Regional Rights-Based Framework to increase access of Migrants and Mobile Populations to HIV prevention, care, support and treatment. The forum will be held from 26 – 27 June 2018 in Port-of-Spain, Republic of Trinidad and Tobago.

In excess of 40 participants, including government, private sector, civil society, migrant leaders, development partners and stakeholders, will be engaged in a review of information generated by the Legal Environment Assessments (LEA) processes, including those implemented by the Caribbean Vulnerable Communities Coalition (CVC/COIN), as well as learning from previous work in support of migrant rights completed under the CARICOM PANCAP Global Fund Round 9 Grant and the PANCAP/GIZ Migrants Project.

According to Director of PANCAP, Mr. Dereck Springer, “key outputs of the Forum will lead to the development of a regional framework for strengthening the inclusion of migrant populations in the regional and national HIV responses”. He also highlighted that the Forum will facilitate experts agreeing on partnership approaches to support regional and national-level implementation of these approaches.

Participants will also review lessons learned from previous work in the region in support of migrant rights completed under the PANCAP Global Fund Round 9 grant and the PANCAP/GIZ Migrants project. They will also identify existing and potential gaps in securing and expanding access to migrant and mobile populations to HIV and other health services. The Forum will also encompass a discussion and agreement on priority issues and approaches to strengthen the access to health by migrant populations within the context of securing the right to health.

The PANCAP Director emphasized that it was critical at this point in the region’s HIV response to have consensus on the involvement of migrants and mobile populations in regional and national-level HIV programmes. “Migrants form a significant part of the social and economic spheres in our region,” stated the Director, “as such it is critical that they are included in the planning and implementation of HIV prevention programmes that impact them”.

He further stated, “Migrants and mobile populations have long connected Caribbean countries to each other and with the outside world. Some populations relevant to HIV, move fluidly among countries; yet barriers of language or legal status exclude many migrants from access to health services. This forum intends to address these problems with solutions that include a regional perspective”.

– ENDS –

Editor’s notes:

CARICOM Governments have signed on to the International Organization for Migration (IOM) and other relevant international conventions as evidence of their commitment to protect and promote the rights of migrants.

PANCAP commissioned research into the vulnerabilities of migrants in four Caribbean countries in 2012: Antigua and Barbuda, Barbados, Belize and the Republic of Trinidad and Tobago. These studies fed into efforts to integrate migrant-specific approaches into the work of national HIV programmes. At the end of the Project, migrant workers had access to HIV prevention services including education and testing for HIV in the beneficiary countries.

The PANCAP-GIZ Migrant Project worked in Antigua and Barbuda, Dominican Republic, Guyana, Haiti, Sint Maarten, Suriname and the Republic of Trinidad and Tobago. Each of the GIZ countries has developed a plan for migrants that is intended to sustain the interventions initiated under the GIZ project.

The GIZ Migrant Project worked to improve inclusion of migrants on regional and national HIV Bodies in order to advocate for equal access to health care. This was achieved as follows: Guyana (2 NGOs), DR (2 NGOs), Suriname (1 TWG–HIV + Migrant/MoH), Antigua (1 NGO 3 H Foundation),1 NGO (Caribbean Vulnerable Coalition Trainings to empower migrants and their representatives are conducted in: Antigua, the Dominican Republic, Guyana, Suriname, and Trinidad and Tobago).

The participation of migrant representatives on the Country Coordinating Mechanism (CCM) in Suriname enabled the inclusion of vulnerable migrants as a key population in its Global Fund grant and the founding of a non-governmental organization for migrants.

Comprehensive HIV prevention programmes to support reduction in the spread of HIV that facilitate linkages to the continuum of care and serve as a catalyst for reducing stigma, are lacking in the majority of countries. Many countries do not have targeted programmes for key populations and lack the capacity to develop and implement key populations-specific programming along the prevention, diagnosis, treatment and care continuum.

