ENHANCING COUNTRY OWNERSHIP: AN ANALYTICAL REVIEW OF COUNTRY HIV PROGRAMMES

1. ENHANCING COUNTRY OWNERSHIP: AN ANALYTICAL REVIEW OF COUNTRY HIV PROGRAMMES Dr. Morris Edwards: Head, Strategy and Resourcing Division, PCU Dr. Ingrid Cox Pierre: Strategy and Resourcing Officer, Care, Treatment and Support

2. Focus of Presentation Role of the PANCAP Coordinating unit in achievement of the goals of Caribbean Regional Strategic Framework (CRSF) 2008 – 2012 Analysis of country needs for achieving these goals. Challenges encountered in the process

3. Background Vision of the Caribbean Regional Strategic Framework (CRSF) 2008 - 2012 “Substantially reduce the spread and impact of HIV in the Caribbean through sustainable systems of universal access to HIV prevention, treatment, care, and support”.

4. Assigned roles PANCAP Coordinating Unit (PCU) Coordination of regional response Resource mobilization Advocacy

5. PANCAP 10th AGM identified critical areas for emphasis to achieve the goals of the CRSF. Reduction of new HIV infections by 50%. Elimination of mother to child transmission of HIV. Increased access to treatment by 80%. Accelerate the agenda to achieve human rights for PLHIV including the elimination of travel restrictions for PLHIV. Elimination of travel restrictions for PLHIV.

6. For the PCU to effectively perform its role, it must be able to collect information at country level and from partners on: Ongoing initiatives Available resources Gaps in implementation of national strategies

7. Activities conducted by PCU to support its functions Development of the PANCAP Biennial Operational Plan (PBOP) Country assessments to ascertain implementation gaps in their NSP Convening a Partners meeting and development of an implementation matrix of ongoing activities in countries by partners

8. Activities conducted by PCU to support its functions…….. Establishment of a lab partners working group Review of financial resources available at country level for implementation of NSP and their contribution to the achievement of the Tenth AGM targets.

9. Resource mobilization by PCU Estimated (under estimate) US$58 M required for implementation of the CRSF. The PCU has mobilized approximately US$47 M of this estimate However priority areas of prevention and treatment and care have secured resources in excess of that budgeted for by the CRSF

10. COMPARATIVE ANALYSIS OF FINANCIAL SUPPORT TO THE CRSF 2008-2012 Source: Progress Report and Financial Analysis of Implementation of the CRSF for 17th Executive Board Meeting

11. Inadequacy of resource mobilization efforts Although secured funds are in excess of that budgeted for in these two areas, regional reports have identified that: Some areas in prevention, especially interventions with MARPS (other than MSM and CSWs) and PMTCT are critical areas or gaps in the response. The area of treatment and care is inadequately supplied as many countries are below the required coverage for persons who require ARVs

12. Inadequacy of resource mobilization……. This emphasizes the importance of information to guide the resource mobilization process and focus efforts where needed

13. Country Analysis Methodology Available country NSPs were evaluated for alignment with the CRSF Country assessments were conducted from 2010 to 2011 looking at gaps in implementation of country NSPs or implementation plans The reports were presented at prior meetings and to the PACC

14. Country Analysis Methodology….. A financial review of allocated resources at country level in relation to the tenth AGM targets Template designed to collect information on areas of focus under the individual 10th AGM targets noting: Area of strategic focus Source of funding (whether govt. or donor) Specific area funded e.g prevention programmes for MARPS Budget allocated Timeframe of support Identified gaps in the response and associated funding

15. Results 9 countries responded: Antigua and Barbuda Dominica Jamaica Suriname Belize St. Kitts and Nevis Montserrat Tortola Trinidad and Tobago

16. Results….. Countries are at different stages in reaching the 2015 targets. Main issue is sustainable funding, especially of commodities such as ARVs. Funding in most of the reporting countries is still largely supported by donor agencies.

17. Results….. The areas highlighted as deficient in the funding of the CRSF correspond closely to those that are being reported in countries. There is the need to include stigma and discrimination in the area of human rights There is a need for targeted prevention interventions especially for groups such as youth, with critical focus on minors because of early sexual debut.

18. Prevention Targets

23. Elimination Target

24. Elimination target Many countries did not outline deficiency in funding in this area however regional data available shows that the coverage is not optimal

26. Treatment and Care Target

29. Human Rights Target

33. Challenges

34. Challenges Main challenges encountered in gathering the data were: Regional level: Difficulty in getting the required data from regional partners and donor agencies. National level Poor response from member countries possibly due to: Competing interests: Harmonization of donor efforts at country level is needed Unavailability of data or information needed at country level

35. THE MEETING is invited to: • (i) Advise on mechanisms to overcome the challenges with information sharing; and • (ii) Agree on the strategic objectives, regional public goods and services and activities to be included in the Biennial Operational Plan, 2012-2013