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Under the Multi-country Global Fund (GF) Grant Project for the Caribbean, three (3) additional countries, Antigua and Barbuda, Belize and Guyana, have advanced with the implementation of Pre-exposure Prophylaxis (PrEP).  Technical support for the advancement of these countries to implement this high impact prevention service was provided by the Pan American Health Organisation (PAHO) and PANCAP.  Barbados, a recipient under the grant, has provided support to the three (3) countries by transferring knowledge and experience over the years.  Approximately seven (7) countries in the Caribbean are currently implementing PrEP as opposed to two (Barbados and Bahamas) in 2019, all at different levels of implementation.

Under the current Global Fund project, with the technical guidance and support of PAHO, a comprehensive PrEP guidance package was developed to support countries in initiating PrEP services.  The purpose of the package is to facilitate the standardization of the services, data collection, and monitoring across the Region.  In addition, the package includes generic clinical guidelines (based on recommendations from World Health Organisation – WHO guidelines) for PrEP and nPeP for key populations, clinical intake forms, social media products, brochures, PrEP registration, monitoring and training tools.

To further strengthen PrEP implementation in the Region and with the technical support of PAHO, PANCAP is collaborating with Callen-Lorde, a Global leader in Key Population health care in the United States.  The partnership will support in-country capacity building to generate demand for PrEP and skills critical to providing quality PrEP services to key populations.

Due to the pandemic, onsite, in-person capacity building in New York was not possible.  However, the collaboration will move forward with country visits by experts from Callen -Lorde to strengthen the national services based on the specific needs and concerns of the Member States mentioned above.

In May, a virtual planning session was held with the team from Callen-Lorde, PAHO, PANCAP and national teams from the individual countries to determine the level of implementation and technical expertise critical to strengthening PrEP services.

Mr Collin Kirton, Officer-in-Charge, PANCAP, lauded the collaboration, “This initiative with Callen-Lorde is building on ongoing work which commenced with the support of PAHO in 2018.  Callen-Lorde brings many years of programme implementation and clinical experience to this initiative and our Region.  I am pleased that Callen-Lorde will support your technical assistance needs and urge you to clearly define these so that the technical assistance is intentional, targeted and will be most useful in advancing PrEP programmes in our Region”.

The Caribbean Regional Network of People Living with HIV/AIDS (CRN+) facilitated a virtual election for new directors to serve on its board.  The election was held on 28 January 2022.

Mr William Moultrie III was elected the new Chair, Mr Ricky Pascoe, Vice-Chair; Ms Renatta Langlais, Secretary, Ms Christel Charles, Treasurer, Mr Marten Colom, Assistant Secretary, Mr Kenny White, Assistant Treasurer and Ms Diana Weekes, Board Member.

With the installation of a new Board of Directors, CRN+ plans to focus on advocacy for People Living with HIV (PLHIV) across the Region.  The mandate of the new board includes increasing representation for PLHIV and further establishing CRN+ as “the authentic voice” for and on behalf of PLHIV.

Mr Moultrie III expressed his satisfaction with the new board, stating, “now is the time to change how we operate.  We need to act more, and we need to be inclusive; we need to unite PLHIV.  These are the critical keys for our success.”

Several Caribbean countries have graduated to middle-income status over the past ten (10) years, and more are transitioning out of eligibility for external funding from traditional donors. This has increased the burden on countries to fund and manage their priority health programmes without external support. Further, the economic impact of COVID-19 has put increased burden on countries where the expertise of HIV programmes has been leveraged but without budgetary increases.

Civil Society Organisations (CSOs) and Community-Based Organisations (CBOs) have been critical players in their national HIV responses, providing expertise for efficient service delivery and deeper penetration into general, key and vulnerable populations. External donors have traditionally supported these non-government entities; hence CSOs will be significantly impacted by the decrease in funding. This risk of losing the gains made over the past decades would further isolate the key and vulnerable communities.

Social contracting has been proposed for several years as a viable option to sustain the critical work by CSOs and CBOs in their country’s HIV response.

