COMMUNIQUE ISSUED AT THE CONCLUSION OF THE EIGHTH ANNUAL GENERAL MEETING OF THE PAN CARIBBEAN PARTNERSHIP AGAINST HIV AND AIDS (PANCAP), 29-31 OCTOBER 2008, MONTEGO BAY, JAMAICA
Posted in: Communiques | 03 January 2008 | Release Ref #: 326/2008 | 1160
(CARICOM Secretariat, Turkeyen, Greater Georgetown, Guyana) Under the theme, Leadership: Uniting Vision and Purpose, the Eighth Annual General Meeting (AGM) of the Pan Caribbean Partnership against HIV and AIDS (PANCAP) was held on 29 -31 October 2008, in Montego Bay, Jamaica.
The three-day meeting attracted some 170 registered and specially invited guests drawn from 29 countries of the English, Dutch, French and Spanish Caribbean, 33 regional agencies, 15 bilateral and multilateral agencies and 10 development partners.
Chairman of the Opening Session, PANCAP Coordinating Unit Director, Mr. Carl Browne, told the gathering that the two main objectives of the meeting were to benefit from updates on the most recent developments in the field of HIV and AIDS in the Caribbean, and to create a forum for networking and information sharing among PANCAP partners.
The keynote address was given by Her Excellency, Dame Pearlette Louisy, Governor General of Saint Lucia. The Governor General noted that there was much to celebrate: HIV infection has stabilised across the region and has shown a decline in at least three countries, mother-to-child transmission of HIV infection has declined in all countries of the Region, and moderate progress has been made in aspects of treatment, care and support, among other achievements. She however cautioned that we must not forget that the Caribbean’s HIV prevalence rate is still 1½ times that of the global average, twice that of North America and Eastern Europe and more than five-fold that of Western and Central Europe.
Dame Louisy stressed the need for leaders to incorporate the lessons learned from experiences of those in the field and for fashioning leadership that is responsive to the changing requirements of the HIV and AIDS epidemic.
Other speakers at the opening session included Hon. Rudyard Spencer, Minister of Health Jamaica who, in welcome remarks, commended PANCAP for doing a remarkable job in raising the awareness of policy makers in the Caribbean on the extent and complexity of the epidemic and in establishing a culture of cooperation, coordination and collaboration in the Region in the fight against HIV and AIDS. Hon. John Fabien, Minister of Health, Dominica and Chair of the Regional Coordinating Mechanism (RCM), urged that emphasis be placed on the robust implementation of the newly-developed Caribbean Regional Strategic Framework on HIV and AIDS (2008-2012) as a platform for accelerating universal access to HIV and AIDS-related prevention, treatment, care and support service.
Dr Edward Greene, Assistant Secretary General, Caribbean Community (CARICOM) Secretariat, placed the developments of PANCAP in their international and regional influences, and advocated for the new leadership to take into consideration the lessons of the past, and also to incorporate the new information technologies in the strategies for making leadership effective in introducing and responding to changes. Dr Kevin Harvey, Chair of the Caribbean Coalition of National AIDS Programme Coordinators (CCNAPC), commended PANCAP for incorporating the membership of CCNAPC into the AGM which augurs well for the joint leadership of the two important regional organizations.
The Leadership Forum focused on the theme of the AGM, "Leadership, uniting vision and purpose". The keynote speaker, Prof Sir Kenneth Hall, Governor General of Jamaica, in his presentation, reflected on three principles in respect of uniting vision with purpose: the international and regional context in which a vision for PANCAP is formed and crystalised; the preconditions for connecting vision with purpose; and, the attributes for transforming vision into purpose and action.
The end result, according to the Governor General, is creative leadership based on a deep rooted passion and urge to think differently, and collective leadership for sustainability. These are all critical to achieving the ambitious goal of universal access to prevention, care, treatment and support by 2010.
