Transcript Slide 1

ENHANCING COUNTRY
OWNERSHIP:
AN ANALYTICAL REVIEW OF COUNTRY
HIV PROGRAMMES
Dr. Morris Edwards: Head, Strategy and Resourcing Division, PCU
Dr. Ingrid Cox Pierre: Strategy and Resourcing Officer, Care, Treatment and
Support
Focus of Presentation
 Role of the PANCAP Coordinating unit in
achievement of the goals of Caribbean Regional
Strategic Framework (CRSF) 2008 – 2012
 Analysis of country needs for achieving
these goals.
 Challenges encountered in the process
Background
Vision of the Caribbean Regional Strategic
Framework (CRSF) 2008 - 2012
“Substantially reduce the spread and impact of
HIV in the Caribbean through sustainable systems
of universal access to HIV prevention, treatment,
care, and support”.
Assigned roles PANCAP Coordinating
Unit (PCU)
 Coordination of regional response
 Resource mobilization
 Advocacy
PANCAP 10th AGM identified critical areas
for emphasis to achieve the goals of the CRSF.
 Reduction of new HIV infections by 50%.
 Elimination of mother to child transmission of HIV.
 Increased access to treatment by 80%.
 Accelerate the agenda to achieve human rights for PLHIV
including the elimination of travel restrictions for PLHIV.
 Elimination of travel restrictions for PLHIV.
For the PCU to effectively perform its role,
it must be able to collect information at
country level and from partners on:
 Ongoing initiatives
 Available resources
 Gaps in implementation of national
strategies
Activities conducted by PCU to support its
functions
 Development of the PANCAP Biennial
Operational Plan (PBOP)
 Country assessments to ascertain implementation
gaps in their NSP
 Convening a Partners meeting and development
of an implementation matrix of ongoing activities
in countries by partners
Activities conducted by PCU to support its
functions……..
 Establishment of a lab partners working group
 Review of financial resources available at country
level for implementation of NSP and their
contribution to the achievement of the Tenth AGM
targets.
Resource mobilization by PCU
 Estimated (under estimate) US$58 M required
for implementation of the CRSF.
 The PCU has mobilized approximately US$47 M
of this estimate
 However priority areas of prevention and
treatment and care have secured resources in
excess of that budgeted for by the CRSF
COMPARATIVE ANALYSIS OF FINANCIAL SUPPORT TO THE CRSF 2008-2012
PRIORITY AREA
CRSF ESTIMATED FUNDING
NEEDS (US$)
(CRSF)
PA1
6,337,300
2,951,189
3,386,111
PA2
9,156,900
912,208
8,244,692
PA3
11,287,600
25,573,778
-14,286,178
PA4
2,000,000
3,467,415
-1,467,415
PA5
9,208,050
4,126,858
5,081,192
PA6
7,730,000
4,250,203
3,479,797
8,027,360
6,343,344
1,684,016
Coordinating
Monitoring
Bodies
SECURED FUNDING
(CRSF)
&
IEC
Strategy
supporting CRSF 2,000,000
2,000,000
Contingency (5%) 2,787,360
2,787,360
Total
58,534,570
47,624,995
10,909,575
Source: Progress Report and Financial Analysis of Implementation of the CRSF for 17th Executive Board Meeting
GAP
Inadequacy of resource mobilization efforts
Although secured funds are in excess of that budgeted for
in these two areas, regional reports have identified that:
 Some areas in prevention, especially interventions
with MARPS (other than MSM and CSWs) and
PMTCT are critical areas or gaps in the
response.
 The area of treatment and care is inadequately supplied as
many countries are below the required coverage for
persons who require ARVs
Inadequacy of resource mobilization…….
 This emphasizes the importance of
information to guide the resource
mobilization process and focus efforts
where needed
Country Analysis Methodology
1. Available country NSPs were evaluated for
alignment with the CRSF
2. Country assessments were conducted from 2010
to 2011 looking at gaps in implementation of
country NSPs or implementation plans
The reports were presented at prior meetings and to
the PACC
Country Analysis Methodology…..
3.
A financial review of allocated resources at country
level in relation to the tenth AGM targets
 Template designed to collect information on areas of
focus under the individual 10th AGM targets noting:

Area of strategic focus

Source of funding (whether govt. or donor)