In early 2021 the CARICOM Secretariat, via PANCAP, advanced this mechanism by developing a tool kit to guide countries on the process should they consider social contracting a viable option. Later in 2021, PANCAP examined seven (7) countries to determine if they already had a funding mechanism to support non-government players or were interested in establishing or strengthening social contracting as a financing option. The latter would be a mechanism by which governments would finance programmes, interventions and other activities implemented by CSOs to respond to HIV and AIDS through a public tender.

Barbados, Guyana and Jamaica have already commenced implementation or have decided to pilot social contracting. However, other countries were identified as being near ready to advance should 1) the appropriate advocacy be provided and 2) domestic funding be identified. Antigua and Barbuda was one such country.

The AIDS Secretariat, Antigua and Barbuda, convened a workshop in March with critical CSOs to increase their understanding of social contracting and its benefits. This was followed by individual in-person organisation meetings to explore their capacity and interest in receiving public resources. Sessions were then held with senior government gatekeepers, including the Ministry of Health Wellness and Environment and the Ministry of Finance, to identify procurement processes, a potential package of services, and gaps in targets.

Weeks of hard work culminated on 31 March 2022, when discussions were held between CARICOM-PANCAP and the Ministry of Health, Wellness and the Environment in Antigua and Barbuda on social contracting. Honourable Molwyn Morgorson Joseph, Minister of Health, Wellness and the Environment, indicated his strong support for the tremendous work of the National AIDS Secretariat and the work of CSOs in reaching key populations. He also expressed his confidence in social contracting being a valuable tool to support Antigua and Barbuda’s national response.

Minister Joseph intends to meet with CSO partners to recognise their work and has reached out to CARICOM for additional support in developing the critical programme documents and government submissions to start a pilot in the next fiscal year, 2023-2024. Antigua and Barbuda would be the first country in the Organisation of Eastern Caribbean States (OECS) to implement social contracting.

Image: Office of the Minister of Health, Wellness and the Environment, Antigua and Barbuda (left to right): Ms Ena Henry, Permanent Secretary, Ms Sandra McLeish PANCAP Consultant; Honourable Molwyn Morgorson Joseph, Minister of Health, Wellness and the Environment; Dr Rhonda Sealy-Thomas, Chief Medical Officer and Ms Delcora Williams, AIDS Programme Manager.

On Tuesday 8 March 2022, the National AIDS Commission (NAC) Belize launched its HIV Self-testing (HIVST) Pilot Project to increase HIV testing and prevention, particularly focusing on reaching men. The HIVST Pilot Project is supported by the Caribbean Med Labs Foundation (CMLF) under the PANCAP-CVC-COIN Multi-Country Regional Grant of which Belize is a beneficiary.

As part of the pilot project, CMLF provided the NAC with fifty (50) OraQuick HIVST kits.

“The OraQuick HIVST kits that we’re piloting have been pre-approved by the World Health Organization (WHO) and is 99% reliable, convenient, and private”, stated Mr Enrique Romero, Executive Director, NAC, Belize.

The Belize Pilot Project is facility-based and implemented by Civil Society Organizations – Belize Family Life Association (BFLA) and Belize’s Civil Society Organization Hub (CSO-Hub) through Go Joven Belize. The pilot project will allow for the documentation of testing experiences as well as validation of results to determine test kit reliability as well as inform decision-making for subsequent implementation.

An estimated 5,500 persons living in Belize are HIV positive. In 2020, 193 persons were newly infected with HIV: 89 females and 104 males, the majority being young adults ages 20-39. There were also 94 AIDS-related deaths.

“Majority of persons becoming infected with HIV are young adults, particularly members of vulnerable populations, sex workers, men who have sex with men (MSM) and transgender persons; this is the population we are targeting under this Pilot,” stated Mr Romero.

The HIVST Pilot Project in Belize comes at a most crucial time. Since the start of the pandemic, testing across the country has slowed, and progress made in HIV prevention could be lost.  Incidents of stigma and discrimination have also increased.