Mr. Jacob Gayle, Deputy Vice President Ford Foundation, pointed out that the Caribbean has been noted for strong leadership, which has assisted PANCAP to achieve more than was expected over the past eight years. He urged PANCAP to facilitate cross-border action, because HIV has taught that real life is not limited by political boundaries; build a new cadre of young leaders; use its link with CARICOM to hold peer political leaders accountable for serving its populations; and soliciting global partnership, while protecting local leadership.
Among the practical experiences that emerged from the Leadership forum were the Barbados proposal to make their system of viral load testing available to the rest of the Region, the UWI-initiated Caribbean Health Leadership Initiative, and the development of a workplace programme in education and training.
Caribbean Regional Strategic Framework
The new Caribbean Regional Strategic Framework (CRSF) on HIV and AIDS, 2008–2012 has been adopted formally by the Eighth Annual General Meeting. This followed the earlier endorsement by the Caucus of Ministers of Health of the Caribbean held in Washington D.C. in September 2008. The goals of the new CRSF are:
(i) To reduce the numbers of new HIV infections by 25%
(ii) To reduce the number of deaths from AIDS by 25%
(iii) To reduce the impact of HIV and AIDS on households by 25%
The priority areas to be addressed are:
(i) Creating an enabling environment to advance Universal Access
(ii) Strengthening multi-sectoral response.
(iv) Care, treatment, support
(v) Capacity building
(vi) Monitoring, evaluation, research
The cost of implementing the CRSF is US$60M and development parties were encouraged to commit to providing financial support.
The meeting discussed the timing of operationalizing the CRSF and the strategies for mobilizing and harmonizing donor resourcing of the CRSF. The meeting also discussed the merits of making human rights an additional priority area to the six that have already been highlighted in the framework.
The meeting was informed that no single entity could sufficiently undertake resourcing of the CRSF and that there was a harmonization committee that was reviewing the harmonization of donor resources. The meeting was also informed that human rights was a cross cutting issue and was specifically addressed in priority area one and therefore did not need to be a separate priority area.
Technical update on new developments in the field of HIV and AIDS
The meeting discussed the new developments in the areas of prevention, care and treatment, especially the failures of vaccines and microbicides to prevent the transmission of HIV infection. The meeting also discussed the results of recent trials that male circumcision in high prevalence settings significantly reduces the chance of men acquiring HIV infection. Additionally, the meeting discussed the evidence that combination prevention, such as ensuring safe blood supply; expanding voluntary counselling and testing; promoting behaviour change; ensuring access to prevention commodities and services, works. The meeting also discussed the impact of new antiretroviral therapies on improving health of persons living with HIV and AIDS by as much as two decades.
The meeting reaffirmed the need to focus on the tried and proven means of prevention, especially focusing on a combination of methods, as no one method by itself is effective.
Current status of HIV and AIDS in the Caribbean
The Caribbean has the second highest HIV prevalence rate in the world after sub-Saharan Africa. An estimated 230,000 persons in the Caribbean are living with HIV and AIDS, which is one of the leading causes of death among persons in the 25-44 age group.
The HIV epidemic in the Caribbean is due mainly to heterosexual transmission, although transmission occurs through homo/bisexual intercourse, mother-to-child and injecting drug use.
The epidemic in the Caribbean can be described as “ generalized”. However, during recent times, some countries in the region namely Haiti, Dominican Republic, The Bahamas and Barbados have recorded significant declines in HIV rates among antenatal attendees. In sub-populations such as men who have sex with men (MSM), and commercial sex workers (CSW), HIV infection rates are disturbingly high.
The Caribbean has responded to the epidemic at the regional level as well as the national level. At the regional level the Heads of Government established the Pan Caribbean Partnership against HIV and AIDS to lead the regional HIV and AIDS response. The CRSF was developed and significant funds raised to support the regional response. Country level responses have realized some success. For example, there have been gains in reducing HIV transmission from mothers to their babies; there is dramatic decline in mortality and morbidity; HIV testing and counselling are widely available; and high level of awareness and condom use has increased.
