1. CAREC HIV/AIDS/STI PROGRAMMES THE WAY FORWARD Caribbean Epidemiology Centre PAHO/WHO

2. CAREC’s Mission To improve the health status of the Caribbean people by working with and developing member country capacity to implement programs of health promotion and disease prevention based on sound epidemiology, laboratory technology and related public health disciplines

3. Vision Information-based organization generating, providing and using information with a variety of publics, which directly or indirectly improves health of population

4. CAREC at a Glance The Caribbean’s health monitoring and disease prevention agency - 21 countries A PAHO/WHO Centre in the Americas Founded 1975 after outbreaks of polio, typhoid The Caribbean’s health monitoring and disease prevention agency - 21 countries A PAHO/WHO Centre in the Americas Founded 1975 after outbreaks of polio, typhoid

5. CAREC at a Glance Epidemiology & Laboratory Services, Information, Training, Research; Special Programs: Immunisation, STI, Tourism, Health & Resource Conservation Public Health Advocacy; Resource Mobilisation; Quality Assurance US $5 million budget, 120 staff Epidemiology & Laboratory Services, Information, Training, Research; Special Programs: Immunisation, STI, Tourism, Health & Resource Conservation Public Health Advocacy; Resource Mobilisation; Quality Assurance US $5 million budget, 120 staff

6. CAREC Budget by Source of Funding, 1999 ($US) WORLD BANK CIDA QUOTAS $1.73M PAHO/WHO $1.2M NSL IDB CDC WRAIR IDRC NIH FTC GTZ UKDFID

7. Classification of CAREC Member Countries by Population Size TYPEPOP.COUNTRIES Small >250,000 T&T, Jamaica, Barbados, Bahamas, Guyana, Suriname T&T, Jamaica, Barbados, Bahamas, Guyana, Suriname Mini 50,000 - 250,000 Antigua, Grenada, St. Vincent, St. Lucia, Netherlands Antilles, Dominica, Bermuda, Belize, Aruba Antigua, Grenada, St. Vincent, St. Lucia, Netherlands Antilles, Dominica, Bermuda, Belize, Aruba Micro <50,000 St. Kitts, BVI, Cayman Islands, TCI, Anguilla, Montserrat St. Kitts, BVI, Cayman Islands, TCI, Anguilla, Montserrat

8. Changes of Mortality Patterns in CAREC Member Countries 1980 - 1995

9. Caribbean Cooperation in Health Priorities Health Systems Development Human Resource Development Family Health Food & Nutrition Health Systems Development Human Resource Development Family Health Food & Nutrition Chronic Non- Communicable Diseases Communicable Diseases Mental Health Environmental Health

10. Communicable Disease: CCH Sub- Priorities Food & Water Borne Disease Vector Borne Disease Vaccine Preventable Diseases STIs/HIV/AIDS TB Food & Water Borne Disease Vector Borne Disease Vaccine Preventable Diseases STIs/HIV/AIDS TB

11. Estimates of Annual Incidence of AIDS Cases in CMCs 1982 - 1999 - 500 1,000 1,500 2,000 2,500 198219831984198519861987198819891990199119921993199419951996199719981999

12. 5.8% 0.7% 9.6% 35.3% 28.1% 12.9% 7.6% 0% 5% 10% 15% 20% 25% 30% 35% 40% 0-45-1415-2425-3435-4445-5455+ Age Group Distribution of Reported AIDS Cases 1982 - 1998

13. Gender Distribution of Reported Adult AIDS Cases 1982 - 1998 Male 67% Female 33%

14. 3.6% 2% 1.5% 1% 0.99% 0.92% 0.5% 0.3% 0.12% 7.1% 0%1%2%3%4%5%6%7% 8% Guyana (1996) Bahamas (1995) Belize (1996) Jamaica (1998) Barbados (1996) Trinidad & Tobago (1996) Montserrat (1995) Antigua & Barbuda (1998) St. Vincent & Grenadines (1995) Dominica (1997) St. Lucia (1995) Prevalence of HIV among Pregnant Women

15. DFID Prevention and Control of HIV/AIDS and Sexually Transmitted Infections in the Caribbean Department for International Development GOAL: To reduce incidence and impact of HIV/AIDS and contribute towards improving the reproductive health and well being of participating countries CAREC Caribbean Epidemiology Centre &

16. DFID United Kingdom Caribbean Overseas Territories (UKCOT’S) HIV/AIDS Project Department for International Development GOAL: To strengthen capacity of four UKCOTS to manage the prevention and control of HIV/AIDS CAREC Caribbean Epidemiology Centre &

17. DFID Prevention and Control of HIV/AIDS and Sexually Transmitted Infections in the Caribbean Department for International Development OUTPUTS: Improved HIV/AIDS/CSTI case management in selected CMCs Development and implementation of IEC interventions aimed at reaching certain vulnerable groups Improved management of National AIDS Programmes in participating CMCs Implementation of sentinel surveillance for HIV, Syphillis and Hepatitis B in six CMCs CAREC Caribbean Epidemiology Centre &

18. DFID Prevention and Control of HIV/AIDS and Sexually Transmitted Infections in the Caribbean Department for International Development CAREC Caribbean Epidemiology Centre & Upgrade of CATIN at CAREC Major Achievements Acquisition/installation of equipment to enhance database operation and facilitate training in the field

19. DFID Prevention and Control of HIV/AIDS and Sexually Transmitted Infections in the Caribbean Department for International Development CAREC Caribbean Epidemiology Centre & Implementation of CATIN in other CMCs Major Achievements Installation and training done in Barbados. Needs assessment completed in Guyana. Installation scheduled for early May

20. DFID Prevention and Control of HIV/AIDS and Sexually Transmitted Infections in the Caribbean Department for International Development CAREC Caribbean Epidemiology Centre & Implementation of CATIN in other CMCs Major Achievements Review meeting held with pilot countries - Antigua and Barbuda, Dominica, Grenada, St Lucia, St Vincent and the Grenadines - to guide future development

21. DFID Prevention and Control of HIV/AIDS and Sexually Transmitted Infections in the Caribbean Department for International Development CAREC Caribbean Epidemiology Centre & Review of Laboratories Major Achievements Review undertaken of lab in Antigua. Major issues including management, lack of key supplies, reliability testing highlighted. Follow-up QA workshop being discussed.

22. DFID United Kingdom Caribbean Overseas Territories (UKCOT’S) HIV/AIDS Project Department for International Development OUTPUTS : Strengthening HIV/AIDS/STI case management Supporting development/implementation of behavioural, communication and information interventions for vulnerable groups Supporting development/implementation of behavioural, communication and information interventions for vulnerable groups Providing technical support for strengthening management of national AIDS Programmes Providing technical support for strengthening management of national AIDS Programmes Improving epidemiological surveillance including health information systems. Improving epidemiological surveillance including health information systems. CAREC Caribbean Epidemiology Centre &