NEW YORK, USA — The Caribbean has joined the community of nations in framing and endorsing the 2016 Political Declaration on Ending AIDS. The ambitious declaration was adopted at the United Nations General Assembly high-level meeting on ending AIDS, attended by high level government officials of around 100 countries from June 8 – 10 in New York.
Speaking on behalf of the Caribbean Community (CARICOM) states, St Kitts and Nevis prime minister and CARICOM lead with responsibility for human resources, health and HIV, Dr Timothy Harris, expressed solidarity with the global commitment to intensify efforts to end AIDS.
“We in the Caribbean pledge our support for the political declaration to be implemented, in accordance with our national circumstances and priorities, acknowledging that it is… a significant commitment to promoting the health and wellbeing of all of our citizens,” Harris said.
About the Political Declaration
The process leading to the finalisation of the political declaration included negotiations by a range of stakeholders including governments, civil society and the private sector. The adopted text presents an urgent agenda to accelerate the fight to end the AIDS epidemic by 2030.
The declaration adopted UNAIDS 90-90-90 treatment targets, committing the world to almost doubling the number of people on HIV treatment by 2020 as well as ensuring 1.6 million children living with HIV are on treatment by 2018.
Countries promised to eliminate mother-to-child HIV transmission and to ensure that the health and well-being of mothers living with HIV are sustained. They also committed to ensuring that all women and girls and key populations are reached by tailored combination prevention services.
The declaration explicitly recognizes key populations at higher risk of HIV, including men who have sex with men, people who inject drugs, sex workers, prisoners and transgender people. To accelerate progress, the Declaration places strong emphasis on tailoring responses that focus on the most affected locations and populations.
Member states recognized that human rights violations and gender inequality remain major obstacles in the AIDS response, and pledged to eliminate HIV-related stigma and discrimination and violence against women. They also highlighted the critical importance of universal access to sexual and reproductive health and reproductive rights.
The Caribbean situation
Harris noted significant strides in Caribbean HIV responses over the past decade, including increasing the proportion of people living with HIV who access antiretroviral treatment to 44% and reducing AIDS-related deaths by 56%. He also reiterated the Caribbean’s ambition to become the first region in the world to eliminate mother-to-child HIV transmission. Cuba was first to be validated as doing so in 2015 while several other Caribbean countries are on track to repeat the feat this year.
However, Harris pointed to ongoing challenges, particularly as it relates to communities with “concentrated” HIV epidemics.
“Prevalence among the key risk groups such as men who have sex with men can be as high as 32%,” Harris acknowledged. “And in many countries data are increasingly revealing spikes in prevalence among women and girls. This trend must be stopped.”
According to UNAIDS Latin America and Caribbean Regional Support Team director, Dr César Núñez, the declaration offers a framework to help countries target investments and outreach to the communities that need them most.
“This is a significant step forward in the response as countries have committed to address the critical linkages between health, injustice, inequality and poverty,” Núñez said. “For the Caribbean that means ensuring that the needs of adolescents, gay men and other men who have sex with men, transgender people, sex workers, prisoners, people who use drugs and other key populations are specifically addressed.”
Significant investments needed
While all Caribbean countries reiterated their commitment to dramatically scaling up prevention, testing and treatment services over the next five years, they were unanimous in underlining the need for increased international investments in order to do so.
Representatives from across the region in addressing the General Assembly, called for a review of funding eligibility criteria, particularly for middle income Caribbean countries that are now, or are soon to be, ineligible for donor funding. They insisted that the vulnerabilities of small, developing states and conditions such as high debt burdens and competing health and development priorities, should be taken into account.
“CARICOM countries are making every effort to achieve the level of financial sustainability required to achieve the targets for ending AIDS. Nevertheless, we will continue to advocate against the insidious classification based on GDP only, for access to concessional funding for HIV and other development areas,” Harris said.
During a mission to the region in November 2015, ahead of the high-level meeting, UNAIDS executive director Michel Sidibé pledged his support to advocating for change in global HIV financing criteria.
“We need to band together to demonstrate that the concept of low- and high-income countries is obsolete,” Sidibé said then. “How do we finance vulnerabilities? We need to focus more on fragile communities.”