Dr. Brian Armour Trinidad and Tobago

2004: International Best Practice Governance Structure (UNAIDS)  14 February 2001: close to 10 yrs PANCAP  62 members: Caribbean (English, Dutch, French)  Achievements ◦ Regional Coordination; Policies; Goods and Services; ◦ Prevention, Care and Treatment Initiatives ◦ Resource Mobilization ◦ Advocacy Initiatives

CRSF: Eg: Trinidad and Tobago Country ◦ MoH: RCM (seat roster); ◦ MoH & NACC: AGM Civil Society Organizations: ◦ CRN+, CCC Regional Institutions ◦ HEU, CHRC, PHCO, TTHTC (CHART), UN agencies

PANCAP Regional vs Country Impact  Model Codes of Practice ◦ Psycho-social practitioners in HIV and AIDS care ◦ HIV and AIDS for Caribbean Medical Practitioners  Model Policies ◦ Condom ◦ Workplace

PANCAP/National : Policy awareness National: Legislative agenda  Has policy and codes of practice been enough? ◦ Access: Prevention/Treatment  Emancipated Minors  Vulnerable populations ◦ Information:  Sex/condom education in schools ◦ PLHIV  Person: Anti Stigma & Discrimination  Patient (Public Health) : Rights vs Responsibilities

Partnership & Coalition Actual  Anti-Stigma and Discrimination Toolkits  Caribbean HIV and AIDS- related Studies*  PANCAP Regional Stigma Unit (2009)  Pan Caribbean Business Coalition (2005) Future expansion  Potential for country impact  Potential to conduct in new territories  Stigma epidemic: Leadership (CARICOM, National)  Regional Business Franchises with national chains

Direct Interventions: PANCAP; RSA (PAHO, CHART)  ART coverage (guidelines)  Healthcare worker sensitization  Pipeline (clinical care)  Laboratory HIV diagnostics (CD4, viral load, DNA-PCR, HIV DR)  PMTCT  Mini Grants & Life Skills

PANCAP governance  Preserve country gains  Embrace new opportunities for regional coordination ◦ Elimination initiative (PMTCT) ◦ PEPFAR (laboratory accreditation; quality management; equipment and resources) ◦ Decentralization and integration of services (larger territories)

 Oct 2009:US$46.74M  Global Fund US $34.7M  Support (inc. governance)  Prevention and Control  Response Scale Up  Prevention and Rep. Health  Coordination and Harmonization

 Ensure resources reaches epidemic (HIV prevalence rates of larger territories)  Consider resource mobilization for territories in specific national programs OR

◦ Requiring recipient RSA to indicate for national recipient territories  Inclusion and exclusion criteria to select/not select  funding streams  resource allocations  disaggregate by territory in RSA performance progress reports Validated by National Authorities (Health/NACC/CCM) and discussed at RCM, AGM of PANCAP

 Many and Varied including ◦ Cheaper ARV ◦ Human Resource Development ◦ Technical Assistance ◦ Universal Access  Future Advocacy ◦ Cheaper HIV reagent kits (heat stable) ◦ Infectious Disease; Public Health; M&E; IT ◦ Caribbean Technical Support Facility ◦ Millennium Development Goal (#6)

 Regional Coordination: best practice for territories’ involvement  Regional Policies good but increased national awareness policy drives and advocacy for national legislative agendas  Regional Goods and Services: ◦ redirect to new territories with respect to research, leadership stigma sensitization ◦ business franchises with national chains having great promise

 In direct intervention programs, endorsement of new regional initiatives (eg elimination initiative, lab strengthening through PEPFAR)  Resource mobilization can be considered for direct toward specific national programs.  RSA to PANCAP to account for country resource allocation that must be validated by recipient territories