The Pan America Health Organization (PAHO) and The Pan-Caribbean Partnership against HIV and AIDS (PANCAP) brought together stakeholders of the Caribbean's HIV response to develop a set of concrete actions needed to implement the Call To Action that emanated from the 2017 Latin America and Caribbean Forum on HIV and Sustainability.
The group was also sensitized on policy approaches required to reduce HIV treatment and other health inequalities. It is expected that the meeting's outputs and deliberations will be included in the post-2018 Caribbean Regional Strategic Framework on HIV and AIDS (CRSF). These actions will support expanding equitable access to health and social services while strengthening health system responses to HIV and its sustainability.
Dereck Springer, Director of PANCAP welcomed participants with a timely reminder of the critical junction at which the region now stands in its HIV response.
In her opening remarks, Sannia Sutherland, Programme Coordinator, Caribbean Vulnerable Communities Coalition (CVC) underscored that throughout the Caribbean, Community-based organizations (CBOs) and the populations for which they work, are key players in the delivery of health services, as they have unique advantages in advocacy, demand-creation, and linkage to services and keeping governments, and donors accountable. However, they often deliver services without stable and predictable funding or systemic linkages to formal public health facilities.
“We have been working assiduously to promote the legal empowerment of key populations (KPs) to improve access to health and justice and reduce human rights violations with a view to promoting an enabling environment as we join fast-track efforts," Sutherland said.
She also emphasized that despite the interventions, stigma and discrimination in health services are widespread, limiting key populations’ access to services.
“Weak justice systems and a limited culture of rights litigation result in impunity. More generally, the application of laws and policies allow the use of arbitrary interpretations of laws to affect operational policies, which in turn limit access to services," she said.
Dr. James Guwani, Team Leader and Senior Advisor, Fast Track, The Joint United Nations Programme on HIV/AIDS (UNAIDS) Caribbean Sub-Regional Office brought attention to the fact that the Regional Meeting on Ending AIDS falls at the halfway point to 2020.
“That’s a deadline the global community agreed upon for meeting targets that will set us on a course to end the AIDS epidemic”, stated Dr. Guwani. He congratulated PANCAP Director, Dereck Springer, as well as PAHO for their leadership in sharing the vision of a region without AIDS. He noted that their commitment to exploring the scientific as well as social dimensions of the challenge is invaluable, particularly now that the 2020 Fast-Track target is approaching.
He further stated that through the 2016 Political Declaration on ending AIDS, the community of nations has agreed to adopt a Fast-Track strategy that involves increasing prevention, testing, and treatment services while working to eliminate stigma and discrimination. He emphasized that central to this goal are the 90-90-90 Treatment Targets.
In her keynote address, Dr. Bernadette Theodore-Gandi, PAHO/WHO Representative to Jamaica, Bermuda and The Cayman Islands expressed optimism that HIV and AIDS will not be epidemics much longer, and at that time, the region will be proud to be part of initiatives like the Regional Meeting, being supportive players in the response.
She highlighted that the UNAIDS Global AIDS Monitoring database shows that the Caribbean region has seen an 18% reduction in new infections of HIV and 23% reduction in the number of AIDS-related deaths this year.
“Once, thought to be too ambitious, the Caribbean region now leads the world in the elimination of Mother-to-Child transmission of HIV and syphilis”, said Dr. Theodore-Gandi, “Currently, 7 out of the 11 countries were validated globally for EMTCT, and 7 out of the 8 countries achieving dual elimination of HIV and syphilis are from the Caribbean. These are inspiring steps toward ending the epidemic."
She advocated that winning the fight against AIDS, however, requires an appreciation of the factors outside of health that also drive the epidemic.
Dr. Theodore-Gandi stated that Meeting all the targets of the other 17 SDGs will also contribute significantly to ending AIDS, as they too provide guidance that supports health and well-being in a holistic way.
"By ending poverty and hunger, SDGs 1 and 2, the region will be supporting people living with HIV and their families with the capacity to better manage their lives and adhere to treatment. And of course, SDG 5 - gender equality; the fight against AIDS will never be won in this region if we fail to address gender inequities, including violence against women and girls,” Theodore-Gandi said.
She further stated that if the region is to reduce inequalities (SDG 10) there must be an agreement that the principles of Universal Health also include people living with HIV, men who have sex with men, women, and girls, sex workers, persons of transgender experience, persons incarcerated, people living with disabilities and all populations most-at-risk. She advocated that if the region is to address the underlying factors that leave people vulnerable to HIV infection, no person or group would be left behind.
She advocated that an effective HIV response is also a human rights-based response and that to move the region’s HIV response from a phase of plateau to a place of sustained high impact, some countries must accelerate the removal of laws which criminalize people living with HIV and key populations.
“I encourage all stakeholders of political influence to recognize their role in creating an enabling policy and legal environment which support an effective response to HIV prevention, care and treatment services for all who need them,” stated Dr. Theodore-Gandi.
She warned that the evidence is conclusive that failing to do this sends people living with HIV and key communities into hiding and farther away from the services they need to keep them alive and healthy. She encouraged the participants to build on their existing work and the experiences of all stakeholders and to take into strong account the voices of people living with HIV, key communities and civil society working in the trenches.
Ministers of government, parliamentarians, legislators, permanent secretaries, chief medical officers, and national AIDS programme managers from over 16 countries as well as regional and national representatives from civil society, and development partners participated in the Regional Meeting which concluded on November 2.