Under the PANCAP Round 9 Global Fund project, efforts were made to integrate migrant-specific interventions into the national HIV response in Antigua and Barbuda, Barbados, Belize and Trinidad and Tobago. Key population (KPs) specific interventions targeting MSM, sex workers, miners and loggers have been implemented under the Global Fund project in Guyana. Jamaica, Belize, Suriname and Haiti have also implemented Global Fund-funded projects for KPs. The findings of the PANCAP CVC-COIN Baseline assessment for the Global Fund grants suggest that some improvement was achieved with the GIZ project, which reported the following of migrant-friendly HIV services: NGOs in Suriname continue to provide migrant-friendly services for both HIV and Malaria. In Guyana, services for migrants and mobile populations were provided under the Global Fund grant but may not otherwise be sustained. In the Dominican Republic, MOSCTHA, a non-profit organization, has been implementing projects for more than 30 years, aimed at improving the quality of life of Haitian immigrants, their families, and other vulnerable populations.
MOSCTHA heads a migrant alliance, a network of more than ten local NGOs specifically working with Haitian immigrants on issues related to health and human rights.

Other specific vulnerabilities of migrant workers which are challenges to linkage and retention in care are:
• Not being aware of their right to information and right to health due to legal status, stigma, and socio-economic and cultural alienation.
• Not being exposed to the relevant HIV education and information
• Not aware of where to access basic prevention information and products, as well as where and how to utilize services from which migrants are excluded
• Lack of familiarity with the institutions and discourse in the host country
• Lack of citizen rights, dependency and xenophobia in the host societies
• Poor working conditions and absence of social security, such as health insurance
• Fear of deportation prevents access to health services to test for HIV, and even if they are tested, they may not collect the result.
• Sexual exploitation and human trafficking.

The PANCAP Coordinating Unit has commissioned a desk review and interviews with key informants to complement the aforementioned information.

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 and AIDS (UNAIDS) 90-90-90 Targets?

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

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

PANCAP Champion Dr. Arif Bulkan elected to UN Human Rights Committee

PANCAP Champion Dr. Christopher Arif Bulkan was Thursday elected to serve on the United Nations Human Rights Committee for a term of four years from 2019 – 2022, the Ministry of Foreign Affairs announced.  This is the first time a Guyanese has been selected to serve on the Committee. 

Dr. Bulkan, nominated by the Government of Guyana, was elected along with the candidates of Tunisia, France, Slovenia, Greece, Japan, Uganda, Albania and Chile in the elections held during the 36th session of the meeting of States Parties to the International Covenant on Civil and Political Rights (ICCPR), at the United Nations Headquarters in New York. Dr. Bulkan’s election represents the first time that a national of Guyana will serve on the Human Rights Committee.

The Human Rights Committee is a body of eighteen independent experts of high moral character and recognized competence in the field of human rights that monitors implementation of the International Covenant on Civil and Political Rights by its State parties. The Committee examines the reports submitted by all States parties and issues recommendations to address concerns in the reports of the State party.

Dr. Bulkan has been elected in his personal capacity, and is well-suited to discharge the responsibilities of the Human Rights Committee, given his academic background and strong record of work and achievements in relation to the promotion of human rights within Guyana, the Caribbean and beyond.

He holds a Master of Law from University College London (1997) and a Bachelors of Law from the University of West Indies (1998). He obtained a Ph.D. in Law from the Osgoode Hall Law School, York University, in Toronto, Canada in May 2008.

Dr. Bulkan co-founded the University of West Indies Rights Advocacy Project (U-RAP), in 2009. U-RAP promotes Human Rights and Social Justice in the Caribbean by undertaking and participating in strategic litigation, socio-legal research and legal education.

Dr. Bulkan is positive that his election is a meaningful portent of the global community’s commitment to engaging the Caribbean in the work of the Human Rights Committee through the promotion of universal human rights norms and standards. He also aspires to use his tenure on the Committee to engender greater investment by countries of the region in the aims and values of the Covenant.

Mr. Dereck Springer, Director of PANCAP, extends congratulations to Dr. Bulkan on this significant achievement.  The PANCAP Director emphasized that Dr. Bulkan has been a powerful voice for Human Rights and access to quality healthcare by all and anticipates the same dedication in his new capacity on the United Nations Human Rights Committee.

Read about Dr. Bulkan’s role as a PANCAP Champion for Change here. 