Specific area funded e.g prevention programmes for MARPS

Budget allocated

Timeframe of support

Identified gaps in the response and associated funding
Results
9 countries responded:
 Antigua and Barbuda
 Dominica
 Jamaica
 Suriname
 Belize
 St. Kitts and Nevis
 Montserrat
 Tortola
 Trinidad and Tobago
Results…..
 Countries are at different stages in reaching the 2015
targets.
 Main issue is sustainable funding, especially of
commodities such as ARVs.
 Funding in most of the reporting countries is still
largely supported by donor agencies.
Results…..
 The areas highlighted as deficient in the funding of
the CRSF correspond closely to those that are being
reported in countries.
 There is the need to include stigma and
discrimination in the area of human rights
 There is a need for targeted prevention interventions
especially for groups such as youth, with critical
focus on minors because of early sexual debut.
Prevention Targets
AB
Bze
Strategic information
related to prevention
efforts especially MARPs
X
X
Models for development of
prevention strategies
especially in MARPs
X
Prevention Target Gaps
Support to HFLE
programme for
sustainability and
technical assistance (TA)
for expansion of education
sector response
Expansion of STI services
and integration into
existing services e.g PHC
X
Dom
Jam
Mon
X
X
X
X
Sur
Tor
SKN
X
X
X
X
X
X
X
X
X
X
TT
X
X
Prevention Target Gaps
AB
Bze
BCC especially with
reference to a
communication
strategy for the target
groups and programme
planning
Support for expansion
of testing sites
including test kits and
training of providers
Programmes for drug
users and interventions
for incarcerated youth
and inmates.
Dom
Jam
Mon
X
X
X
Sur
Tor
SKN
TT
X
X
X
X
X
X
Prevention Target Gaps
AB
Bze
Prevention interventions
in youth such as SRH
interventions for parents,
support for adolescent
PLHIV, comprehensive
programmes to respond
to sexually active minors
in the school setting
Dom
Jam
Mon
Sur
X
Tor
SKN
X
Development of gender
based interventions
X
X
X
Prevention in positives
X
X
X
TT
Prevention Target
Gaps
Strengthening the
NGO,CBO and CSO
contribution to the
prevention response
Strengthening
universal access to
social support services
for PLHIVs
Legislation and
policies related to
testing of minors.
AB Bze
Dom
Jam Mon Sur
Tor
SKN
TT
X
X
X
Elimination Target
Elimination target
Many countries did not outline deficiency in
funding in this area however regional data
available shows that the coverage is not
optimal
Elimination Target
Gaps
Elimination
Target
Gaps
Drugs for PMTCT
Drugs for PMTCT
Financial resources for
Financial
resources
for
procurement
of testing
procurement of testing supplies,
supplies, testing at least
testing at least twice during
twice
during pregnancy
pregnancy and partner testing
and partner testing
AB
AB Bze
BzeDom
Do Jam
Jam Mon
MonSur
Sur Tor
Tor SKN
SK TT
T
m
N
T
X
X
X
X
X
X
X
X
X
X
X
Programmes to improve
Programmes
to improve
adherence to PMTCT
drugs by
adherence
to PMTCT drugs
Positive mothers
X
X
X
by
Positive
Follow
up of mothers
exposed infants
Follow
up into
of exposed
Integration
MCH
infants
programmes
X
Integration
Surveillance into MCH
programmes
XX
Surveillance
X
X
X
X
X
Treatment and Care Target
Treatment & Care Target Gaps
AB
Diagnosis and treatment
of Opportunistic
infections (OI).
X
Bze
Dom
Jam
Mon
Sur
X
X
Laboratory tests for
monitoring ARV treatment
Research on drug
resistance
SKN TT
X
Strategies including
policies for integration of
HIV/STI care into existing
services
Sustainability of treatment X
Tor
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Treatment & Care Target Gaps
Social support programmes
for adolescent, orphans and
children living with HIV
AB
Bze
Dom
X
Jam
Mon
Sur
Tor
X
Capacity building in
forecasting for procurement
of ARV drugs to prevent
stock outs
Capacity building in
laboratory surveillance,
internal quality control
documentation and
implementation, external
quality assurance
SKN TT
X
X
X
X
Human Rights
Target
Human Rights Target Gaps
Funding for expansion of
initiatives: development of
polices and legislation as well
as advocacy
Development of a framework
and policies to encourage
support and empowerment of
PLHIVs
Capacity building for
monitoring and advocacy of the
policy and legislative arena
Training of CSOs, NGOs etc
and other partners within the
multi-sectoral response in
advocacy
AB
Bze
Dom
Jam
X
X
X
X
Mon
Sur
Tor
SKN
X
X
X
TT
X
X
X
X
Jam
Mon
Capacity building for
redress mechanisms
X
X
Sensitization of health
care workers
X
Development of sector
wide change agents
X
Human Rights Target Gaps
Gender agenda with focus
on gender violence related
to women and sexual
orientation
AB
Bze
Dom
X
Sur
X
Tor
SKN TT
Human Rights Target Gaps
Removal of punitive laws
related to same sex relationships
Research related to S&D
AB
Bze
Dom
Jam
Mon
Sur
Tor
SKN
TT
X
X
Advocacy to include developed
policies in the legislative
agenda
X
Capacity building of
administrative and financial
abilities is essential to improve
the effectiveness of their
advocacy agenda.
X
M&E reporting and
management capacity of CSOs
X
Challenges
Challenges
Main challenges encountered in gathering the data were:
 Regional level:
 Difficulty in getting the required data from regional partners and
donor agencies.
 National level
 Poor response from member countries possibly due to:
– Competing interests: Harmonization of donor efforts at country
level is needed
– Unavailability of data or information needed at country level
THE MEETING is invited to:
(i)Advise on mechanisms to overcome the
challenges with information sharing; and
(ii) Agree on the strategic objectives, regional
public goods and services and activities to be
included in the Biennial Operational Plan,
2012-2013