Despite the tremendous achievements, sexual patterns in the Caribbean contribute to the continued spread of HIV. Many persons are at increased risk of infection due to social vulnerability arising from poverty, illiteracy, unemployment, gender inequity and sexual orientation. The Caribbean response to HIV has also been challenged by the lack of technical capacity to manage HIV programmes and deliver high quality prevention programmes to vulnerable populations and young people. Another major challenge is identifying the many persons infected with HIV who are unaware of their status. The absence of an enabling environment creates serious problems for persons who are HIV positive and in need of services.
As a region, controlling the spread of HIV requires greater emphasis on prevention. This strategy can be facilitated by more enlightened policies. There is need to: Expand HIV testing; educate of in and out of school youths; promote positive images; promote prevention options such as abstinence, condoms (male and female), fidelity, voluntary counselling and testing, and behaviour change communication.
Meeting of Ministers of Health and Education
to Stop HIV and STIs in Latin America and the Caribbean
A report on the first meeting of Ministers of Health and Education of Latin America and the Caribbean on HIV and AIDS in Mexico in July was presented to the AGM. The Mexico meeting involved 33 countries, of which thirteen (13) CARICOM Countries were represented by 13 Ministers of Health and 10 Ministers of Education. The Declaration on Prevention of HIV through Education that resulted included several actionable recommendations. Among them were nine (9) key goals to meet sexual and reproductive health needs.
The meeting agreed that there was need for follow up by the Council for Human and Social Development (COHSOD) to establish a CARICOM position on prevention of HIV through education, taking into consideration the Declaration of Port of Spain, accelerating the response of the education sector to HIV and Aids in the Caribbean Region (June 2006).
Use of Virtual Reality to impact on Stigma and Discrimination
In a special session on the use of new technology as enabling communication, the Meeting benefited from a presentation on how the Community proposed for consideration, the use of virtual reality simulation in developing awareness of stigma and discrimination and collecting data on levels of discrimination.
The immersion techniques of Virtual Reality can provide for the eliciting of psycho-social data for vulnerable groups and for the management of experiences to impact stigma and discrimination.
Since the challenge with stigma and discrimination is to put policy makers, service providers, and service users in the same psychosocial space, Virtual Reality provides that opportunity and then allows these players to reflect, react and adjust their action within their sphere of authority.
The Caribbean in moving forward with this can have opportunity to effect change in a world class problem
Updates: Recent Innovations in the Field of HIV And AIDS in the Caribbean
During the past year, there have been several very innovative HIV and AIDS-related interventions in areas of policy and programme development, service delivery and reaching difficult populations. Four of those areas addressed are:
(i) Strengthening the Community of PLHIV in the Caribbean
(ii) Caribbean Media Broadcast Partnership at a Glance
(iii) Education and HIV and AIDS in the Caribbean
(iv) Engaging the Informal Economy in an HIV Response.
Strengthening the Community of PLHIV in the Caribbean
Among the key issues highlighted in this presentation were:
- The skills building workshops/sensitization seminars provided to PLHIV to treat with the epidemic, by the Caribbean Regional Network of People Living with HIV/AIDS, a regional civil society organization established in July 2005
- The GIPA principle contributed to the overall success of the CRN+ Global Fund project and specifically highlighted the targets achieved.
- Projects focusing on personal development and micro-entrepreneurial skills of PLHIV should be promoted to contribute to implementation of the GIPA principle.
- There is a continuing challenge to expand the programme to other overseas countries and territories.
Caribbean Broadcast Media Partnership (CBMP)
June 27 2009 is designated as Regional Testing Day in an effort to accelerate prevention efforts.
The CBMP, since its establishment, has launched several innovative campaigns to scale up prevention in the region utilizing the broadcast media. The campaigns have demonstrated a collaborative effort by all sectors of society to publicise the message about HIV and AIDS. Simultaneous to the campaigns the CBMP has been undertaking skills-building seminars for staff on HIV/AIDS, and advocacy efforts which were effective in promoting these campaigns.