Men targeted for increased HIV testing

Poor health-seeking behaviour by Caribbean men is exacerbating the already difficult job of having them tested for HIV, according to Kandasi Levermore, Executive Director of Jamaica AIDS Support for Life (JASL) and member of the Caribbean Vulnerable Communities Coalition (CVC).

“Poor health-seeking behaviours by our men throughout the region are still cause for concern with regard to them coming forward to be tested for HIV. But at the same time, I must note that there have been some improved numbers,” Levermore said.

Although data was not provided to show the actual increase, Levermore said that the CVC has developed specific programmes to target males, as against women, who have been taking advantage of opportunities to know their HIV status.

“In order to instigate this increase, we (the CVC) had to initiate specific programmes for men as a means to encourage them to go out and get tested,” she told a recent Gleaner Editors’ Forum.

“Some of the methods include us offering incentives to the women that you will get X if you bring a man for testing. If it’s a man who comes to get tested, then we can offer them some safe-sex commodities – stuff like flavoured condoms and other means that will enhance the changed behavior to get them coming out to be tested,” Levermore said.

A 2017 study shows that an estimated 32,000 persons are living with the HIV in Jamaica, with as many as 50 percent unaware of their status. The most urbanized parishes have the highest number of cumulative cases, with St James recording 2,094.6 HIV cases per 100,000 persons followed by Kingston and St. Andrew, with 1,570.1 cases per 100,000 persons.

The total number of reported AIDS cases in Jamaica between January 1982 and December 2011 is 16,264, with the number of deaths associated with the epidemic for the same period being 8,498.

Males account for 689.3 cases per 100,000 of cumulative AIDS cases, compared to 504.9 cases per 100,000 females. Although the disease affects more men than women, over time, females are accounting for an increased proportion of the AIDS cases that are reported annually.

It means that women are accessing testing far more than their male counterparts, Levermore noted.

“Some men come to get the condoms; they’ll come if the leader comes in to be tested. So we have to go behind the scenes and programme them; work on the leaders, work on the role models. We ask them to bring out their ‘parries’ (friends) and find ways to get them out,” she said. “We are seeing more men being tested, but definitely not in the numbers we would want”.

United Nations Member States stress that critical efforts must be scaled up to end AIDS

NEW YORK/GENEVA, 13 June 2018—At the halfway point to the 2020 Fast-Track Targets agreed by the United Nations General Assembly in 2016, United Nations Member States have come together to review progress in responding to HIV. Gathered at the United Nations Headquarters in New York, United States of America, Member States presented the progress and challenges in their countries and heard from the United Nations Secretary-General, who presented his report on the global response to HIV.

The President of the General Assembly Miroslav Lajčák opened the meeting. “We cannot forget that what we are doing today ties into our other goals and objectives,” he said. “We can use today’s meeting to explore opportunities for even more action. Let’s keep going. Let’s keep fighting this virus—and the stigma that comes with it.”

The United Nations Secretary-General presented his report, Leveraging the AIDS response for United Nations reform and global health, and said, “The world is making good progress towards ending the AIDS epidemic by 2030, but progress is uneven and fragile. At this pivotal moment, we must renew our focus and shared commitment to a world free of AIDS.”

The report shows that the exponential scale-up of antiretroviral therapy has now reached more than half of all people living with HIV, which in turn has contributed to a decline of one third in AIDS-related deaths, from 1.5 million in 2010 to 1 million in 2016. It also notes the progress in stopping new HIV infections among children and highlights that eliminating mother-to-child transmission of HIV is possible if the world remains focused.
The Executive Director of UNAIDS, Michel Sidibé, attended the plenary meeting. He said, “We are at a critical juncture on the path towards ending AIDS. We must unite and use our collective force to push HIV into permanent decline.”

More than 30 Member States reported on progress in their countries, many expressing their appreciation and support for the work of UNAIDS and the Joint Programme while reiterating their commitment to achieving the targets in the 2016 United Nations Political Declaration on Ending AIDS.