Viewing HIVST as a pathway of empowerment, the NAC is reenergized and remains optimistic about the future of HIV prevention, diagnosis, and treatment in Belize.

Persons interested in participating in the ongoing pilot can visit BFLA or the CSO-Hub for testing.

To support National AIDS Programmes and Civil Society Organisations in the implementation of HIVST, PANCAP has developed and distributed a series of instructional videos including a step-by-step demonstration on how to use an HIVST kit.  The videos are available for download on the PANCAP website and YouTube Channel.

World Tuberculosis (TB) Day is observed on 24 March each year to raise awareness and understanding about one of the world’s top infectious killers and catalyze action to address its devastating health, social, and economic impact around the world. The theme of World TB Day 2022 – ‘Invest to End TB. Save Lives.’ – conveys the urgent need to invest resources to ramp up the fight against TB and achieve the commitments to end TB made by global leaders. This is especially critical in the context of the COVID-19 pandemic and the ongoing conflict in Eastern Europe, the African Region and the Middle East that has put progress at risk.

At the press briefing, WHO will release new guidelines on addressing TB in children and adolescents.  Over 1.1 million children and adolescents under 15 years fell ill with TB globally in 2020, and 226 000 children and adolescents lost their lives from this preventable and curable disease. COVID-19 has had an additional negative and disproportionate impact on children and adolescents with TB or at risk, with increased TB transmission in the household, less care-seeking and access to health services. In 2020, an estimated 63% of children and young adolescents below 15 years with TB were not reached with or not officially reported to have accessed life-saving TB diagnosis and treatment services; the proportion was even higher – 72% – for children under 5 years. Almost two-thirds of eligible children under 5 did not receive TB preventive treatment and therefore remain at risk of getting sick.

TB is the second top infectious killer after COVID-19 in the world claiming over 4100 lives each day.

More information and communications material can be found at this link:

https://www.who.int/campaigns/world-tb-day/2022

Speakers:

• Dr Tereza  KASAEVA – Director, Global Tuberculosis Programme, World Health Organization
• Dr Kerri VINEY –  Team Lead, Vulnerable Populations, Communities and Co-morbidities Unit, Global TB Programme, WHO
• Ciara GOSLETT, Adolescent drug-resistant TB survivor, South Africa

Date/time: Monday, 21 March 2022, 15:30hrs CET/Geneva

Zoom link:
https://who-e.zoom.us/j/96325516384
Passcode: vpcTBvpc22

Phone access:

International numbers available: https://who-e.zoom.us/u/adGUxXUf24

Webinar ID: 963 2551 6384

Numeric Passcode for phone access: 9325008211

Media Contact:

Christian Lindmeier
Communications Officer
Tel:      +41 22 791 1948
Mob:   +41 79 5006552
lindmeierch@who.int

The Pan-Caribbean Partnership against HIV and AIDS (PANCAP), in collaboration with the Pan American Health Organisation (PAHO), will host a webinar on public health interventions for reducing HIV deaths through expanded HIV testing, rapid staging of HIV individuals, rapid screening of opportunistic infections (Tuberculosis, Cryptococcosis and Histoplasmosis), and rapid treatment initiation.

The virtual event will be facilitated by Dr Omar Sued, Advisor, HIV/STI Care and Treatment, PAHO and hosted by Dr Shanti Singh-Anthony, Coordinator, Knowledge Management, PANCAP.

The webinar will be held on Thursday 17 March 2022, during the following times:

Belmopan, Belize                               09:00 AM CST

Eastern Time, ET                               10:00 AM EST

Georgetown, Guyana                         11:00 AM GYT

Kingston, Jamaica                              10:00 AM EST

Port-au-Prince, Haiti                           11:00 AM EST

Port-of-Spain, Trinidad and Tobago    11:00 AM AST

Suriname Time, SRT                           12:00 PM SRT

All regional stakeholders involved in the HIV response are invited to register and participate using the following link: https://register.gotowebinar.com/register/6301012388664543503

For more information, please contact:

Timothy Austin

Senior Project Officer, Communications

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

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.

