Caribbean Regional Strategic Framework

Introduction to the Caribbean Regional Strategic Framework on HIV and AIDS

Since the inception of the Pan Caribbean Partnership Against HIV (PANCAP) in 2001, the Caribbean regional response to HIV has made significant strides. HIV prevalence has declined from 1.3 percent to one percent in 2012. New infections among children have been reduced by 52 percent over the same time period. Treatment coverage rates have dramatically improved with over 90 percent of HIV positive pregnant women receiving services to prevent mother-to-child-transmission and 70 percent of eligible people living with HIV receiving ARVs.

These successes rest on the combined efforts of regional public health agencies, donor partners, civil society and private sector agencies, which comprise PANCAP, in supporting national programmes to improve their capacity to implement prevention, treatment and care interventions. Substantial investments have been made in strengthening health systems and in scaling-up services for on-going care and support for the increasing numbers of people who are living longer with HIV. Regional public goods and services have lowered transaction costs by providing more affordable access to medicines and shared capacity in specialised services, information and advocacy.

Building on these achievements, the Caribbean Regional Strategic Framework 2014-2018 represents a commitment to inclusive and harmonised multisectoral action in order to achieve universal access to comprehensive, high-quality health services. As the epidemic remains entrenched in certain key populations, further reductions in AIDS-related mortality and transmission rates will only be possible with the removal of the legal, social and cultural obstacles which particularly affect these groups. This will require strengthened collaboration across sectors, including with Ministries of Legal Affairs, Home Affairs, Women and Gender, Planning and Social Development, parliamentarians, the judiciary, human rights and gender-equality advocates and the faith-based community, among others.

Achieving an AIDS-free Caribbean, even as resources for HIV are shrinking, requires strategic action at both the regional and national levels. The small island developing states of the Caribbean must find the resources to sustain prevention programmes, increase access to services for key populations, expand treatment programmes and meet the needs of an ageing population of PLHIV. To this end, the Caribbean Regional Strategic Framework 2014-2018 provides high level guidance to ensure that resources are directed towards effective interventions that maximise the impact of regional efforts, and provide good value or money, including by intensifying intervention efforts where HIV is most heavily concentrated.

Developed through a lengthy consultative process, the CRSF 2014-2018 articulates the vision and collective priorities of Caribbean states and regional-level partners. Six Strategic Priority Areas (SPAs) have been defined as key to achieving the vision of an AIDS-free Caribbean, while promoting sustainable health and development. These are:

1. An enabling environment
2. Shared responsibility
3. Prevention of HIV transmission
4. Care, treatment and support
5. Integration
6. Sustainability

Expected results defined within each SPA allow for partner countries to set national targets, bearing in mind variations in levels of country capacity and development. The CRSF 2014-2018 will be operationalised through two-year plans which will complement national strategies by focusing on regional actions and regional public goods and services. Operational plans will define priority actions, roles and responsibilities, timeframes and lines of accountability. A monitoring and evaluation framework, designed to minimise the reporting burden on countries, will ensure the region is progressing towards the achievement of expected results. Oversight of the implementation of operational plans will be the responsibility of the Priority Areas Coordinating Committee (PACC), which reports to the PANCAP Executive Board and to the Annual General Meeting.