“The United States strongly supports UNAIDS and its leadership in combatting the HIV/AIDS pandemic,” said Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy. “UNAIDS’ focus on producing the most extensive data collection on HIV epidemiology continues to be fundamentally important and is our roadmap to controlling this pandemic. We cannot achieve the targets to end the AIDS epidemic by

2030 without the right data to track our progress, pinpoint our unmet need and effectively and efficiently direct resources for maximum impact.”
The report of the United Nations Secretary-General shows that while the number of people accessing treatment almost tripled from 2010 to June 2017, from 7.7 million people on treatment to 20.9 million, 15.8 million people are still in need of treatment, and progress in expanding access to treatment for children is particularly slow. Just 43% of children living with HIV had access to treatment in 2016.

It also flags that more needs to be done to stop new HIV infections. New HIV infections declined by 18% from 2010 to 2016, from 2.2 million to 1.8 million, but to reach the target of 500 000 new infections by 2020 HIV prevention efforts must be significantly stepped up, particularly among populations at higher risk, a sentiment echoed by many of the speakers at the plenary meeting.

Lazarus O. Amayo, Permanent Representative of Kenya to the United Nations, spoke on behalf of the African Group. “A lot remains to be done as AIDS continues to disproportionately affect sub-Saharan Africa, with the risk of new HIV infections remaining exceptionally high among young women in eastern and southern Africa,” he said. “We reiterate the need for a comprehensive, universal and integrated approach to HIV and AIDS, as well as investments towards it.” In eastern and southern Africa, young women aged between 15 and 24 years account for 26% of new HIV infections, despite making up just 10% of the population.

The report shows there is still much work to do to reach the targets in the 2016 United Nations Political Declaration on Ending AIDS, including filling the US$ 7 billion shortfall in funding for the AIDS response. It sets out five strong recommendations to get countries on track, including mobilizing an HIV testing revolution, safeguarding human rights and promoting gender equality and using the HIV Prevention 2020 Road Map to accelerate reductions in new HIV infections.

In 2016 (*June 2017) an estimated:

*20.9 million [18.4 million–21.7 million] people were accessing antiretroviral therapy (in June 2017)
36.7 million [30.8 million–42.9 million] people globally were living with HIV
1.8 million [1.6 million–2.1 million] people became newly infected with HIV
1.0 million [830 000–1.2 million] people died from AIDS-related illnesses

-ENDS- 

Contact
UNAIDS | Sophie Barton-Knott | tel. +41 79 514 6896 | bartonknotts@unaids.org

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination, and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

NGOs worry about fate of HIV programmes when donor funds dry up

There are growing fears that many programmes administered by non-governmental organizations to assist the most vulnerable Jamaicans could be shuttered shortly as international funding dries up.

Addressing a recent Gleaner Editors’ Forum last Thursday, Kandasi Levermore, Executive Director of Jamaica AIDS Support for Life (JASL), disclosed that in a few years, several donor agencies would be transitioning, and there is no local funding to assist individuals in vulnerable groups.

“The challenge that we are going to be having in a few years when these donors transition because a lot of these projects are not funded by the Government of Jamaica, [is that] there will be a point where there will be a gap,” said Levermore.

Among the programmes likely to be affected are those involved in the empowerment of individuals living with HIV and HIV-related illnesses, women at risk of domestic violence as a result of their health status, as well as those that sensitize law-enforcement and health professionals about the treatment of persons living with HIV. “The Global Fund has been engaging in transition dialogue for years, and we finally fear that it is coming,” said Levermore. “There is going to be a gap in the country’s response. So how are we going to ensure that we sustain these activities and our scaled-up activities? That’s going to be the question that we need to answer now,” she added.

CURRENT FEARS

It is feared that these programmes could be placed on the back burner by the Ministry of Health, which is now focusing its resources on areas such as cervical cancer prevention among primary school-age girls and the growing obesity crisis in Jamaica.

“We are asking the Government to begin looking at mechanisms to sustain this type of engagement that is not now present in the structure of NGOs and how they deliver their programmes,” Levermore pleaded.

“We have been having this discussion for years, and once you talk money, you hear about fiscal space, but the real question is, ‘can the country’s response stave off the tide without a mechanism to sustain the efforts?’ ” added Levermore.