- The launch of the popular Live Up campaign: love, protect and respect each other which was aimed at encouraging personal and individual responsibility, and provided messages of hope and personal action. The live up campaign was extended through celebrities.
- Meetings, bulletins, newsletters were part of the advocacy efforts.
- In just under two years the membership swelled to 82 in 25 countries.
- Financial and technical support for the global media initiative will enable the expansion of the programmes across the Region.
- There are small project awards which will be localized to address specific peculiarities in countries.
- Other effective partnering efforts included the SMS campaign through CCNAPC and Digicel, and strategic Alliance with Scotiabank and PANCAP. There is also collaboration with the NAPS and Ministries of Health.
- The effectiveness of the campaign is measured through an annual executive survey. Statistics provided by CHRC, for example, will be very critical in the campaigns. Steps have been taken to take public surveys to access the effectiveness of the campaign.
Several issues were highlighted as steps to improving and sustaining the work of the CBMP
- There is need for a symposium with a technical group
- The need for the development of tools in an effort to review the strategies for BCC
- Need to design campaigns – learning the lessons that have emerged from campaigns
- Media impact is also another aspect and there is need to examine the virtues of imbedded images
- The virtue of Edutainment as a way of reaching people
- Opportunities to create synergies on target events, for example, the friendly spaces that would include and attract the younger population who would be enticed into certain behaviour patterns
- The image of the artist is also another issue, hence the need for a Summit of DJ’s given their influence and the further proposal that it be kept in juxtaposition with the AGM.
- In assessing the programme, one of the factors contributing to the successful activities in a short space of time is funding.
- Need to attract funding and TA for the programme. Dr. Leacock to develop funding strategies to make the I&C Component effective.
Education and HIV and AIDS in the Caribbean
This initiative is seen as a means of Information, education and raising awareness. The presentation highlighted several issues which were seen as effective in addressing the HIV and AIDS pandemic.
- Education is one of the ways to address young people on the risks of HIV and AIDS. It is in effect a social vaccine.
- Surveys have shown that while many people know about HIV and AIDS, young people are not quite sensitized. Hence the need for more information to influence behaviour.
- Challenges include overburdened systems, insufficient financial and human resource capacity including lack of collaboration between key health sector entities.
- Enhanced partnerships has been identified as one of the areas to address HIV and AIDS education and the need for further examination by the region of this observation.
- UNESCO’s partnership with the World Bank, the Partnership for Child Development (PCD) and the Education Development Centre (EDC) was aimed at providing better quality support to governments and policy makers in the area, which has resulted in the development of a costed National Education Sector Strategic Plan for HIV and AIDS in some territories (Jamaica and Guyana).
- There is need for greater alliance with other partners to achieve the goals of the CRSF by 2012
- There is need for in-country leadership to drive the response; the education sector to work within the national response and the involvement of stakeholders from the inception.
- The presence of a HIV and AIDS coordinator in the Education sector is relevant to accelerate the HIV and AIDS agenda
- There is also need for coordinated international support and clear sector policies and plans to attract/negotiate resources.
Engaging the Informal Economy in an HIV Response
The recent innovations in this area illustrated several important issues:
- A significant portion of the economically active people is in the Caribbean is in the informal economy ranging from 7% in some smaller states to 50% in the larger states.
- The characteristics of the group of workers in the informal economy precludes them from having any clear legislation and protection mechanism making them more susceptible to HIV;
- The enactment of a BCC programme as a prevention mechanism targeting hairdressers and barbers was one creative approach to engage these groups in a workplace response to HIV and AIDS
- Need for HIV education and response in Informal Economy operations
- Informal Economy work environment challenging for initiating a response
- Developing a mechanism to engage the IE actors in an HIV response.
- Multiple partnering with other agencies is necessary
VENUE OF NEXT MEETING
The Ninth Annual General Meeting will be held in October 2009, in Grenada.