PANCAP and the HIV/AIDS challenge in the Caribbean

Importance of partnerships and human rights in the global, regional and national response to hiv and aids: Address by he kofi a annan to the Tenth Annual General Meeting of the pan Caribbean Partnership against hiv and aids (pancap) 31 october 2010, st maarten

Thank you for that warm welcome. I am truly honoured to be with you today.
Let me begin by thanking our host – the Prime Minister and people of St Maarten – and congratulating you on your new status and constitution.

These are exciting times for the entire country. I wish you all the very best for the future.
We are here to mark the 10th anniversary of the Pan-Caribbean Partnership against HIV/AIDS [PANCAP], to look at what has been achieved and discuss the challenges ahead.
I want to pay tribute to CARICOM and its Secretary-General, Edwin Carrington, for their foresight in setting up PANCAP and for your leadership in spearheading the fight against HIV/AIDS in the Caribbean.

Hailed by international partners as a model for others to follow, PANCAP has been crucial in mobilizing a broad and effective regional response to the disease.
Your work has helped prevent tens of thousands of new HIV infections and saved thousands of lives.

But, we all recognized, there is no room for complacency globally or here in this region.
Thirty years since the start of this terrible epidemic, too many people still get infected and too many die of AIDS-related illness.

Discrimination, including the flouting of the most basic widespread human rights, is still widespread for those living with HIV/AIDS.

And while we have seen real progress across the board, five more people still contract the virus for every two who start treatment.

Despite the tremendous efforts of PANCAP, the Caribbean has not been spared.
Indeed, with the exception of Sub-Saharan Africa, the region faces the greatest HIV/AIDS challenge.

An estimated 240,000 people live today with HIV in the Caribbean. Twenty thousand more are newly infected each year.

The battle in which you are in the front-line is, of course, something to which I have a personal commitment.

This year also marks the tenth anniversary of the pledge I made to make the fight against HIV/AIDS my personal priority as UN Secretary-General.

I called for a global common strategy and a war chest to fight the disease.
I underlined the need for greater prevention, access to better treatments, gender equality and the end of discrimination to stem the tide of the epidemic.

And I stressed the need to build partnerships between stakeholders including governments, multilateral agencies, donors, philanthropic organizations and pharmaceutical companies, to defeat this scourge.
Looking back over the last ten years, we can see real progress.
Infection rates have dropped 17% worldwide since 2001.

Kofi Annan

With over 5 million lives saved because of its financing of programmes, the Global Fund is, in my view, one of the great success stories of the past ten years.

Here in the Caribbean, thanks to the work of PANCAP and the expansion of anti-retroviral treatment, the annual number of deaths related to HIV has fallen 40% since 2000.
But you are, I know, determined to improve on what has been achieved.

You have set yourself a goal of further reducing new infections and mortality by a quarter by 2015.

Your determination is underlined by the preparatory work conducted for PANCAP’s second regional strategic framework.

You have identified the need for a more inclusive approach in the fight against HIV/AIDS – one that involves greater participation of the private sector, vulnerable groups and NGOs.
You point out that the education and tourism sectors are central to prevention strategies.
You also acknowledge that stigma and discrimination constitute major obstacles to prevention and treatment.

And you recognize that the legal frameworks in many Caribbean countries need be reformed to enable a more effective regional strategy to take root.
Ladies and gentlemen, I congratulate you on this continued focus on both rights and partnership.

We all have to step up our efforts to create a world in which everyone, whatever their background, is treated with the respect and dignity they deserve as fellow human beings.
We have to view the fight against HIV/AIDS within the wider battle to uphold human rights.
Unless we do, the danger is that we will fail to meet our ambitions.
For what we know about HIV/AIDS is that some groups are more vulnerable to the epidemic because of their condition, or the legal and social environment in which they live.
Women and girls are particularly at risk. Too many suffer sexual abuse or feel unable to insist on protected sex.

AIDS is the number-one cause of death globally for all women of childbearing age.
This requires us to put women at the very centre of the AIDS response.
They must also be empowered to speak up and protect themselves and their children.
We can only achieve this if we tackle gender inequality and the discriminatory laws and cultural traditions which enforce it.

We know as well that sexual minorities, drug users, and people infected by HIV/AIDS, suffer from daily discrimination and prejudices, discouraging them from seeking help and treatment.
In this region, as with many other places, there remains widespread homophobia and violence against gay men.

