 Hon Terrence Deyalsingh, Minister of Health, Republic of Trinidad and Tobago (CARICOM Secretariat, Turkeyen, Greater Georgetown, Guyana) 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, concluded the Sixth Meeting of National AIDS Programme (NAP) Managers and Key Partners in the Republic of Trinidad and Tobago on Wednesday, 14 March 2018. The meeting came two years ahead of the 2020 deadline for reaching the 90-90-90 targets—90% of people living with HIV diagnosed, 90% of diagnosed people on treatment and 90% of those on treatment virally suppressed.
The forum opened on Monday March 12 with a Feature Address by the Honourable Terrence Deyalsingh, Minister of Health, Republic of Trinidad and Tobago. Minister Deyalsingh noted that in light of reduced technical and financial support from international partners, the region must collectively mobilize domestic resources especially for the support of prevention and the elimination of HIV-related stigma and discrimination among key and vulnerable populations.
These sentiments were echoed by the participants including National AIDS Programme (NAP) Managers, Chief Medical Officers, Permanent Secretaries, development, and implementing partners, including civil society organizations that work with people living with HIV and key population groups and youth.
In closing remarks, Dr. Nikkiah Forbes, Director, National HIV/AIDS and Infectious Diseases Programme at the Bahamas Ministry of Health, proposed integration of HIV care into other healthcare services in order to assure sustainability of the HIV response. She highlighted that participants recognized integration as one potential solution for improving the accessibility of health services and suggested that it could help countries meet the demand for increased HIV-related treatment, care and support services in the context of scaling up to “Treat All”. (“Treat All” involves offering treatment to all people diagnosed with HIV regardless of CD4 count.)
“Caribbean countries are diverse and integration will need to be tailored for each country context,” stated Dr Forbes, “HIV should never have been completely separated from the health agenda and synergies need to be fostered with sexual reproductive health services”.
She further stated that integration requires healthcare worker training on “Treat All” as well as the meaningful and sustained involvement of Civil Society Organizations (CSOs). For example, there should be leadership and inclusion of People Living with HIV (PLHIV) and key populations on the prevention, treatment and care needs of their communities. Dr. Forbes noted that there should be a focus on quality of care, with steps taken to ensure that members of key populations can access sexual and reproductive health services including HIV and AIDS prevention.
She posited that to achieve integration the region should conduct south-to-south collaborations and draw on regional expertise for training healthcare workers on the front-line response.
Dr Forbes emphasized the integral role of civil society organizations, “CSOs we have not forgotten you”, she stated. “You must be placed and supported in the planning and implementation process which only strengthens the argument for the need for social contracting and crystalizing this in policy. This is how we will sustain the regional response”.
She concluded with an urgent plea for heightened government involvement in funding the HIV response. She advocated that governments need to own the HIV response and in owning it, they need to make the investments needed to reach the prevention, testing and treatment targets that will set the region on course to end AIDS by 2030.
“I make a respectful but urgent plea to our governments to commit to, as well as finance, their National and Regional AIDS response”, stated Dr Forbes. “Without an urgent strategy to sustain the response we risk leaving many vulnerable groups behind and undoing the gains we have made in reducing HIV transmission”.
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