Trans-Friendly Health Services Needed

Executive Director of the Caribbean Vulnerable Communities Coalition (CVC), Ivan Cruickshank, wants the health sector to provide what he calls “trans-friendly” health services to transgender people in Jamaica.

“This means putting policies in place that can accommodate people who come in as trans and provide service to them. It would also mean the training of your healthcare providers to be able to provide trans-health services,” he said.

Speaking at a Gleaner Editors’ Forum at the newspaper’s offices on North Street in Kingston last Thursday, Cruickshank pointed out that many of the organisations working with vulnerable groups have partnered with civil-society bodies to train health workers in providing trans-health services.

“Trans-health service is a unique type of health service. So, you have to make sure that you have the policy framework that allows for the training of your medical professionals and that the service delivery points are able to deliver trans-friendly health services.”

Cruickshank revealed that there was a “particular toolkit that we have called Transit”, which provides a comprehensive package of services to transgender people, including hormone therapy.

He said that Transit would also help to ensure that persons who present themselves as transgender would be treated as such and not as males because of their physical appearances.

POLICE TREATMENT

Cruickshank also addressed the question of how transgenders should be treated by law enforcers when they commit an offense and are to be taken into custody.

He said that NGOs have worked with some police officers who have placed transgender people in a different cell.

“What they have done is that they have, pretty much, separated them, and even at some of our correctional facilities, they have separated them for their own protection and to ensure that they are addressing, in their own unique way, some of the issues that might arise.”

He estimated that the trans community represented about two percent of the Jamaican male population.

PANCAP aims to enhance HIV prevention, care, treatment and support with Knowledge Exchange Event

Monday, 11 June 2018 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, collaborated with the Integral Orientation and Research Center/ Centro de Orientación e Investigación Integral (COIN) for a face-to-face knowledge exchange event in Santo Domingo, Dominican Republic from 4-8 June 2018.

COIN is a social interest institution based in the Dominican Republic that implements HIV prevention, care, treatment and support programmes for key populations.  The entity has been a key partner of the Ministry of Public Health and Social Assistance (Dominican Republic) and grassroots, community-based organizations in service delivery.

The objective of the knowledge exchange event was to provide participants with first-hand experience of COIN’s operations.  This included a detailed explanation of how the entity has coordinated and collaborated with the Ministry of Health, other civil society organizations and stakeholders in delivering comprehensive HIV services in communities and to key populations.

Ten persons from four countries, Jamaica, Guyana, Suriname and the Republic of Trinidad and Tobago, were involved in the learning exchange event.  The team consisted of National AIDS Programme Managers, civil society organization (CSO) representatives, HIV clinicians and social workers.

The event encompassed participants engaging with officials of the Ministry of Public Health and Social Assistance, the National HIV response and community-based organizations through site visits to clinics and outreaches.

The learning exchange was spearheaded by Dr. Shanti Singh-Anthony, PANCAP Knowledge Management Coordinator, who stated “there was a wealth of knowledge to be shared with our participants on the Dominican Republic’s national HIV response and COIN’s experience of service delivery, prioritization of key populations and their collaboration with the Ministry of Public Health and Social Assistance and other in-country partners”.

She further explained that the goal of the knowledge exchange was to share successful models of care delivery in reaching key populations with prevention, Antiretrovirals (ARTs) and support services at the national level and for participants to understand the intersection with community-based models.

“Our objective was for participants to experience successful interventions by COIN aimed at reducing stigma and discrimination among key populations”, stated Dr. Singh-Anthony, “and to expose them to the components of COIN’s Pre-Exposure Prophylaxis (PrEP) programme as a new prevention modality”.

She further stated that another critical objective was for participants to understand the degree and mechanisms of coordination and collaboration between COIN, the Dominican Republic Ministry of Public Health and Social Assistance, civil society organizations and other stakeholders in supporting the scale-up of HIV prevention, care and treatment services to key populations.

Dr. Singh-Anthony highlighted that the activity also facilitated knowledge sharing and exchange among the participants on the Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 Targets and World Health Organization “Treat All” recommendation.