Marcia John (not her real name), a Guyanese transgender woman, readied to leave a transgender support group meeting. She slipped off her black wig, replacing it with a bandana and hat. Her employer only allows her to perform her duties if she presents as a man.

“I have no choice,” she said. “I have to work.”

In 2018, the Caribbean Court of Justice ruled that an 1893 Guyana law that prohibited cross-dressing was unconstitutional. Last August, lawmakers formally removed that section from the law books. But for Ms John and other transgender women, this has not been enough to transform how they navigate social spaces. Intolerant attitudes remain, with sometimes dire implications for transgender people’s welfare and livelihoods.

Led by the University of the West Indies Rights Advocacy Project, the cross-dressing law challenge started with a constitutional action filed in the Guyana High Court in 2010. Eight years and two appeals later, the litigants earned a historic win.

“At the heart of the right to equality and non-discrimination lies a recognition that a fundamental goal of any constitutional democracy is to develop a society in which all citizens are respected and regarded as equal,” the Caribbean’s final appellate court ruled in 2018.

Reflecting on the impact of the landmark law reform effort, Alessandra Hereman, Guyana Trans United (GTU) Project Coordinator, said that the main benefit has been more visibility.

“The community’s increased media presence in the lead-up to the case brought transgender issues into the public space. People realised that transgender Guyanese exist and are part of our society. Some thought we should be treated equally, and others held on to their religious beliefs. But transgender issues were brought to the fore and were part of public discourse,” she said from GTU’s Georgetown office.

Formed in 2012, GTU has worked over the past decade to facilitate the dialogue and sensitisation needed alongside key law and policy reforms to create a safe and empowering social context for transgender people. They contribute to the ongoing effort to shift the attitudes and perceptions of healthcare providers around sexual orientation and gender identity. This work strengthens the community’s access to health services, including HIV prevention, testing and treatment. With support from UNAIDS, GTU also trained journalists on covering transgender people and issues ethically and accurately.

“Law reform is essential, but it is not a stand-alone,” said James Guwani, the Director of the UNAIDS Caribbean Sub-Regional Office. “Alongside strategies like judicial review and political advocacy, there must be ongoing community dialogue and targeted efforts to increase social inclusion.”

At present, GTU has two high law and policy reform priorities. First, Guyana’s Prevention of Discrimination Act of 1997 makes no mention of sexual orientation or gender identity.

“Employers use the lack of this protected status to discriminate against lesbian, gay, bisexual and transgender (LGBT) persons. Amending that legislation would mean that if you violate the rights of an LGBT person, there would be some mechanism for redress. Having that in place will tell people you can’t discriminate because there will be consequences,” Ms Hereman explained.

The CARICOM Secretariat, through the Pan Caribbean Partnership against HIV and AIDS (PANCAP), has developed a model anti-discrimination bill to guide Caribbean countries in creating anti-discrimination laws. PANCAP continues to advocate with regional stakeholders, including policymakers, for countries to adopt the model as it provides for the protection of persons against discrimination, including discrimination involving harassment, victimisation and vilification on the grounds of HIV status, sexual orientation, etc. It is hoped that the model will lead to more access to health care for key populations with the overarching goal of a Caribbean free of AIDS and new HIV infections, in which all people are happier, healthier, productive, safe and respected.

Next on GTU’s list is the revision of the Teachers’ Code of Conduct to be inclusive of the needs of LGBT students.

“They must know that they have a duty to create an enabling environment for all students so that LGBT pupils have an opportunity to learn without bullying,” Ms Hereman said.

Lack of gender recognition legislation and the criminalisation of sex between people of the same sex remain challenges in the Guyana and wider Caribbean contexts. The United Caribbean Trans Network has mounted a campaign around gender identity recognition, while the Society against Sexual Orientation Discrimination (SASOD) is working to remove Sections 351 to 353 of the Criminal Law (Offences) Act, which make sex between men punishable with life imprisonment. However, GTU is first prioritising issues that it says go to the heart of transgender people’s ability to get an education and access employment. Exclusion from these spaces compounds their vulnerability to poverty, violence and disease.

