1. 1 The UN Perspective UNAIDS Trinidad & Tobago Tenth PANCAP Annual General Meeting, November 2, 2010 The AIDS Response in the Post-Earthquake Reconstruction of Haiti

2. 2 Coordination Issues Fragmentation of the HIV response, multiple bodies (UN, NGO-forum, donors) working autonomously, insufficient dialogue. National AIDS Programme lacking necessary leverage to ensure a multisectoral approach. Primarily vertical response with insufficient sustained and coordinated planning, and accountability. CCM is the only mechanism for dialogue and coordination, with lack of inclusiveness, under representation of vulnerable populations, and too health oriented On-going transition of the GFATM-PR (from a private foundation to UNDP) has further weakened the coordination.

3. 3 HIV and the Humanitarian Response HIV/AIDS interventions inadequately integrated in relevant strategies for reconstruction in the three affected departments. Room for addressing HIV in the expanded response and recovery phase in an environment of competing priorities in the reconstruction process, Food and nutritional support provided to PLHIV receiving treatment Increase in gender based violence in the camps. Significant increase in reported pregnancy rates in the camps indicating high levels of unprotected sex and limited access to PMTCT services. Specific vulnerability of women and girls, young children and other marginalized groups, discrimination of PLHIV and exclusion in recovery activities, stigma on LGBTI groups and lack of services, especially in un- managed camps (70% of the total), in a context of insecurity and violence.

4. 4 Challenges for the Future of the AIDS Response Weakened capacity of Health system to deliver services, verticalized programme Multiplicity of NGO response, with support from international donors AIDS response primarily from health sector (treatment, care and support), with limited involvement of non-health sectors and no national entity for coordination. Prevention programmes insufficiently funded, fragmented and not targeting the groups of population that are most at risk and/or most vulnerable. Challenges in sustaining AIDS response, mostly externally funded, and donors shifting their interventions to using HIV funds for health system strengthening Some of the very vulnerable populations are at much greater risk of HIV infection after the earthquake: adolescents and youths, children and adults involved in sex work, MSM and transgender, children victims of human trafficking.

5. 5 Way Forward for better Coordination CCM should strengthen its Secretariat, and facilitate better representation particularly of vulnerable groups National AIDS Commission to be established Interim commission to be set up immediately with representation of different constituencies of partners and Departmental level representation; The role of the line ministries to be clearly defined for a multisectoral response coordinated by the NAC; Composition and efficiency of the CCM to be strengthened, in the challenging context of Global Fund round7 implementation; Regional support is necessary. A PANCAP Ministerial level support mission to the country to share experiences and improve support to the country response through regional public goods, would be welcomed.

6. 6 Recommendations for HIV in the Humanitarian Response Training needed on linking humanitarian HIV action to the reconstruction of the longer-term national AIDS response in Haiti, strengthening an integrated HIV response and building capacity; Ensure that programmes are in place to strengthen HIV prevention for vulnerable groups such as young girls and marginalized groups in camps Design a data collection system and collect data and other relevant information, on impact of the disaster on vulnerable groups and on PLHIV

7. 7 Way Forward for the Future of the AIDS Response Conduct an assessment of the health sector response to HIV with support from PAHO/WHO PANCAP to provide support on how HIV can strengthen the health system and and for de-verticalization of the HIV program; Given the increased risk of HIV infection among highly vulnerable groups, a specific combination HIV prevention approach should focus on structural interventions, with possible support from GF R9; Better strategic information should be produced shared and used in a coordinated fashion with support from and in conjunction with regional initiatives Preparing Haiti for the future financing of the HIV/AIDS response would also be an important task for the UN and regional partners