January 31, 2014
Initiative to sustain Caribbean HIV responses underway

Government representatives from the Health and Finance Ministries of eight Caribbean countries joined civil society and international development partners in Gros Islet, St. Lucia last week for two days of deliberations on securing a sustainable future for their HIV responses. The meeting was hosted by the Joint United Nations Programme on HIV/AIDS (UNAIDS) Caribbean Regional Support Team and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).{{more}}

Antigua and Barbuda, the Bahamas, Dominica, Grenada, St. Kitts and Nevis, St Lucia, St Vincent and the Grenadines and Suriname were represented. Last year another group of eight countries from the region met in Kingston, Jamaica to brainstorm viable approaches for financing the AIDS response. Of these, six have appointed dedicated teams and begun work on country-specific sustainability planning.

At present about two-thirds of HIV investments in the region as a whole come from international donors. However, a very different funding context is emerging. This is partly due to the economic classification of many Caribbean countries as Upper Middle Income by the World Bank, notwithstanding many economies’ high debt burdens. Another factor is the global economic slowdown.

The response to the HIV pandemic has benefitted from unprecedented political and financial support from development partners, but this support is waning as competing development priorities arise. The region must move quickly to increase the effectiveness and efficiency of HIV programming, increase domestic investments and make the case for sustained global partnerships.

During the ceremony, UNAIDS Caribbean Regional Support Team Investment and Efficiency Adviser, Melissa Sobers, acknowledged advances in the region’s AIDS responses such as lowering new infections and AIDS-related deaths and increasing access to life-saving treatment for people living with HIV. She emphasized, however, that investing in HIV is a long term commitment.

“We cannot leave the treatment and quality of life of people living with HIV to chance. Neither can we compromise our efforts to prevent new HIV infections. It is critical that we make evidence-based decisions now about results and resources,” Sobers said.

The UNAIDS Investment Framework offers a paradigm for prioritizing the most effective and needed programmes and allocating resources optimally. It helps countries develop targeted plans for increasing efficiencies, eliminating waste and sustaining the AIDS response.

US Ambassador to Barbados and the Eastern Caribbean, Larry L Palmer, revealed that PEPFAR plans to conduct expenditure analyses on prevention, care and treatment programmes in several Caribbean countries. This effort will be expanded in 2014 and 2015.

“Results will be used to improve national programme planning. This includes making rapid course corrections, improving planning and effectiveness, and avoiding inefficient use of resources,” Palmer said.

St Lucian Health Minister, Alvina Reynolds, pointed to the island’s strong foundation for sustainability planning. Antiretroviral drugs in St Lucia are bought through a sub-regional procurement mechanism, with lower prices negotiated through the Clinton Health Access Initiative. Also, the National Strategic Plan for Health includes a mandate to develop a more decentralised service delivery model and ensure health care services are financially sustainable.

“But even as we increase domestic investments and efficiencies, we need the continued support of international partners,” Reynolds stressed.

The meeting’s planned outcomes include country-specific technical support plans and roadmaps to improve the strategic allocation of HIV resources.