“We occupy the lowest socioeconomic level in society. Guyana is now an oil-producing nation. LGBT people should have opportunities as well,” Ms Hereman insisted.

Friday, 25 February 2022 (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 regional stakeholders for a three-day capacity building activity for health care providers in Belize on the Clinical Management of Pre-exposure Prophylaxis (PrEP) for serodiscordant couples and Key Populations. 

Pre-exposure Prophylaxis (PrEP) is the use of antiretroviral (ARV) drugs by persons without HIV infection to prevent the acquisition of HIV.  

It is an effective prevention strategy that is recommended to reduce HIV infections, especially in Men who have sex with men (MSM), Sex Workers and the Transgender population.

The training was implemented in collaboration with the Pan American Health Organisation (PAHO), Ministry of Health and Wellness and the National AIDS Commission (NAC), Belize.

Health care providers were emersed in an in-depth discussion on the most recent World Health Organisation (WHO) recommendations on PrEP, Non-occupational HIV Post-Exposure Prophylaxis (nPEP) and new scientific evidence and implementation data emerging from the field. 

Participants were also exposed to WHO guidance on PrEP programming.  In addition, the capacity building activity provided a space for participants to share experiences as Belize prepares for PrEP and nPEP implementation.

Mr Enrique Romero, Executive Director, National AIDS Commission (NAC) Secretariat, Belize, highlighted that PrEP is a key implementation strategy for HIV prevention under Belize’s HIV National Strategic Plan (NSP).  He also stated that Belize would be implementing a PrEP pilot programme in 2022, and the capacity building exercise would be integral to the pilot’s success.  

The Executive Director further emphasised that the involvement of civil society organisations would be at the core of the PrEP implementation, specifically concerning awareness and education for Key Populations. 

Ms Sandra Jones, Technical Advisor HIV/STI, TB & Viral Hepatitis, PAHO/WHO – Subregional Program Coordination, Caribbean, underscored the significance of the training activity as more countries in the Region commence PrEP implementation.  Antigua and Barbuda, Belize and Guyana have joined four other countries that have established PrEP services, including The Bahamas, Barbados, Haiti and Jamaica. 

Ms Jones further highlighted that PAHO and PANCAP collaborated on the development of training materials, guidelines and videos for capacity building within National HIV Programmes to ensure the standardisation of PrEP training materials for the Region. In addition, information, education and communication products were developed for community health promotion, including brochures and social media posters accessible via the PANCAP website. 

The PrEP training activities were supported by the Multi-country Caribbean grant for PANCAP, Caribbean Vulnerable Communities Coalition (CVC) and Centro de Orientación e Investigación Integral (COIN) via the Global Fund to Fight AIDS, Tuberculosis and Malaria.

– ENDS –

Contact: 

Timothy Austin 

Senior Project Officer, Communications 

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 

Helpful links:

What is PrEP?

https://www.paho.org/en/topics/combination-hiv-prevention/pre-exposure-prophylaxis-prep 

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. 

Zero Discrimination Day will be observed on Tuesday 1 March under the theme “Remove laws that harm, create laws that empower”.  The Region will be highlighting the urgent need to take action against discriminatory laws.

In many countries, laws result in people being treated differently, excluded from essential services, or subject to undue restrictions on how they live their lives, simply because of who they are, what they do, or who they love.  Such laws are discriminatory—they deny human rights and fundamental freedoms.

Civil Society Organisations and other stakeholders will be advocating for the removal of discriminatory laws and the enactment of laws that protect people from discrimination.

On Zero Discrimination Day, we celebrate the right of everyone to live a full and productive life—and live it with dignity and free from discrimination.

Please find below this year’s theme in French and Spanish.  A campaign brochure and social media materials will be available on PANCAP.org in the coming days.  Bookmark the campaign page here: https://pancap.org/pancap-events/zero-discrimination-day/ 

Spanish – Abolamos leyes discriminatorias, creemos leyes empoderantes
French – Abolissons les lois discriminantes, adoptons des lois protectrices