This is not just a breach of their human rights but, by making it more likely they will engage in high-risk behaviour, it impedes the fight against HIV/AIDS.
Punitive laws and policies that stigmatize particular individuals and block effective HIV/AIDS strategies must be rolled-back.

And far more must be done to ensure that programmes are tailored to the specific needs of each vulnerable group.

And here, of course, the role of leadership at the political, economic and social levels is crucial.
We need everyone to speak out against discrimination and to ensure – through legislation, education and by example – that equality before the law and freedom from discrimination is respected, protected and fulfilled.

I am delighted that through your new regional strategic framework, you aim for policies and legislation that affirm human rights and counter deep underlying social barriers.
You also stress the need to build new and stronger partnerships at community and national level.

For the HIV epidemic is not only a health issue but also has serious economic, social and cultural dimensions.

Winning this battle requires the support and commitment of all sectors of society.
I am pleased that one of the goals of this conference is to identify ways to build partnerships that can deploy the unique knowledge, access and resources across the community to improve the HIV/AIDs response. We need, for example, the meaningful involvement of community-based groups, NGOs and faith-based organizations.

These partnerships must include employers and trade unions who can play a key role by making the workplace an access point for HIV prevention, treatment and support.
Researchers, doctors and pharmaceutical companies, working together, can help to develop drugs to treat the virus.

With strong encouragement from outside, we have already seen how drug companies can make medicines more cheaply so that more people could afford them.
I am sure the private sector can step up its efforts to reduce the cost of delivering treatment so that more people can be treated for less.

Evidence shows that better access to anti-retroviral treatment as well as prevention programmes such as male circumcision can prevent millions of deaths.

But, of course, we also need to see adequate and sustained funding.
Since 2001, the Caribbean region has received approximately USD 1.2 billion of grant and concessionary funding to fight HIV/AIDS.

PANCAP’s vision led to it being, in 2003, the first recipient of a regional grant awarded by the Global Fund.

And since that first award, no less than seven PANCAP partners have benefited from country grants.
But the replenishment meeting for the Global Fund that took place last month reminds us that the war chest is not limitless.

I remain an optimist. But I also recognise that maintaining and increasing funding for HIV/AIDS has not got any easier.

The global economic crisis has increased pressure on government resources across the world.
Some wealthier countries have responded by freezing or reducing their investments in global health.

It is unfair that those countries which have done least to cause the financial crisis should have to pay such a high price.

But while I believe we must continue to press strongly for more funding, we must also do more to get the most benefit from each dollar spent.

For too long, the flow of aid was disparate and often failed to respond adequately to the practical needs of those affected by the disease.

Many prevention efforts were not targeting the communities where transmission is highest.
We are putting this right. UNAIDS is working to help countries analyze information to understand which populations are at the greatest risk.
I’d like to take this opportunity to pay tribute to Michel Sidibé and his colleagues for their extraordinary work and dedication.
Ladies and gentlemen, their work, your work is of critical importance.
This became even clearer last month when over 140 world leaders gathered in New York to discuss how to step up efforts to achieve the Millennium Development Goals before the 2015 deadline.

One message came through clearly: the AIDS response must be an integral part of meeting all of the Goals.

This new approach called the “AIDS plus MDGs” is the very essence of what partnerships ought to be.

It creates explicit linkages between services to prevent and treat HIV with other economic and social policies that are crucial to the realization of the Goals.

It puts investments in AIDS to work for larger health and development outcomes; and
It takes AIDS out of isolation, to help accelerate progress in child and maternal health, as well as sexual and reproductive health.

This approach, like many of the efforts I described earlier, will require strong leadership.
This must come from political leaders, global thinkers, religious leaders, NGO representatives, and businessmen and women.

It must, in short, come from you. You have the responsibility to continue showing a lead by forging innovative partnerships across sectors.
We need your leadership and political courage if we are to repeal discriminatory laws and roll back prejudice.

You must continue to fight stigma and educate your communities.

And you must step up the battle to empower women, girls and youth and make them central to your strategies to defeat the scourge of HIV/AIDS.

It is a daunting challenge. But your success over the last decade shows just what can be achieved with vision, commitment, courage and leadership.

I have no doubt that you are up to the task. I wish you every success. Thank you very much.