Participants were also challenged to develop country-specific action plans to enhance in-country collaboration among members of the multidisciplinary team.  “The true measure of success will be the degree to which participants implement COIN’s model of care and other best practices within their country context,” stated Dr. Singh-Anthony, “we would have succeeded when this highly successful model is utilized to improve HIV prevention services to key populations across the region”.

-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 and AIDS (UNAIDS) 90-90-90 Targets?

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

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

“Take pride in yourself” – Anglican Bishop tells LGBT faith forum

The Bishop of the Anglican Diocese of Guyana, Charles Davidson,  hosted a forum on faith for lesbian, gay, bisexual and transgender (LGBT) Guyanese at his official residence – Austin House – in Kingston, Georgetown in June 2018.

According to a release from the Society Against Sexual Orientation Discrimination (SASOD), the forum was part of a calendar of activities for the second annual Guyana Pride Festival, a week-long celebration organised by a coalition of the country’s three LGBT groups: Guyana Trans United (GTU), Guyana Rainbow Foundation (GuyBow) and the SASOD.

Homosexuality and the Anglican Church

According to SASOD, the Bishop, who leads the Anglican faith in Guyana and Suriname, said that the church has nothing against homosexuality and gay persons are accepted in the congregation, the challenge faced by many however is understanding sexuality. “We may not accept the [sexual] behaviour that you do but you are still children of God. The challenge is to try and understand sexuality. There are lots of Christians who wouldn’t even have a conversation [about sexuality] but they might quote scriptures. Jesus Christ spoke more about money more than he talked about sex. We are spending a lot of time worrying about sex when we should be spending a lot of time on an individual and their wholeness,” Bishop Davidson was quoted as saying.

The Buggery Laws

He stated that people are still struggling in the Caribbean because historically same-sex intimacy was never a practice accepted in the region due to strict colonial rule. This extends to the buggery laws which he described as “crazy.” Davidson expressed hope that the laws are reviewed since they are discriminatory and recognizing that that kind of behaviour is private.

“The seventh commandment says thou shall not commit adultery, yet there is no law in the law books of Guyana that says if we catch you committing adultery we will send you to jail for two years, as the buggery law says.” He went on to say that there are members of the Church who are not married, but living with persons. “We have our own challenges in the church to begin understanding these things,” the Bishop noted.

The sixty-four-year-old Bishop expressed that in years to come life will become easier for LGBT people. He has noticed younger persons in his congregation are more educated, understanding and accepting of gender and sexual diversity. “It is not an issue for them. It is an issue for old people like me,” he remarked.

He said it is an idea that the Church itself will struggle with, but they will have to continue to struggle to fully understand without discrimination and hatred towards LGBT persons.

More conversations needed

Bishop Davidson expressed his interest in meeting with transgender sex workers who are known to be working around the St. George’s Cathedral. “Some situations are not as loving as they ought to be but you still have to love people,” he said when talking about transgender sex workers. “I want to sit with a group of sex workers to hear their stories, to find out why they are in this position and to offer them the opportunity to find employment in a different way. I am not telling them that they are not gay. All I am saying is don’t let persons take advantage of who you are, be careful and take precautions,” he added.

SASOD’s Managing Director, Joel Simpson, committed to arranging such a meeting, stating that dialogue is indeed necessary and any support to vulnerable persons would not be turned away.

“I wish you well, make the right choices and take pride in yourself. At the end of the day, love makes the world go ‘round and the church is about love so we can’t disregard LGBT persons. The conversations will go on but the struggle continues and we wouldn’t give up,” the Bishop concluded.

Scotiabank and LIVE UP: The Caribbean Media Alliance reflect on 10 years of hosting Regional Testing Day

After ten successful years of working togeth­er to reduce the stigma associated with HIV testing, Scotiabank and LIVE Up: The Caribbean Media Alliance, wish to inform the public that 2017 was the final year of our joint partnership for the regional initiative, Regional Testing Day.

In 2017, Scotiabank formed the Interna­tional Youth Advisory Council, under the leadership of LIVE UP Executive Director Dr. Allyson Leacock. From this, ‘The Scotiabank Young People in the Community Index’ was launched, which recognizes young people as one of the world’s greatest resources. Scotiabank has therefore dedicated to committing 70 percent of all global philanthropic efforts toward causes that positively impact this segment.

