Progress of implementation of the Caribbean Regional Strategic Framework Morris Edwards Head, Strategy & Resourcing Division Pancap Coordinating Unit

Context What are we trying to achieve? How are we trying to achieve it? How will we measure achievements?

Context What Universal access to prevention, care, treatment and support in Caribbean countries How Creating an enabling environment that fosters universal access Supporting an expanded and coordinated multisectoral response Preventing transmission of HIV to the uninfected Providing treatment, care and support to those in need Building capacity for HIV/AIDS services Conducting monitoring, evaluation and research

How to measure Activity/Output – Delivery of 39 Regional Public Goods & Services Outcome – Changes in 19 Core Caribbean Indicators Impact – Reducing new infections by 25% – Reducing mortality by 25% – Reducing socioeconomic impact by 25%

Achievements PA1 Regional Model Policy on Stigma and Discrimination Model HIV anti-stigma legislation Operational Regional Stigma & Discrimination Unit (RSDU) Implementation of regional project to improve access of migrants to HIV services Conduct of socioeconomic impact studies

Achievements PA2 Analysis of 19 country NSP needs and provision of support for development of some NSPs & IPs Approval & adoption of model policy for education sector Support to the PCBC to engender more private sector involvement in the regional response Support through GFATM Grant – Development of PLHIV & MARP networks – Capacity building of NGOs, CBOs, FBOs – Ongoing implementation of HLFE policies & programmes

% of schools implementing HFLE by country

Achievements and Gaps PA3 Achievements Established & supported PMTCT programmes in all countries SRH and Condom Social Marketing programmes in 13 countries targeting youths & MARPs. Gaps Research to support development of interventions to address MARPs. Addressing MARPs. Positive prevention methodologies for PLHIV Sharing of best practices for prevention & promotion strategies. Addressing STIs.

% of pregnant women on Art by country

Ability to correctly identify modes of transmission and dispel myths

Multiple partner and condom use by country COUNTRYM WITH > 1 PARTNER PAST YR F WITH > 1 PARTNER PAST YR CONDOM USE (M) WITH > 1 PARTNER CONDOM USE (F) >1 PARTNER ANTIGUA2%87% BAHAMAS25%41% GUYANA10%1%65%48% HAITI23%2%42%26% JAMAICA62%1%65%52%

Condom use amongst FSW & MSM

Achievements and Gaps PA4 Achievements Curriculum development for training health care providers Training of health care providers Development and distribution of regional guidelines on TB/HIV care Gaps Research Referral mechanisms to social services

% of adults and children with advanced HIV infection receiving treatment

Patients on ART who are alive after 12 months

Achievements and Gaps PA5 Achievements Significant numbers trained in HIV prevention, care, treatment and support, leadership development. Strengthening laboratory systems Strengthening pooled procurement Human resource development in all pre- service training programmes

Achievements and Gaps PA6 Providing support to develop & implement M&E plans Research

Conclusions Moderate but steady progress in implementation of CRSF, especially in the delivery of RPGS. – Achievements in 66% of RPGS – Gaps in 33% Prevention remains the area of most concern. Challenges with measuring outcomes Lots more to be done