1. Dr. Brian Armour Trinidad and Tobago

2. 2004: International Best Practice Governance Structure (UNAIDS)  14 February 2001: close to 10 yrs PANCAP  62 members: Caribbean (English, Dutch, French)  Achievements ◦ Regional Coordination; ◦ Regional Policies; ◦ Regional Goods and Services; ◦ Care and Treatment Initiatives; ◦ Prevention; ◦ Resource Mobilization ◦ Advocacy Initiatives.

3. CRSF: 2008-2012 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

4. PANCAP Regional vs Country Impact PANCAP/National : Policy awareness National: Legislative agenda  Model Codes of Practice ◦ Psycho-social practitioners in HIV and AIDS care ◦ HIV and AIDS for Caribbean Medical Practitioners  Model Policies ◦ Condom ◦ Workplace  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 (eg Confidentiality vs Disclosure

5. 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

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

7.  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

8.  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  Inclusion and exclusion criteria to select/not select  funding streams to  resource allocations to territories in RSA performance progress reports, validated by National Authorities (Health/NACC/CCM) and discussed at RCM, AGM of PANCAP

9.  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)

10.  Regional Coordination: best practice for territories’ involvement  Regional Policies good but increased national impact can come from awareness drives to national policy makers and advocacy to national legislators for national legislative agendas +/- debates/referendums for community buy in  Regional Goods and Services can have room for redirect to new territories with respect to research, leadership stigma sensitization and business franchises with national chains having great promise

11.  In direct intervention programs, endorsement of new regional initiatives already in focus among countries (eg elimination initiative, lab strengthening through PEPFAR) can be the remit of PANCAP to be an independent assessor and advocate for territories to ensure program effectiveness  Resource mobilization can be considered for direct toward specific national programs. Alternatively management accountability of RSA to PANCAP to ensure country resource allocation that must be validated by recipient territories

12.  Advocacy has had national impact gains and new areas to continue future impact suggested for consideration