With this adjustment to the Bank’s global sponsorship strategy and the untimely passing of a key member of the LIVE UP team, both entities have mutually agreed to move forward in new directions; a fitting manner in which to conclude their ten years of active partnership.

Significant Achievements:

Since the initiative’s start ten years ago, much progress has been made in the fight against HIV.

The region’s successes include:

• A reduction in people living with HIV (PLHIV) from 450,000 to 285,000.
• A reduction in the number of deaths by 40-60%.
• An increase in the number of PLHIV on treatment from under 10% to almost 50%.

The Caribbean could also be the first region in the world to eliminate mother-to-child transmission of HIV, ostensibly because of HIV testing of pregnant mothers. The World Health Organisation validated six (6) other Caribbean countries (in addition to Cuba), for having successfully eliminated mother-to-child transmission (EMTCT) of HIV on World AIDS Day 2017.

Achievements for this Public-Private Partnership (PPP) include:

• The use of over 30 Scotiabank branches in 20 countries as testing clinics.
• The bipartisan support of competing political parties across the region at the highest level of Prime Minister and Opposition Leader for regional launches.
• A robust and consistent show of support from faith-based communities across the region, especially the Barbados Evangelical Association.
• The decentralization of testing to reach targeted vulnerable communities and populations.

Within a decade the initiative resulted in a remarkable increase in tests conducted. In 2008, 2300 people from 6 countries were tested. By the end of the initiative in 2017, 162,000 people were tested at over 300 testing sites in 21 countries.

Work to be Highly Commended:

Scotiabank’s Senior Manager, International Philanthropy, Roy Rodriguez applauded the work of both teams.

‘Scotiabank and LIVE UP have enjoyed a long and successful partnership with Regional Testing Day. We have by no means yet won the fight against HIV and AIDS, but our collaborative efforts went a long way towards the awareness that HIV testing should neither be feared nor avoided. I am also incredibly proud of our Scotiabankers across the region, who often stepped outside of their usual roles to ensure that Regional Testing Day was successfully executed year on year.’

Mr. Rodriguez also praised the tremendous work done by LIVE UP’s Executive Director, Dr. Allyson Leacock. ‘Dr. Leacock was, and continues to be resolute and steadfast in the fight against HIV/AIDS. One person with a desire to make a great difference was all it took to mobilize so many individuals and organizations into action. That is purpose!

She impressed my fellow Scotiabank executives both in the region and the global office, and there was never a doubt that she could deliver on what she set out to do. It was a pleasure having her as our teammate for the past decade.’

He added, ‘ … to the people of the region, continue to get tested. Regional Testing Day was the tool, but you are the catalyst, and this small but significant first step will help us to rid the world of this dreaded virus.’

His sentiments were echoed by Dr. Leacock, who thanked Scotiabank for their years of support. ‘This event has shown the region and the world that Scotiabank is a global leader that is exemplary in its philanthropic commitment to eliminating HIV from the public health landscape. Over the years, we have appreciated their support from leadership at the highest levels with Jim Tobin, Director, Sponsorship, Philanthropy and Strategic Partnerships. Our key contact, who showed a genuine interest in our progress and development throughout the years, was Roy Rodriguez, Senior Manager, Sponsorship, and Philanthropy.

As we mark the 10th anniversary of success, LIVE UP thanks Scotiabank and in particular Roy Rodriguez for his sustained interest and support throughout the decade of Regional Testing Day. The power of Public-Private Partnerships in advancing the region’s development agenda is exemplified in Regional Testing Day. Showcased as a best practice at the International AIDS Conference in 2012, we also thank the Pan Caribbean Partnership against HIV/AIDS-PANCAP for being the partner charged with mobilizing the region’s Ministries and Departments of Health. The 112 media houses in our LIVE UP partnership also played a critical role in sharing information and educating the region’s people on the HIV epidemic.’

Scotiabank and LIVE UP wish to thank the people of the region for their unwavering support of Regional Testing Day, and for positively impacting the Caribbean’s statistics year over year during the life of the initiative.